title: Superantigens and chronic rhinosinusitis II: analysis of T-cell receptor V beta domains in nasal polyps.
abstract: BACKGROUND
  The superantigen (SAg) hypothesis of chronic rhinosinusitis (CRS) suggests that toxins within the nose stimulate massive oligoclonal expansion of T-cell populations with subsequent eosinophil recruitment and tissue inflammation. SAgs are capable of activating 1 x 10(4) more lymphocytes than conventional antigens by binding specific Vbeta-domains of the T-cell receptor (TCR). The net effect is skewing from the normal Vbeta-profile by oligoclonal expansion of specific domains. This study will assess polyp tissue for evidence of an SAg response in CRS with nasal polyps (CRSwNP).
  
  
  METHODS
  This study consists of a prospective analysis of 18 CRSwNP subjects undergoing sinus surgery. Flow cytometry was used to analyze the distribution of 24 specific TCR V beta-domains in lymphocytes from polyp tissue and blood. Evidence of oligoclonal expansion was tabulated for each specimen and defined as mean normative percentage + 2 SD.
  
  
  RESULTS
  Eighteen of 18 CRSwNP subjects showed expansion of polyp lymphocytes expressing TCRs with specific V beta-domains. The average number of V beta-clones per CRSwNP subject was seven in polyp lymphocytes but only two in blood lymphocytes.
  
  
  CONCLUSIONS
  The current results indicate that polyp lymphocytes exhibit significant oligoclonal expansion of specific V beta-domains. These data are considered diagnostic of a SAg effect. The corresponding blood profile is much less, suggesting that the nose is the primary source of stimulus. Although the trigger(s) for this expansion are unknown, these data are consistent with the hypothesis that staphylococcal toxins are central to the development of CRSwNP.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA. dbcentmd@northwestern.edu
authors.forename: David B
authors.initials: DB
authors.lastname: Conley
authors.forename: Anju
authors.initials: A
authors.lastname: Tripathi
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Seiberling
authors.forename: Lydia A
authors.initials: LA
authors.lastname: Suh
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Harris
authors.forename: Mary C
authors.initials: MC
authors.lastname: Paniagua
authors.forename: Leslie C
authors.initials: LC
authors.lastname: Grammer
authors.forename: Robert C
authors.initials: RC
authors.lastname: Kern
mesh_terms: D002908:Chronic Disease; D006801:Humans; D009298:Nasal Polyps / Q000276:immunology* / Q000382:microbiology; D017434:Protein Structure, Tertiary; D016693:Receptors, Antigen, T-Cell, alpha-beta / Q000032:analysis*; D012220:Rhinitis / Q000276:immunology / Q000382:microbiology*; D012852:Sinusitis / Q000276:immunology / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000276:immunology*; D018089:Superantigens / Q000276:immunology*; D013601:T-Lymphocytes / Q000737:chemistry* / Q000276:immunology
chemical_list: D016693:Receptors, Antigen, T-Cell, alpha-beta; D018089:Superantigens