IL-21 Is Increased in Nasal Polyposis and after Stimulation with &lt;b&gt;&lt;i&gt;Staphylococcus aureus&lt;/i&gt;&lt;/b&gt; Enterotoxin B

Calus, Lien; Derycke, Lara; Dullaers, Mélissa; Zele, Thibaut Van; Ruyck, Natalie De; Pérez-Novo, Claudina; Holtappels, Gabriële; Vos, Geert De; Lambrecht, Bart N.; Bachert, Claus; Gevaert, Philippe

doi:10.1159/000481435

Cited by 20 publications

(17 citation statements)

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“…For CRSsNP patients, IL‐21 was the only cytokine correlated with any SNOT‐22 domain (Extranasal Rhinologic Symptoms, R s = 0.41, p = 0.01). The literature is sparse with respect to the role of IL‐21 in CRSsNP; however, work by Calus et al in CRSwNP patients showed upregulation of IL‐21 in response to Staphylococcus aureus enterotoxin, which suggests that mucus IL‐21 levels may be a marker of bacterial exposure. Patients without polyps were also observed to have significant correlations between IFN‐γ, IL‐12, IL‐17A, IL‐21, and global QoL metrics, representing a different inflammatory milieu than what was observed in CRSwNP.…”

Section: Discussionmentioning

confidence: 99%

Investigating the correlation between mucus cytokine levels, inflammatory cell counts, and baseline quality‐of‐life measures in chronic rhinosinusitis

Chowdhury

Chandra

et al. 2019

Int Forum Allergy Rhinol

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Background: It is hypothesized that uncontrolled inflammation is responsible for many of the manifestations and symptoms of chronic rhinosinusitis (CRS). Although earlier work has demonstrated an association between olfactory loss and mucus cytokines, the impact on other symptoms is unknown. In this study we investigated the relationship between cytokines, inflammatory cell counts, and patientreported outcomes measures to be er understand how the inflammatory microenvironment correlates with CRS symptomatology. Methods:The 22-item Sino-Nasal Outcome Test (SNOT-22) and 8-item Short Form Health Survey (SF-8) were administered to 76 patients undergoing endoscopic sinus surgery for CRS. Mucus was collected intraoperatively from the middle meatus and tested for 17 cytokines using a multiplex flow cytometric bead assay. Eosinophil/neutrophil counts were obtained from histopathologic slide review. Spearman correlations between cytokines, cell counts, and quality-oflife subdomain scores were assessed without multiple comparisons correction due to the small sample size. Results:Interleukin-4 (IL-4) correlated significantly with the Rhinologic domain (R s = 0.25, p = 0.03), whereas eosinophil and neutrophil counts were inversely correlated with the Extranasal Rhinologic domain (R s = −0.32, p = 0.01; and R s = −0.27, p = 0.03). Subgroup analysis for nasal polyposis (CRSwNP) showed significant correlations between IL-6 and Total SF-8 (R s = 0.35, p = 0.02), General Health (R s = 0.34, p = 0.03), and Emotional (R s = 0.47, p = 0.002) scores. In patients without polyps (CRSsNP), IL-21 correlated positively with Extranasal Rhinologic Symptoms domain (R s = 0.41, p = 0.01). Conclusion:This pilot study identifies possible pairwise correlations between mucus cytokine levels and baseline quality-of-life measures that need confirmation in larger, targeted studies. Due to the exploratory methodology, positive results may be spurious and should only be used as a starting point for future confirmatory work. C 2019 ARS-AAOA, LLC. How to Cite this Article:Chowdhury NI, Chandra RK, Li P, Ely K, Turner JH. Investigating the correlation between mucus cytokine levels, inflammatory cell counts, and baseline quality-of-life measures in chronic rhinosinusitis. Int Forum Allergy Rhinol. 2019;9:538-544. C hronic rhinosinusitis (CRS) is a heterogeneous group of diseases involving the paranasal sinuses with a

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Section: Discussionmentioning

confidence: 99%

Investigating the correlation between mucus cytokine levels, inflammatory cell counts, and baseline quality‐of‐life measures in chronic rhinosinusitis

Chowdhury

Chandra

et al. 2019

Int Forum Allergy Rhinol

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“…Xiao et al and Calus et al reported a higher frequency of IL‐21 + CD4 + T cells locally in patients with CRSwNP than in control subjects 113,122 . Calus et al 122 further revealed that polyp CXCR5 + CD4 + T cells could induce the differentiation of naïve B cells into plasmablasts in vitro. Zhang et al 112 observed a significant expansion of CXCR5 + T FH cells in nasal polyps in comparison to those in the inferior turbinate mucosa from control subjects.…”

Section: Tfh and Tfr Cells In Allergic Diseasesmentioning

confidence: 96%

“…IgE and IgD are suggested to activate mast cells to drive local eosinophilic inflammation, and IgG can contribute to the activation of classical complement pathways in nasal polyps 115,120,121 . Xiao et al and Calus et al reported a higher frequency of IL‐21 + CD4 + T cells locally in patients with CRSwNP than in control subjects 113,122 . Calus et al 122 further revealed that polyp CXCR5 + CD4 + T cells could induce the differentiation of naïve B cells into plasmablasts in vitro.…”

Section: Tfh and Tfr Cells In Allergic Diseasesmentioning

confidence: 99%

Roles of follicular helper and regulatory T cells in allergic diseases and allergen immunotherapy

Yao

Chen

et al. 2020

Allergy

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Allergic diseases are characterized by overactive type 2 immune responses to allergens and immunoglobulin E (IgE)‐mediated hypersensitivity. Emerging evidence suggests that follicular helper T (TFH) cells, rather than type 2 T‐helper (TH2) cells, play a crucial role in controlling IgE production. However, follicular regulatory T (TFR) cells, a specialized subset of regulatory T (TREG) cells resident in B‐cell follicles, restricts TFH cell‐mediated help in extrafollicular antibody production, germinal center (GC) formation, immunoglobulin affinity maturation, and long‐lived, high‐affinity plasma and memory B‐cell differentiation. In mouse models of allergic asthma and food allergy, CXCR5+ TFH cells, not CXCR5− conventional TH2 cells, are needed to support IgE production, otherwise exacerbated by CXCR5+ TFR cell deletion. Upregulation of TFH cell activities, including a skewing toward type 2 TFH (TFH2) and IL‐13 producing TFH (TFH13) phenotypes, and defects in TFR cells have been identified in patients with allergic diseases. Allergen immunotherapy (AIT) reinstates the balance between TFH and TFR cells in patients with allergic diseases, resulting in clinical benefits. Collectively, further understanding of TFH and TFR cells and their role in the immunopathogenesis of allergic diseases creates opportunities to develop novel therapeutic approaches.

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“…Staphylococcal enterotoxin B has also been shown to regulate T follicular helper cells in nasal polyps by increasing the amount of IL-21 and IL-21 positive T cells in surgical sinus tissue stimulated with SEB ex vivo [24]. Takeda and colleagues have demonstrated that S. aureus is not the only bacteria that stimulate T H 2 inflammation in nasal polyp tissue, however.…”

Section: Staphylococcal Toxins and Crsmentioning

confidence: 99%

The Role of Staphylococcus aureus in Patients with Chronic Sinusitis and Nasal Polyposis

Vickery

Ramakrishnan²,

Suh

2019

Curr Allergy Asthma Rep

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Purpose of Review Staphylococcus aureus (S. aureus) is correlated with the development of persistent severe inflammatory disease of the upper airway including chronic rhinosinusitis with nasal polyps (CRSwNP). The presence of S. aureus is associated with atopic disease including allergic rhinitis and atopic dermatitis and is associated with poor outcomes. Recent Findings Several different strains of S. aureus generate different toxins and gene products that can account for organism pathogenicity. S. aureus bacteria and its antigens shape the bacterial and fungal microbiome and the mucosal niche which generates host responses that can account for inflammation. The multiple disease phenotypes and molecular endotypes seen in CRSwNP can be characterized by T-helper cell environment within the inflammatory milieu, the presence of epithelial barrier dysfunction, aberrant eicosanoid metabolism, poor wound healing, and dysfunctional host-bacteria interactions which lead to recalcitrant disease and worse surgical outcomes. Summary Understanding the pathomechanisms that S. aureus utilizes to promote nasal polyp formation, prolonged tissue inflammation, and bacterial dysbiosis are essential in our efforts to identify new therapeutic approaches to resolve this chronic inflammatory process.

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IL-21 Is Increased in Nasal Polyposis and after Stimulation with <b><i>Staphylococcus aureus</i></b> Enterotoxin B

Cited by 20 publications

References 40 publications

Investigating the correlation between mucus cytokine levels, inflammatory cell counts, and baseline quality‐of‐life measures in chronic rhinosinusitis

Investigating the correlation between mucus cytokine levels, inflammatory cell counts, and baseline quality‐of‐life measures in chronic rhinosinusitis

Roles of follicular helper and regulatory T cells in allergic diseases and allergen immunotherapy

The Role of Staphylococcus aureus in Patients with Chronic Sinusitis and Nasal Polyposis

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