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Local fungus-specific Immunoglobulin E production in chronic rhinosinusitis with nasal polyps
Y Ohki1, Y Okamoto1, T Iinuma1
1Department of Otolaryngology, Head and Neck Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Background:
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous disease, and its pathogenesis remains controversial. This study aimed to examine the involvement of fungi in CRSwNP pathogenesis.
Methods:
We enrolled 29 controls and 111 CRSwNP patients. We analyzed fungi in the nasal secretions, serum fungus-specific immunoglobulin E (IgE) levels, and nasal polyp (NP) IgE levels. Moreover, we evaluated the correlation between patients' IgE levels and computed tomography (CT) scores.
Results:
There was no difference in fungal detection rate between CRSwNP patients with and without asthma. Specific IgEs against various antigens were highly detectable in NPs of CRSwNP patients. In CRSwNP patients, fungus-specific IgE levels in NPs were correlated with CT scores. Serum fungus-specific IgEs became undetectable after operation in more than half of the CRSwNP patients without asthma but not in those with asthma. Other serum airborne antigen-specific IgEs did not become undetectable after operation.
Conclusions:
Fungus-specific IgEs were highly detectable in NPs of CRSwNP patients, and NPs comprised a major region of specific IgE production. Fungi may therefore play an important role in CRSwNP pathogenesis by inducing Th2 immune responses, including IgE synthesis.
Insights
Fungi may drive chronic rhinosinusitis with nasal polyps (CRSwNP) by triggering specific immunoglobulin E (IgE) production in nasal polyps. This suggests fungi are key players in CRSwNP development.
Area of Science:
- Immunology
- Otolaryngology
- Microbiology
Background:
- Chronic rhinosinusitis with nasal polyps (CRSwNP) is a complex condition with unclear causes.
- Investigating the role of fungal presence in CRSwNP pathogenesis is crucial.
Purpose of the Study:
- To determine the involvement of fungi in the development of CRSwNP.
- To analyze the correlation between fungal presence, IgE levels, and disease severity.
Main Methods:
- Analysis of fungi in nasal secretions from 111 CRSwNP patients and 29 controls.
- Measurement of serum and nasal polyp (NP) fungus-specific immunoglobulin E (IgE) levels.
- Correlation of IgE levels with computed tomography (CT) scores.
Main Results:
- High detectability of fungus-specific IgEs within nasal polyps of CRSwNP patients.
- Significant correlation between NP fungus-specific IgE levels and CT scores.
- Post-operative reduction in serum fungus-specific IgEs observed in non-asthmatic CRSwNP patients.
Conclusions:
- Nasal polyps are a primary site for specific IgE production against fungi in CRSwNP.
- Fungi likely contribute to CRSwNP pathogenesis by inducing Th2 immune responses and IgE synthesis.
