Screening for staphylococcal superantigen genes shows no correlation with the presence or the severity of chronic rhinosinusitis and nasal polyposis.
BACKGROUND
Staphylococcus aureus secretes numerous exotoxins which may exhibit superantigenic properties. Whereas the virulence of several of them is well documented, their exact biological effects are not fully understood. Exotoxins may influence the immune and inflammatory state of various organs, including the sinonasal mucosa: their possible involvement in chronic rhinosinusitis has been suggested and is one of the main trends in current research. The aim of this study was to investigate whether the presence of any of the 22 currently known staphylococcal exotoxin genes could be correlated with chronic rhinosinusitis.


RESULTS
We conducted a prospective, multi-centred European study, analysing 93 Staphylococcus aureus positive swabs taken from the middle meatus of patients suffering from chronic rhinosinusitis, with or without nasal polyposis, and controls. Strains were systematically tested for the presence of the 22 currently known exotoxin genes and genotyped according to their agr groups. No direct correlation was observed between chronic rhinosinusitis, with or without nasal polyposis, and either agr groups or the presence of the most studied exotoxins genes (egc, sea, seb, pvl, exfoliatins or tsst-1). However, genes for enterotoxins P and Q were frequently observed in nasal polyposis for the first time, but absent in the control group. The number of exotoxin genes detected was not statistically different among the 3 patient groups.


CONCLUSIONS
Unlike many previous studies have been suggesting, we did not find any evident correlation between staphylococcal exotoxin genes and the presence or severity of chronic rhinosinusitis with or without nasal polyposis.
Heymans
Frédéric
F
Rhinology-Olfactology Unit, Department of Otorhinolaryngology and ENT Surgery, Geneva University Hospital, Geneva, Switzerland.
Fischer
Adrien
A
Stow
Nicholas W
NW
Girard
Myriam
M
Vourexakis
Zacharias
Z
Des Courtis
Antoine
A
Renzi
Gesuele
G
Huggler
Elzbieta
E
Vlaminck
Stefan
S
Bonfils
Pierre
P
Mladina
Ranko
R
Lund
Valerie
V
Schrenzel
Jacques
J
François
Patrice
P
Lacroix
Jean Silvain
JS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001427:Bacterial Toxins / Q000276:immunology; D002908:Chronic Disease; D004768:Enterotoxins / Q000276:immunology; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000276:immunology*; D011446:Prospective Studies; D012852:Sinusitis / Q000276:immunology*; D013210:Staphylococcus / Q000276:immunology*; D018089:Superantigens / Q000276:immunology*
D001427:Bacterial Toxins; D004768:Enterotoxins; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal