title: Detection of Staphylococcus aureus in nasal tissue with peptide nucleic acid-fluorescence in situ hybridization.
abstract: BACKGROUND
  Staphylococcus aureus (SA) in the nose can be a simple colonizer but also may create an intramucosal reservoir causing recurrent infections or can be a specific immune modulator through superantigenic mechanisms. Because the colonization rate of SA is high, but immunologic reactions causing chronic disease are less frequent, the purpose of this study was to identify the presence of intramucosal SA in healthy subjects and in patients with chronic rhinosinusitis (CRS) and to eventually relate those to the specific immunologic changes due to SA enterotoxins.
  
  
  METHODS
  Nasal tissue was collected in 40 subjects (9 controls, 21 CRS patients with [CRSwNP], and 10 CRS patients without nasal polyps [CRSsNP]). Tissues were homogenized, and mediators and specific IgE-antibodies against SA enterotoxins (SAE-IgE) were measured using the UniCAP system. The tissue was analyzed for the presence of SA by the peptide nucleic acid-fluorescence in situ hybridization (PNA-FISH) technique (AdvanDx), and a semiquantitative scoring system was applied. Mann-Whitney exact test was used for statistical analysis.
  
  
  RESULTS
  SA in the mucosal tissue was detected in a higher quantity among CRSwNP subjects with aspirin exacerbated respiratory disease (AERD) versus controls and CRSsNP (p=0.03). Among CRSwNP patients, Th2 markers (eosinophil cationic protein, p=0.006, and total IgE, p=0.004) were increased related to the SAE-IgE status but not related to the presence of SA in the tissue.
  
  
  CONCLUSIONS
  This study describes the detection of SA within nasal tissue using the PNA-FISH technique. The presence of SA in the submucosa did not correlate with the amplification of the Th2-related inflammation typically found in CRSwNP patients, but this reaction is dependent on the formation of SAE-IgE within mucosal tissue. We also show, for the first time, that submucosal SA is a prevalent finding in CRSwNP patients with AERD.
authors.affiliation: Upper Airways Research Laboratory (URL), Department of Otorhinolaryngology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
authors.forename: Marie-Noëlle
authors.initials: MN
authors.lastname: Corriveau
authors.forename: Nan
authors.initials: N
authors.lastname: Zhang
authors.forename: Gabriele
authors.initials: G
authors.lastname: Holtappels
authors.forename: Nadine
authors.initials: N
authors.lastname: Van Roy
authors.forename: Claus
authors.initials: C
authors.lastname: Bachert
mesh_terms: D000293:Adolescent; D000328:Adult; D001241:Aspirin / Q000009:adverse effects; D016207:Cytokines / Q000378:metabolism; D004342:Drug Hypersensitivity / Q000097:blood / Q000150:complications / Q000276:immunology / Q000382:microbiology* / Q000503:physiopathology; D004768:Enterotoxins / Q000276:immunology; D047150:Eosinophil Cationic Protein / Q000096:biosynthesis / Q000097:blood; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000096:biosynthesis / Q000097:blood; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000378:metabolism*; D009298:Nasal Polyps; D009666:Nose / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D009693:Nucleic Acid Hybridization / Q000379:methods; D012130:Respiratory Hypersensitivity / Q000097:blood / Q000150:complications / Q000276:immunology / Q000382:microbiology* / Q000503:physiopathology; D013203:Staphylococcal Infections / Q000097:blood / Q000150:complications / Q000276:immunology / Q000382:microbiology* / Q000503:physiopathology; D013211:Staphylococcus aureus / Q000254:growth & development / Q000276:immunology* / Q000472:pathogenicity; D014774:Virulence
chemical_list: D016207:Cytokines; D004768:Enterotoxins; D007073:Immunoglobulin E; D047150:Eosinophil Cationic Protein; C479220:RNASE3 protein, human; D001241:Aspirin