title: Local IgE production in nonatopic nasal polyposis.
abstract: BACKGROUND
  Chronic rhinosinusitis with nasal polyposis (CRSwNP) represents an eosinophilic T-helper 2 inflammatory response. Local production of IgE within nasal polyps (NPs) has been demonstrated, suggesting a role for local IgE in the pathogenesis of NP in atopic CRS patients. We hypothesized that local IgE specific to inhalant allergens may also play a role in the genesis of NP in nonatopic CRS patients.
  
  
  METHODS
  Sinus and inferior turbinate tissue was obtained from nonatopic CRSwNP patients (n = 7), chronic rhinosinusitis without nasal polyps (CRSsNP) patients (n = 15), and healthy controls (n = 9) at the time of surgery. ImmunoCAP analysis (Phadia AB, Portage, MI) for 14 common inhalant antigens was performed on tissue homogenates to determine the antigen-specific response.
  
  
  RESULTS
  Total IgE levels did not differ in sinus or turbinate tissue between CRSwNP, CRSsNP, or control patients. CRSwNP sinus tissue had higher levels of specific IgE for cockroach and plantain (p = .03) than other groups and elevated Alternaria IgE levels when compared with CRSsNP sinus tissue (p < .05). No significant differences were found for any of the other antigen-specific IgE levels. Fifty-seven percent of CRSwNP polyps demonstrated a polyclonal IgE response, whereas the other 43% had no demonstrable antigen-specific IgE. In contrast, only 17% of CRSsNP patients demonstrated a polyclonal response within sinus tissue, whereas 67% had no detectable antigen-specific IgE. There was no significant difference in levels of IgE in inferior turbinate tissue between the groups (p > .05).
  
  
  CONCLUSIONS
  Localized mucosal IgE specific to common inhalant allergens appears to play a role in a subset of CRSwNP patients without evidence of systemic atopy.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland.
authors.forename: Patrick
authors.initials: P
authors.lastname: Sheahan
authors.forename: Chadwick N
authors.initials: CN
authors.lastname: Ahn
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Harvey
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Wise
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Mulligan
authors.forename: Deanne M R
authors.initials: DM
authors.lastname: Lathers
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Schlosser
mesh_terms: D000485:Allergens; D004804:Eosinophils / Q000378:metabolism; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000378:metabolism*; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000378:metabolism*; D012221:Rhinitis, Allergic, Perennial / Q000378:metabolism*; D014420:Turbinates / Q000378:metabolism
chemical_list: D000485:Allergens; D007073:Immunoglobulin E