title: Increased local IgE production induced by common aeroallergens and phenotypic alteration of mast cells in Chinese eosinophilic, but not non-eosinophilic, chronic rhinosinusitis with nasal polyps.
abstract: BACKGROUND
  Eosinophilic and non-eosinophilic chronic rhinosinusitis with nasal polyps (CRSwNP) display distinct patterns of inflammation. However, the pathogenic mechanisms underlying the heterogeneity of CRSwNP need further investigation.
  
  
  OBJECTIVE
  To investigate local immunoglobulin E (IgE) production and phenotype of mast cells in eosinophilic and non-eosinophilic CRSwNP in Chinese.
  
  
  METHODS
  Total and specific IgE levels were analysed by means of the ImmunoCAP system. The molecular steps involved in class-switch recombination to IgE were investigated using RT-PCR assays. Mast cell phenotypes, IgE- and high-affinity IgE receptor (FcεRI)-positive cells, and allergen binding to specific IgE in sinonasal mucosa were determined by means of immunohistochemistry.
  
  
  RESULTS
  Compared with controls and non-eosinophilic CRSwNP, local total IgE levels were increased, and local specific IgE to common aeroallergens was more frequently found, in Chinese eosinophilic CRSwNP independent of atopy and without significant association with Staphylococcus aureus enterotoxins. The ε germline gene transcript was also more frequently detected in eosinophilic CRSwNP. The number of IgE- and FcεRI-positive cells was increased in eosinophilic CRSwNP. Most IgE- and FcεRI-positive cells were mast cells. Dust mite antigens could bind to IgE on mast cells in situ. The number of mast cells positive for both tryptase and chymase and activated mast cells was increased in eosinophilic CRSwNP and the number of activated mast cells positively correlated with local IgE level, eotaxin-1 level, and eosinophil count in CRSwNP.
  
  
  CONCLUSIONS
  The local IgE induced by common aeroallergens may mediate mast cell activation and contribute to subsequent eosinophilic inflammation in Chinese CRSwNP. This study offers a rationale for considering intervention strategies designed to target 'local allergy' in eosinophilic CRSwNP.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: P-P
authors.initials: PP
authors.lastname: Cao
authors.forename: Y-N
authors.initials: YN
authors.lastname: Zhang
authors.forename: B
authors.initials: B
authors.lastname: Liao
authors.forename: J
authors.initials: J
authors.lastname: Ma
authors.forename: B-F
authors.initials: BF
authors.lastname: Wang
authors.forename: H
authors.initials: H
authors.lastname: Wang
authors.forename: M
authors.initials: M
authors.lastname: Zeng
authors.forename: W-H
authors.initials: WH
authors.lastname: Liu
authors.forename: R P
authors.initials: RP
authors.lastname: Schleimer
authors.forename: Z
authors.initials: Z
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000393:Air Pollutants / Q000276:immunology; D000485:Allergens / Q000276:immunology*; D000941:Antigens / Q000276:immunology; D044466:Asian People; D016175:B-Lymphocyte Subsets / Q000276:immunology / Q000378:metabolism; D019013:CD40 Antigens / Q000378:metabolism; D023201:CD40 Ligand / Q000378:metabolism; D002634:Chemotaxis, Leukocyte / Q000276:immunology; D002681:China; D002908:Chronic Disease; D016207:Cytokines / Q000378:metabolism; D004802:Eosinophilia / Q000235:genetics / Q000276:immunology* / Q000378:metabolism; D005260:Female; D005786:Gene Expression Regulation; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology*; D007958:Leukocyte Count; D008297:Male; D008407:Mast Cells / Q000276:immunology* / Q000378:metabolism; D008875:Middle Aged; D009298:Nasal Polyps / Q000150:complications; D010641:Phenotype; D011485:Protein Binding / Q000276:immunology; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D017455:Receptors, IgE / Q000378:metabolism; D012220:Rhinitis / Q000150:complications / Q000175:diagnosis / Q000235:genetics / Q000276:immunology*; D012852:Sinusitis / Q000150:complications / Q000175:diagnosis / Q000235:genetics / Q000276:immunology*; D018418:Th2 Cells / Q000276:immunology / Q000378:metabolism; D055815:Young Adult
chemical_list: D000393:Air Pollutants; D000485:Allergens; D000941:Antigens; D019013:CD40 Antigens; D016207:Cytokines; D012333:RNA, Messenger; D017455:Receptors, IgE; D023201:CD40 Ligand; D007073:Immunoglobulin E
keywords: chronic rhinosinusitis; eosinophil; immunoglobulin E; mast cell; nasal polyps