J Rhinol.  2008 Nov;15(2):98-102.

Role of Fungal and Bacterial Superantigen in the Pathogenesis of Chronic Rhinosinusitis with Polyps

• Shin SH

Abstract

Chronic rhinosinusitis (CRS) is an inflammatory disorder with numerous predisposing factors, including genetics, anatomic anomalies, bacteria, and fungus. CRS with nasal polyps can be distinguished by an eosinophilic type inflammation with a high concentration of IgE. Recent studies have implicated exposure to superantigens derived from Staphylococcus aureus and Alternaria as possible causes for the pahophysiology of nasal polyps. Superantigens are microbial toxins that bind to human leukocyte antigen class II histocompatibility molecules on antigen-presenting cells and T cell receptors on T cells simultaneously, bypassing classical antigen specificity. T lymphocyte sensitization to superantigen with production of the T-helper 2 cytokines has been proposed as a key step in the initiation of nasal polyps. This review summarize the current evidence for an active role of fungal and bacterial superantigens in CRS with nasal polyps. However, therapeutic approaches are so far limited and empirical, and need further improvement.

Keyword

Chronic rhinosinusitis; Sinusitis; Nasal polyp; Bacteria; Fungus; Superantigen

MeSH Terms

Alternaria
Antigen-Presenting Cells
Bacteria
Cytokines
Eosinophils
Fungi
Histocompatibility
Humans
Immunoglobulin E
Inflammation
Leukocytes
Lymphocytes
Nasal Polyps
Polyps
Receptors, Antigen, T-Cell
Sensitivity and Specificity
Sinusitis
Staphylococcus aureus
Superantigens
T-Lymphocytes
Cytokines
Immunoglobulin E
Receptors, Antigen, T-Cell
Superantigens