Total and specific IgE in nasal polyps is related to local eosinophilic inflammation

Background: Nasal polyps (NPs) are characterized by eosinophilic inflammati on and often coexist with asthma, However, the role of atopy and IgE in NP pathogenesis is unclear Objective: We sought to determine whether there is an association between t otal and specific IgE to a variety of allergens in polyp and nonpolyp tissu e and markers of eosinophilic inflammation or skin test results. Methods: Homogenates were prepared from nasal tissue of 20 patients with NP s and 20 patients without NPs and analyzed for concentrations of IL-5, IL-4 , eotaxin, leukotriene (LT) C4/D4/E4, sCD23, and histamine (ELISA). Eosinop hil cationic protein (ECP), tryptase, and total and specific IgE for inhala nt allergens and Staphylococcus aureus enterotoxins were measured (ImmunoCA P). Results: The concentrations of total IgE, IL-5, eotaxin, ECP, LTC4/D4/E4, a nd sCD23 were significantly higher in NP tissue compared with nonpolyp tiss ue. Total IgE was significantly correlated to IL-5, ECP, LTC4/D4/E4, and sC D23 and to the number of eosinophils in NPs, On the basis of the presence o f specific IgE antibodies in tissue, 3 NP groups were defined. NP group 1 d emonstrated no measurable specific IgE, and NP group 2 selected specific Ig E, The third group demonstrated a multiclonal specific IgE, including IgE t o S aureus enterotoxins, a high total IgE level, and a high prevalence of a sthma. Conclusions: These studies suggest that there is an association between inc reased levels of total IgE, specific IgE, and eosinophilic inflammation in NPs, which may be of relevance in the pathophysiology of nasal polyposis, S imilarly, the presence of specific IgE to staphylococcal enterotoxins A and B also points to a possible role of bacterial superantigens.