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Staphylococcus-aureus-derived Superantigens in Nasal Polyp Disease

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Nasal Polyposis

Abstract

Staphylococcus aureus (SA) secretes enterotoxins, small proteins that act as superantigens because of their potent effect on the immune system. The main mode of action of superantigens is the coupling of the major histocompatibility complex molecule with the T-cell receptor. The effect is a powerful stimulation of the adaptive immune system in a polyclonal (non-antigen-specific) way, resulting in a T-helper-2-biased inflammation. This superantigen mechanism is involved in the pathogenesis of nasal polyps (NP) in about 50% of the cases. The superantigenic effect is hallmarked by immunoglobulin changes in biopsies: high total IgE, polyclonal IgE to multiple allergens, and IgE specific to SA enterotoxins. Serum immunoglobulins coincide only partially with biopsy findings. Patients with this IgE pattern have an increased risk of asthma and aspirin-exacerbated respiratory disease (AERD). Future treatments with topical or systemic antibiotics and monoclonal antibodies to IgE and interleukin-5 (IL-5) are being studied.

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Abbreviations

AERD:

Aspirin-exacerbated respiratory disease

ASNP:

Aspirin-sensitive nasal polyps

ATNP:

Aspirin-tolerant nasal polyps

CysLT:

Cysteinyl leukotrienes

ECP:

Eosinophil cationic protein

IFN-γ:

Interferon-gamma

IL:

Interleukin

MHC:

Major histocompatibility complex

NP:

Nasal polyps

SA:

Staphylococcus aureus

SAE:

Staphylococcus aureus enterotoxin-like toxins

SAE-IgE:

IgE antibodies to SAE

SEA–SEU:

Staphylococcal enterotoxin A–U

TCR:

T cell receptor

TGF-β:

Transforming growth factor-beta

Th:

T helper

TNF-α:

Tumor necrosis factor-alpha

TSST-1:

Toxic shock syndrome toxin-1

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Authors and Affiliations

  1. Upper Airway Research Laboratory (URL), Department of Otorhinolaryngology, Ghent University, De Pintelaan 185, 9000, Gent, Belgium

    Peter Tomassen, Thibaut Van Zele, Philippe Gevaert, Nan Zhang, Claudina Perez-Novo, Nicholas Van Bruaene, Joke Patou & Claus Bachert

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  1. Peter Tomassen
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  2. Thibaut Van Zele
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  3. Philippe Gevaert
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  4. Nan Zhang
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  5. Claudina Perez-Novo
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  6. Nicholas Van Bruaene
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  7. Joke Patou
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  8. Claus Bachert
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Correspondence to Claus Bachert .

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Editors and Affiliations

  1. Faculty of Medicine, Dept. of Otorhinolaryngology, Hacettepe University, Ankara, 06100, Turkey

    T. Metin Önerci

  2. School of Medicine, Dept. Otolaryngology, University of Pittsburgh, Locust Street 1400, Pittsburgh, 15219, USA

    Berrylin J. Ferguson

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Tomassen, P. et al. (2010). Staphylococcus-aureus-derived Superantigens in Nasal Polyp Disease. In: Önerci, T., Ferguson, B. (eds) Nasal Polyposis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-11412-0_10

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  • DOI: https://doi.org/10.1007/978-3-642-11412-0_10

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