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Recalcitrant rhinosinusitis, innate immunity, and mannose-binding lectin
Jeb M Justice1, John W Sleasman2, Donald C Lanza3
1Department of Otolaryngology, University of Florida, Gainesville, Florida, USA.
The Annals of Otology, Rhinology, and Laryngology
|July 27, 2014
Summary
Mannose-binding lectin (MBL) deficiency, found in 33.3% of patients, may link to severe adult rhinosinusitis. Steroid/antibiotic irrigations showed promise for treating recalcitrant cases.
Area of Science:
- Immunology
- Otolaryngology
- Infectious Disease
Background:
- Mannose-binding lectin (MBL) is a key innate immunity protein involved in opsonization.
- MBL deficiency affects 7% of the population and is linked to infections, but its role in rhinosinusitis is unexplored.
- This study investigates MBL deficiency in adult patients with recalcitrant rhinosinusitis.
Observation:
- A retrospective case series analyzed adult patients with low MBL levels from 2010-2012.
- Sinus cultures, immunological tests, and rhinosinusitis treatments were documented.
- The study focused on MBL testing indications and outcomes.
Findings:
- MBL deficiency was observed in 33.3% of tested patients, a significantly higher prevalence than in the general population.
- Low IgG subclasses were noted in 5 of 12 MBL-deficient patients.
- Common pathogens included Staphylococcus aureus, coagulase-negative Staphylococcus, and Pseudomonas aeruginosa.
Implications:
- MBL deficiency may be associated with recalcitrant adult rhinosinusitis.
- Topical steroid and antibiotic irrigations demonstrated therapeutic benefits for these patients.
- Further research is needed to confirm the role of MBL deficiency in rhinosinusitis etiology and management.
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