Quantitative analysis of Staphylococcal enterotoxin B expression and its levels in patients with chronic rhinosinusitis with or without nasal polyps

Year 2017, Volume: 27 Issue: 3, 135 - 140, 25.07.2017

Ozan Gökdoğan Ayşe Kalkancı Yusuf Kızıl Utku Aydil İlker Akyıldız Kayhan Çağlar Sabri Uslu

Abstract

Objectives: This study aims to investigate the presence and levels of Staphylococcal enterotoxin B SEB in chronic rhinosinusitis CRS cases with or without nasal polyps. Patients and Methods: The study included 38 patients with CRS. Patients were divided into two groups as CRS group with nasal polyps group A, n=18 and CRS group without nasal polyps group B, n=20 . The control group group C consisted of 15 patients. Staphylococcal enterotoxin B levels were measured in concha supernatants and serum samples in all three groups and in polyp tissues in group A by using enzyme-linked immunosorbent assay. Real-time polymerase chain reaction analysis was used to reveal enterotoxin B gene expression in polyp and concha tissue samples. Results: Staphylococcal enterotoxin B levels were positive in 11 78.6% and 11 55.0% patients, and in one 6.7% patient in group A, B, and C, respectively. A statistically significant difference was detected between groups in terms of SEB positivity p<0.0001 . When the numbers of SEB gene copies were compared between the groups, there were statistically significant differences between groups A and C p<0.0001 , and between groups B and C p=0.002 . Conclusion: Higher rates of SEB positivity in serum samples and higher numbers of SEB gene copies in concha samples indicate that Staphylococcal superantigens may be associated with CRS development.

Keywords

Enterotoxin B, nasal polyp, rhinosinusitis, Staphylococcus aureus, superantigen

Nazal polipi olan veya olmayan kronik rinosinüzitli hastalarda Stafilokokal enterotoksin B ekspresyonu ve seviyelerinin kantitatif analizi

Abstract

Amaç: Bu çalışmada nazal polipi olan veya olmayan kronik rinosinüzit KRS olgularında Stafilokokal enterotoksin B SEB varlığı ve seviyesi araştırıldı.Hastalar ve Yöntemler: Çalışmaya KRS’li 38 hasta dahil edildi. Hastalar nazal polipli KRS grubu grup A, n=18 ve nazal polipsiz KRS grubu grup B, n=20 olmak üzere iki gruba ayrıldı. Kontrol grubunu grup C 15 hasta oluşturdu. Stafilokokkal enterotoksin B seviyeleri enzim-bağımlı immünosorbent analiz kullanılarak her üç grupta konka süpernatantlarında ve serum örneklerinde ve grup A’da polip dokularında ölçüldü. Polip ve konka doku örneklerinde enterotoksin B gen ekspresyonunu ortaya koymak için gerçek zamanlı polimeraz zincir reaksiyon analizi kullanıldı.Bulgular: Grup A, B ve C’de SEB seviyeleri sırasıyla 11 %78.6 ve 11 %55 hastada ve bir %6.7 hastada pozitif idi. Gruplar arasında SEB pozitifliği açısından istatistiksel olarak anlamlı derecede farklılık saptandı p

Keywords

Enterotoksin B, nazal polip, rinosinüzit, Stafilokokus aureus, süperantijen

References

• Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2012. Rhinol Suppl 2012;23:1-298.
• Meltzer EO, Hamilos DL, Hadley JA, Lanza DC, Marple BF, Nicklas RA, et al. Rhinosinusitis: establishing definitions for clinical research and patient care. J Allergy Clin Immunol 2004;114:155-212.
• Bachert C, Pawankar R, Zhang L, Bunnag C, Fokkens WJ, Hamilos DL, et al. ICON: chronic rhinosinusitis. World Allergy Organ J 2014;7:25.
• Bachert C, Zhang N, Patou J, van Zele T, Gevaert P. Role of staphylococcal superantigens in upper airway disease. Curr Opin Allergy Clin Immunol 2008;8:34-8.
• Sachse F, Becker K, von Eiff C, Metze D, Rudack C. Staphylococcus aureus invades the epithelium in nasal polyposis and induces IL-6 in nasal epithelial cells in vitro. Allergy 2010;65:1430-7.
• Damm M, Quante G, Rosenbohm J, Rieckmann R. Proinflammatory effects of Staphylococcus aureus exotoxin B on nasal epithelial cells. Otolaryngol Head Neck Surg 2006;134:245-9.
• Seiberling KA, Conley DB, Tripathi A, Grammer LC, Shuh L, Haines GK, et al. Superantigens and chronic rhinosinusitis: detection of staphylococcal exotoxins in nasal polyps. Laryngoscope 2005;115:1580-5.
• Alouf JE, Müller-Alouf H. Staphylococcal and streptococcal superantigens: molecular, biological and clinical aspects. Int J Med Microbiol 2003;292:429-40.
• Stow NW, Douglas R, Tantilipikorn P, Lacroix JS. Superantigens. Otolaryngol Clin North Am 2010;43:489-502.
• Wang M, Shi P, Yue Z, Chen B, Zhang H, Zhang D, et al. Superantigens and the expression of T-cell receptor repertoire in chronic rhinosinusitis with nasal polyps. Acta Otolaryngol 2008;128:901-8.
• Shiomori T, Yoshida S, Miyamoto H, Makishima K. Relationship of nasal carriage of Staphylococcus aureus to pathogenesis of perennial allergic rhinitis. J Allergy Clin Immunol 2000;105:449-54.
• Maher JM, Markey JC, Ebert-May D. The other half of the story: effect size analysis in quantitative research. CBE Life Sci Educ 2013;12:345-51.
• Suh YJ, Yoon SH, Sampson AP, Kim HJ, Kim SH, Nahm DH, et al. Specific immunoglobulin E for staphylococcal enterotoxins in nasal polyps from patients with aspirin-intolerant asthma. Clin Exp Allergy 2004;34:1270-5.
• Wang M, Shi P, Chen B, Shi G, Li H, Wang H. Superantigen-induced glucocorticoid insensitivity in the recurrence of chronic rhinosinusitis with nasal polyps. Otolaryngol Head Neck Surg 2011;145:717-22.
• Bachert C, Gevaert P, Holtappels G, Johansson SG, van Cauwenberge P. Total and specific IgE in nasal polyps is related to local eosinophilic inflammation. J Allergy Clin Immunol 2001;107:607-14.
• Ou J, Wang J, Xu Y, Tao ZZ, Kong YG, Chen SM, et al. Staphylococcus aureus superantigens are associated with chronic rhinosinusitis with nasal polyps: a meta- analysis. Eur Arch Otorhinolaryngol 2014;271:2729-36.