title: Response of peripheral blood lymphocytes to fungal extracts and staphylococcal superantigen B in chronic rhinosinusitis.
abstract: BACKGROUND
  Previous studies have suggested that chronic rhinosinusitis may result from a hypersensitivity response of the nasal mucosa to the presence of fungal antigens or staphylococcal superantigens in the nasal mucus. Both of these groups of antigens are present so frequently in the nasal mucus of patients with chronic rhinosinusitis that their presence together is likely to be a common event.
  
  
  OBJECTIVE
  The objective of this study was to determine whether the combined presence of fungal antigens and staphylococcal superantigens exert a synergistic proinflammatory effect on peripheral blood lymphocytes from patients with chronic rhinosinusitis.
  
  
  METHODS
  Peripheral blood lymphocytes were extracted from patients with chronic rhinosinusitis with and without nasal polyposis (n = 7 for both groups) and normal controls (n = 7). These cells were cultured for 48 hours after the addition of fungal extracts (Aspergillus and Alternaria), staphylococcal superantigen type B (SEB), or a combination of these two antigens. Real-time polymerase chain reaction was used to determine the level transcription of interleukinL-5 and interferon-gamma genes.
  
  
  RESULTS
  Fungal extracts alone resulted in minimal changes in the levels of cytokine expression in peripheral blood lymphocytes. SEB increased the expression of IFN-gamma, and this effect was magnified by the addition of SEB and fungal extracts together to the culture medium. There were no differences in the magnitude of responses seen in patients with and without polyps nor between patients with chronic rhinosinusitis and normal controls.
  
  
  CONCLUSIONS
  SEB exerts a powerful proinflammatory effect on peripheral blood lymphocytes and fungal extracts may act synergistically to promote this action.
authors.affiliation: Department of Surgery, Otolaryngology, The Queen Elizabeth Hospital, Woodville, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Douglas
authors.forename: Maressa
authors.initials: M
authors.lastname: Bruhn
authors.forename: Lor-Wai
authors.initials: LW
authors.lastname: Tan
authors.forename: Eng
authors.initials: E
authors.lastname: Ooi
authors.forename: Alkis
authors.initials: A
authors.lastname: Psaltis
authors.forename: Peter-John
authors.initials: PJ
authors.lastname: Wormald
mesh_terms: D000328:Adult; D000368:Aged; D000528:Alternaria; D000942:Antigens, Bacterial / Q000494:pharmacology*; D001230:Aspergillus; D002478:Cells, Cultured; D002908:Chronic Disease; D018450:Disease Progression; D004768:Enterotoxins / Q000494:pharmacology*; D006801:Humans; D007371:Interferon-gamma / Q000096:biosynthesis / Q000235:genetics; D015848:Interleukin-5 / Q000096:biosynthesis / Q000235:genetics; D008214:Lymphocytes / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012220:Rhinitis / Q000097:blood* / Q000382:microbiology; D012852:Sinusitis / Q000097:blood* / Q000382:microbiology; D013210:Staphylococcus / Q000276:immunology; D014158:Transcription, Genetic
chemical_list: D000942:Antigens, Bacterial; D004768:Enterotoxins; D015848:Interleukin-5; C031818:enterotoxin B, staphylococcal; D007371:Interferon-gamma