鼻息肉内IL-5蛋白和针对金黄色葡萄球菌肠毒素的IgE抗体与伴发哮喘相关
2010/11/04
摘要
背景：鼻息肉常常与哮喘相关，但这些患者的表现型尚不清楚。
目的：为研究与哮喘共患病相关的粘膜因子，我们对鼻息肉的炎症形式进行了分析。
方法：对70名比利时患者（34%患有哮喘）的鼻息肉进行研究，分析炎症类型、T细胞因子及针对金黄色葡萄球菌肠毒素的IgE抗体。同时，对93名中国患者的鼻息肉进行研究，这组患者的哮喘共患病发生率较低（8%）。
结果：在有鼻息肉的比利时患者中，54%的样本显示存在嗜酸性粒细胞性炎症，结果显示IL-5为主要的阳性决定因子。组织中肠毒素IgE（37%）与总IgE和嗜酸性粒细胞阳离子蛋白浓度显著相关。肠毒素IgE表达、总IgE大于1442 kU/L以及嗜酸性粒细胞阳离子蛋白大于17,109 mug/L且总IgE浓度大于246 kU/L能预测哮喘发生（优势比：5.8-13）。仅7.5%的中国患者鼻息肉样本显示有嗜酸性粒细胞性炎症。IL-5是嗜酸性粒细胞性炎症的一个阳性决定因子，组织肠毒素IgE（17%的患者）与总IgE和嗜酸性阳离子蛋白浓度显著相关。IL-5的表达或总IgE大于790 kU/L且IL-5浓度大于194 pg/mL能显著预测哮喘共患病（优势比：17.2-96）。
结论：鼻息肉存在的粘膜炎症产生Th2细胞因子和金黄色葡萄球菌肠毒素，表现为嗜酸性粒细胞炎症增加和IgE抗体产生。在患鼻息肉的白种人和亚洲患者中，该表现性与哮喘共患病相关。
（林江涛 审校）
J Allergy Clin Immunol. 2010 Aug 30. [Epub ahead of print]
Presence of IL-5 protein and IgE antibodies to staphylococcal enterotoxins in nasal polyps is associated with comorbid asthma.
Bachert C, Zhang N, Holtappels G, De Lobel L, van Cauwenberge P, Liu S, Lin P, Bousquet J, Van Steen K.
Upper Airway Research Laboratory (URL), Department of Oto-Rhino-Laryngology, Ghent University Hospital, Ghent, Belgium.
Abstract
BACKGROUND: Nasal polyps often are associated with asthma. The phenotype of these patients is unknown.
OBJECTIVE: To identify the mucosal factors associated with asthma comorbidity, we analyzed the inflammatory patterns of nasal polyps.
METHODS: Nasal polyps from 70 Belgian patients, 34% with asthma, were analyzed for type of inflammation, T-cell cytokines, and IgE antibodies to Staphylococcus aureus enterotoxins. The same investigations were repeated in 93 Chinese patients with polyps, a group with a low asthma comorbidity rate (8%).
RESULTS: In Belgian patients with polyps, 54% of samples showed eosinophilic inflammation. A classification tree evaluation identified IL-5 as the main positive determinant. Enterotoxin IgE in tissue (37%) was associated with significantly increased total IgE and eosinophil cationic protein concentrations. Expression of enterotoxin IgE, total IgE at greater than 1,442 kU/L, and eosinophil cationic protein at greater than 17,109 mug/L in samples with a total IgE concentration of greater than 246 kU/L significantly predicted asthma (odds ratio, 5.8-13). Only 7.5% of the samples from Chinese patients with polyps showed eosinophilic inflammation. IL-5 was confirmed as a positive determinant of eosinophilic inflammation, and enterotoxin IgE in tissue (17% of patients) was associated with significantly increased total IgE and eosinophil cationic protein concentrations. The expression of IL-5 or total IgE at greater than 790 kU/L in samples with an IL-5 concentration of greater than 194 pg/mL significantly predicted comorbid asthma (odds ratio, 17.2-96).
CONCLUSION: Mucosal inflammation in nasal polyps orchestrated by T(H)2 cytokines and amplified by S aureus enterotoxins is characterized by an increased eosinophilic inflammation and formation of IgE antibodies. This phenotype is associated with comorbid asthma in white and Asian patients with nasal polyps.
J Allergy Clin Immunol. 2010 Aug 30. [Epub ahead of print]
背景：鼻息肉常常与哮喘相关，但这些患者的表现型尚不清楚。
目的：为研究与哮喘共患病相关的粘膜因子，我们对鼻息肉的炎症形式进行了分析。
方法：对70名比利时患者（34%患有哮喘）的鼻息肉进行研究，分析炎症类型、T细胞因子及针对金黄色葡萄球菌肠毒素的IgE抗体。同时，对93名中国患者的鼻息肉进行研究，这组患者的哮喘共患病发生率较低（8%）。
结果：在有鼻息肉的比利时患者中，54%的样本显示存在嗜酸性粒细胞性炎症，结果显示IL-5为主要的阳性决定因子。组织中肠毒素IgE（37%）与总IgE和嗜酸性粒细胞阳离子蛋白浓度显著相关。肠毒素IgE表达、总IgE大于1442 kU/L以及嗜酸性粒细胞阳离子蛋白大于17,109 mug/L且总IgE浓度大于246 kU/L能预测哮喘发生（优势比：5.8-13）。仅7.5%的中国患者鼻息肉样本显示有嗜酸性粒细胞性炎症。IL-5是嗜酸性粒细胞性炎症的一个阳性决定因子，组织肠毒素IgE（17%的患者）与总IgE和嗜酸性阳离子蛋白浓度显著相关。IL-5的表达或总IgE大于790 kU/L且IL-5浓度大于194 pg/mL能显著预测哮喘共患病（优势比：17.2-96）。
结论：鼻息肉存在的粘膜炎症产生Th2细胞因子和金黄色葡萄球菌肠毒素，表现为嗜酸性粒细胞炎症增加和IgE抗体产生。在患鼻息肉的白种人和亚洲患者中，该表现性与哮喘共患病相关。
（林江涛 审校）
J Allergy Clin Immunol. 2010 Aug 30. [Epub ahead of print]
Presence of IL-5 protein and IgE antibodies to staphylococcal enterotoxins in nasal polyps is associated with comorbid asthma.
Bachert C, Zhang N, Holtappels G, De Lobel L, van Cauwenberge P, Liu S, Lin P, Bousquet J, Van Steen K.
Upper Airway Research Laboratory (URL), Department of Oto-Rhino-Laryngology, Ghent University Hospital, Ghent, Belgium.
Abstract
BACKGROUND: Nasal polyps often are associated with asthma. The phenotype of these patients is unknown.
OBJECTIVE: To identify the mucosal factors associated with asthma comorbidity, we analyzed the inflammatory patterns of nasal polyps.
METHODS: Nasal polyps from 70 Belgian patients, 34% with asthma, were analyzed for type of inflammation, T-cell cytokines, and IgE antibodies to Staphylococcus aureus enterotoxins. The same investigations were repeated in 93 Chinese patients with polyps, a group with a low asthma comorbidity rate (8%).
RESULTS: In Belgian patients with polyps, 54% of samples showed eosinophilic inflammation. A classification tree evaluation identified IL-5 as the main positive determinant. Enterotoxin IgE in tissue (37%) was associated with significantly increased total IgE and eosinophil cationic protein concentrations. Expression of enterotoxin IgE, total IgE at greater than 1,442 kU/L, and eosinophil cationic protein at greater than 17,109 mug/L in samples with a total IgE concentration of greater than 246 kU/L significantly predicted asthma (odds ratio, 5.8-13). Only 7.5% of the samples from Chinese patients with polyps showed eosinophilic inflammation. IL-5 was confirmed as a positive determinant of eosinophilic inflammation, and enterotoxin IgE in tissue (17% of patients) was associated with significantly increased total IgE and eosinophil cationic protein concentrations. The expression of IL-5 or total IgE at greater than 790 kU/L in samples with an IL-5 concentration of greater than 194 pg/mL significantly predicted comorbid asthma (odds ratio, 17.2-96).
CONCLUSION: Mucosal inflammation in nasal polyps orchestrated by T(H)2 cytokines and amplified by S aureus enterotoxins is characterized by an increased eosinophilic inflammation and formation of IgE antibodies. This phenotype is associated with comorbid asthma in white and Asian patients with nasal polyps.
J Allergy Clin Immunol. 2010 Aug 30. [Epub ahead of print]
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