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Published in: Current Allergy and Asthma Reports 3/2011

01-06-2011

The Role of IgE Production in the Pathophysiology of Rhinitis and Rhinosinusitis

Authors: Elizabeth K. Hoddeson, Sarah K. Wise

Published in: Current Allergy and Asthma Reports | Issue 3/2011

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Abstract

A multitude of potential etiologies exist for rhinitis and rhinosinusitis. These sinonasal disorders are heterogeneous entities that are best understood by evaluating the causative factors in each individual patient. More precise diagnosis permits accurate and effective treatment. The association of allergy with sinonasal symptoms has been described for decades; however, the specific relationship between allergy, rhinitis, and rhinosinusitis is complex. Considering allergy in terms of a systemic atopic disorder, along with a local inflammatory process mediated by IgE production in sinonasal tissues, is helpful in unveiling the complex connection between allergy, rhinitis, and rhinosinusitis. This article reviews recent literature regarding local IgE and sinonasal inflammatory conditions.
Literature
1.
go back to reference Joe SA, Patel S. Nonallergic rhinitis. In: Cummings CW, editor. Otolaryngology: head and neck surgery, chapter 46. 5th ed. Philadelphia: Elsevier Mosby; 2010. Joe SA, Patel S. Nonallergic rhinitis. In: Cummings CW, editor. Otolaryngology: head and neck surgery, chapter 46. 5th ed. Philadelphia: Elsevier Mosby; 2010.
2.
go back to reference Rondon C, Romero JJ, Lopez S, et al. Local IgE production and positive nasal provocation test in patients with persistent nonallergic rhinitis. J Allergy Clin Immunol. 2007;119:899.PubMedCrossRef Rondon C, Romero JJ, Lopez S, et al. Local IgE production and positive nasal provocation test in patients with persistent nonallergic rhinitis. J Allergy Clin Immunol. 2007;119:899.PubMedCrossRef
3.
go back to reference Wedbock A, Enbom H, Eriksson NE, et al. Seasonal non-allergic rhinitis (SNAR)—a new disease entity? A clinical and immunological comparison between SNAR, seasonal allergic rhinitis and persistent non-allergic rhinitis. Rhinology. 2005;43:86. Wedbock A, Enbom H, Eriksson NE, et al. Seasonal non-allergic rhinitis (SNAR)—a new disease entity? A clinical and immunological comparison between SNAR, seasonal allergic rhinitis and persistent non-allergic rhinitis. Rhinology. 2005;43:86.
4.
go back to reference Powe DG, Jones NS. Local mucosal immunoglobulin E production: does allergy exist in non-allergic rhinitis? Clin Exp Allergy. 2006;36:1367.PubMedCrossRef Powe DG, Jones NS. Local mucosal immunoglobulin E production: does allergy exist in non-allergic rhinitis? Clin Exp Allergy. 2006;36:1367.PubMedCrossRef
5.
go back to reference Benninger MS. The pathogenesis of rhinosinusitis. In: Cummings CW, editor. Otolaryngology: head and neck surgery, chapter 47. 5th ed. Philadelphia: Elsevier Mosby; 2010. Benninger MS. The pathogenesis of rhinosinusitis. In: Cummings CW, editor. Otolaryngology: head and neck surgery, chapter 47. 5th ed. Philadelphia: Elsevier Mosby; 2010.
6.
go back to reference Benninger MS, Ferguson BJ, Hadley JA, et al. Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg. 2003;129:S1–32.PubMedCrossRef Benninger MS, Ferguson BJ, Hadley JA, et al. Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg. 2003;129:S1–32.PubMedCrossRef
7.
go back to reference Sanclement JA, Webster P, Thomas J, et al. Bacterial biofilms in surgical specimens of patients with chronic rhinosinusitis. Laryngoscope. 2005;115:578–82.PubMedCrossRef Sanclement JA, Webster P, Thomas J, et al. Bacterial biofilms in surgical specimens of patients with chronic rhinosinusitis. Laryngoscope. 2005;115:578–82.PubMedCrossRef
8.
go back to reference Ramadan HH, Sanclement J, Thomas J. Chronic rhinosinusitis and biofilms. Otolaryngol Head Neck Surg. 2005;132:414–7.PubMedCrossRef Ramadan HH, Sanclement J, Thomas J. Chronic rhinosinusitis and biofilms. Otolaryngol Head Neck Surg. 2005;132:414–7.PubMedCrossRef
9.
go back to reference Bent J, Kuhn F. Diagnosis of allergic fungal sinusitis. Otolaryngol Head Neck Surg. 1994;111:580–8.PubMedCrossRef Bent J, Kuhn F. Diagnosis of allergic fungal sinusitis. Otolaryngol Head Neck Surg. 1994;111:580–8.PubMedCrossRef
10.
go back to reference Pant H, Kette FE, Smith WB, et al. Fungal-specific humoral response in eosinophilic mucus chronic rhinosinusitis. Laryngoscope. 2005;115:601–6.PubMedCrossRef Pant H, Kette FE, Smith WB, et al. Fungal-specific humoral response in eosinophilic mucus chronic rhinosinusitis. Laryngoscope. 2005;115:601–6.PubMedCrossRef
11.
go back to reference DelGaudio JM. Direct nasopharyngeal reflux of gastric acid is a contributing factor in refractory chronic rhinosinusitis. Laryngoscope. 2005;115(6):946–57.PubMedCrossRef DelGaudio JM. Direct nasopharyngeal reflux of gastric acid is a contributing factor in refractory chronic rhinosinusitis. Laryngoscope. 2005;115(6):946–57.PubMedCrossRef
12.
go back to reference Emanuel IA et al. Undertreatment of allergy: exploring the utility of sublingual immunotherapy. Otolaryngol Head Neck Surg. 2009;140:615–21.PubMedCrossRef Emanuel IA et al. Undertreatment of allergy: exploring the utility of sublingual immunotherapy. Otolaryngol Head Neck Surg. 2009;140:615–21.PubMedCrossRef
13.
go back to reference Scadding GK et al. Basic guidelines for the management of allergic and non-allergic rhinitis. Clin Exp Allergy. 2008;38:19–42.PubMedCrossRef Scadding GK et al. Basic guidelines for the management of allergic and non-allergic rhinitis. Clin Exp Allergy. 2008;38:19–42.PubMedCrossRef
14.
go back to reference Van Dishoeck HAE, Franssen MGC. The incidence and correlation of allergy and chronic sinusitis. Pract Otolaryngol. 1957;19:502–6. Van Dishoeck HAE, Franssen MGC. The incidence and correlation of allergy and chronic sinusitis. Pract Otolaryngol. 1957;19:502–6.
15.
go back to reference Schlerter WW, Man WJ. Sinusitis and allergy. In: Cauwenberg P, Ekedahl C, editors. Advances in sinusitis—microbiological aspects and treatment. Belgium: Scientifica Society for Medical Information; 1981. Schlerter WW, Man WJ. Sinusitis and allergy. In: Cauwenberg P, Ekedahl C, editors. Advances in sinusitis—microbiological aspects and treatment. Belgium: Scientifica Society for Medical Information; 1981.
16.
go back to reference Savolainen S. Allergy in patients with acute maxillary sinusitis. Allergy. 1989;44:1116–22.CrossRef Savolainen S. Allergy in patients with acute maxillary sinusitis. Allergy. 1989;44:1116–22.CrossRef
17.
go back to reference Karlsson G, Holmberg K. Does allergic rhinitis predispose to sinusitis? Acta Otolaryngol. 1994;515(Suppl):26–8.CrossRef Karlsson G, Holmberg K. Does allergic rhinitis predispose to sinusitis? Acta Otolaryngol. 1994;515(Suppl):26–8.CrossRef
18.
go back to reference McNally PA, White MV, Kaliner MA. Sinusitis in an allergist’s office: analysis of 200 consecutive cases. Allergy Asthma Proc. 1997;18:169–76.PubMedCrossRef McNally PA, White MV, Kaliner MA. Sinusitis in an allergist’s office: analysis of 200 consecutive cases. Allergy Asthma Proc. 1997;18:169–76.PubMedCrossRef
19.
go back to reference Emanuel IA, Shah SB. Chronic rhinosinusitis: allergy and sinus computed tomography relationships. Otolaryngol Head Neck Surg. 2000;123:687–91.PubMedCrossRef Emanuel IA, Shah SB. Chronic rhinosinusitis: allergy and sinus computed tomography relationships. Otolaryngol Head Neck Surg. 2000;123:687–91.PubMedCrossRef
20.
go back to reference Newman LJ, Platts-Mills TA, Phillips CD, et al. Chronic sinusitis. Relationship of computed tomographic findings to allergy, asthma, and eosinophilia. JAMA. 1994;271:363–7.PubMedCrossRef Newman LJ, Platts-Mills TA, Phillips CD, et al. Chronic sinusitis. Relationship of computed tomographic findings to allergy, asthma, and eosinophilia. JAMA. 1994;271:363–7.PubMedCrossRef
21.
go back to reference Rosenfeld RM. Clinical practice guideline: acute sinusitis. Otolaryngol Head Neck Surg. 2007;137(3S):S1–31.PubMedCrossRef Rosenfeld RM. Clinical practice guideline: acute sinusitis. Otolaryngol Head Neck Surg. 2007;137(3S):S1–31.PubMedCrossRef
22.
go back to reference Alho OP, Karttunen TJ, Karttunen R, et al. Subjects with allergic rhinitis show signs of more severely impaired paranasal sinus functioning during viral colds than nonallergic subjects. Allergy. 2003;58:767–71.PubMedCrossRef Alho OP, Karttunen TJ, Karttunen R, et al. Subjects with allergic rhinitis show signs of more severely impaired paranasal sinus functioning during viral colds than nonallergic subjects. Allergy. 2003;58:767–71.PubMedCrossRef
23.
go back to reference Baroody FM, Mucha SM, de Tineo M, Naclerio RM. Nasal challenge with allergen leads to maxillary sinus inflammation. J Allergy Clin Immunol. 2008;121:1126–32.PubMedCrossRef Baroody FM, Mucha SM, de Tineo M, Naclerio RM. Nasal challenge with allergen leads to maxillary sinus inflammation. J Allergy Clin Immunol. 2008;121:1126–32.PubMedCrossRef
24.
25.
go back to reference Fokkens W, Lund V, Mullol J. European position paper on rhinosinusitis and nasal polyps group. Rhinol Suppl. 2007;20:1–136.PubMed Fokkens W, Lund V, Mullol J. European position paper on rhinosinusitis and nasal polyps group. Rhinol Suppl. 2007;20:1–136.PubMed
26.
go back to reference Collins MM, Loughran S, Davidson P, Wilson JA. Nasal polyposis: prevalence of positive food and inhalant skin tests. Otolaryngol Head Neck Surg. 2006;135:680–3.PubMedCrossRef Collins MM, Loughran S, Davidson P, Wilson JA. Nasal polyposis: prevalence of positive food and inhalant skin tests. Otolaryngol Head Neck Surg. 2006;135:680–3.PubMedCrossRef
27.
go back to reference Pant H, Ferguson BJ, Macardle PJ. The role of allergy in rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg. 2009;17(3):232–8.PubMedCrossRef Pant H, Ferguson BJ, Macardle PJ. The role of allergy in rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg. 2009;17(3):232–8.PubMedCrossRef
28.
go back to reference Foley S, Hamid Q. Immunopathology of allergic airway inflammation. In: Adkinson NF, editor. Middleton’s allergy: principles and practice, chapter 30. 7th ed. New York: Mosby; 2009. Foley S, Hamid Q. Immunopathology of allergic airway inflammation. In: Adkinson NF, editor. Middleton’s allergy: principles and practice, chapter 30. 7th ed. New York: Mosby; 2009.
29.
go back to reference Hoddeson EK, Pratt EP, Harvey RJ, Wise SK. Local and systemic IgE in the evaluation and treatment of allergy. Otolaryngol Clin North Am. 2010;43(3):503–20.PubMedCrossRef Hoddeson EK, Pratt EP, Harvey RJ, Wise SK. Local and systemic IgE in the evaluation and treatment of allergy. Otolaryngol Clin North Am. 2010;43(3):503–20.PubMedCrossRef
30.
go back to reference Smurthwaite L, Durham SR. Local IgE synthesis in allergic rhinitis and asthma. Curr Allergy Asthma Rep. 2002;2:231–8.PubMedCrossRef Smurthwaite L, Durham SR. Local IgE synthesis in allergic rhinitis and asthma. Curr Allergy Asthma Rep. 2002;2:231–8.PubMedCrossRef
31.
go back to reference Merret TG, Houri M, Mayer AL, et al. Measurement of specific IgE antibodies in nasal secretion—evidence for local production. Clin Allergy. 1976;6:69–73.CrossRef Merret TG, Houri M, Mayer AL, et al. Measurement of specific IgE antibodies in nasal secretion—evidence for local production. Clin Allergy. 1976;6:69–73.CrossRef
32.
go back to reference • Wise S, Ahn C, Lathers D, et al. Antigen-specific IgE in sinus mucosa of allergic fungal rhinosinusitis patients. Am J Rhinol. 2008;22:451–6. In this study, sinus tissue specimens from AFS patients demonstrated significantly more IgE-positive cells versus CRSsNP and control sinus tissue specimens. Specific IgE was identified for fungal and nonfungal antigens.PubMedCrossRef • Wise S, Ahn C, Lathers D, et al. Antigen-specific IgE in sinus mucosa of allergic fungal rhinosinusitis patients. Am J Rhinol. 2008;22:451–6. In this study, sinus tissue specimens from AFS patients demonstrated significantly more IgE-positive cells versus CRSsNP and control sinus tissue specimens. Specific IgE was identified for fungal and nonfungal antigens.PubMedCrossRef
33.
go back to reference Wise SK, Ahn CN, Schlosser RJ. Localized immunoglobulin E expression in allergic rhinitis and nasal polyposis. Curr Opin Otolaryngol Head Neck Surg. 2009;17:216–22.PubMedCrossRef Wise SK, Ahn CN, Schlosser RJ. Localized immunoglobulin E expression in allergic rhinitis and nasal polyposis. Curr Opin Otolaryngol Head Neck Surg. 2009;17:216–22.PubMedCrossRef
34.
go back to reference Durham S, Gould H, Thiens C. Expression of the 3 germ-line gene transcripts and mRNA for 3 heavy chain of IgE in nasal B cells and the effects of topical corticosteroid. Eur J Immunol. 1997;27:2899–906.PubMedCrossRef Durham S, Gould H, Thiens C. Expression of the 3 germ-line gene transcripts and mRNA for 3 heavy chain of IgE in nasal B cells and the effects of topical corticosteroid. Eur J Immunol. 1997;27:2899–906.PubMedCrossRef
35.
go back to reference Takhar P, Smurthwaite L, Coker H. Allergen drives class switching to IgE in the nasal mucosa of allergic rhinitis. J Immunol. 2005;174:5024–32.PubMed Takhar P, Smurthwaite L, Coker H. Allergen drives class switching to IgE in the nasal mucosa of allergic rhinitis. J Immunol. 2005;174:5024–32.PubMed
36.
go back to reference • Ahn CN, Wise SK, Lathers DM, et al. Local production of antigen-specific IgE in different anatomic subsites of allergic fungal rhinosinusitis patients. Otolaryngol Head Neck Surg. 2009;141(1):97–103. AFS sinonasal tissue had significantly increased levels of IgE-positive cells compared with specimens from controls and CRSsNP patients. No difference was found in the level of local IgE when comparing different anatomic sites in sinonasal tissue specimens from patients with AFS.PubMedCrossRef • Ahn CN, Wise SK, Lathers DM, et al. Local production of antigen-specific IgE in different anatomic subsites of allergic fungal rhinosinusitis patients. Otolaryngol Head Neck Surg. 2009;141(1):97–103. AFS sinonasal tissue had significantly increased levels of IgE-positive cells compared with specimens from controls and CRSsNP patients. No difference was found in the level of local IgE when comparing different anatomic sites in sinonasal tissue specimens from patients with AFS.PubMedCrossRef
37.
go back to reference • Sheahan P, Ahn CN, Harvey RJ, et al. Local IgE production in non-atopic nasal polyposis. J Otolaryngol Head Neck Surg. 2010;39(1):45–51. Although decreased when compared with atopic patients, nonatopic patients with CRSwNP still demonstrated specific local IgE expression in sinonasal tissue.PubMed • Sheahan P, Ahn CN, Harvey RJ, et al. Local IgE production in non-atopic nasal polyposis. J Otolaryngol Head Neck Surg. 2010;39(1):45–51. Although decreased when compared with atopic patients, nonatopic patients with CRSwNP still demonstrated specific local IgE expression in sinonasal tissue.PubMed
38.
go back to reference • Nikakhlagh S, Ghafourian-Boroujerdnia M, Saki N, et al. Immunologic factors in patients with chronic polypoid sinusitis. Niger J Med: J Natl Assoc Resid Doctors Niger. 2010;19(3):316–9. Although serum IgE levels did not differ in CRSwNP patients and healthy controls, IgE in nasal washings was significantly higher in CRSwNP patients, and systemic lymphocyte and CD8 levels were also increased. • Nikakhlagh S, Ghafourian-Boroujerdnia M, Saki N, et al. Immunologic factors in patients with chronic polypoid sinusitis. Niger J Med: J Natl Assoc Resid Doctors Niger. 2010;19(3):316–9. Although serum IgE levels did not differ in CRSwNP patients and healthy controls, IgE in nasal washings was significantly higher in CRSwNP patients, and systemic lymphocyte and CD8 levels were also increased.
39.
go back to reference Van Zele T, Gevaert P, Watelet JB, et al. Staphylococcus aureus colonization and IgE antibody formation to enterotoxins is increased in nasal polyposis. J Allergy Clin Immunol. 2004;114:981–3.PubMedCrossRef Van Zele T, Gevaert P, Watelet JB, et al. Staphylococcus aureus colonization and IgE antibody formation to enterotoxins is increased in nasal polyposis. J Allergy Clin Immunol. 2004;114:981–3.PubMedCrossRef
40.
go back to reference • Bachert C, Zhang N, Patou J. Role of staphylococcal superantigens in upper airway disease. Curr Opin Allergy Clin Immunol. 2008;8(1):34–8. This was a review paper regarding the role of enterotoxins from S. aureus in the pathophysiology of nasal polyps.PubMedCrossRef • Bachert C, Zhang N, Patou J. Role of staphylococcal superantigens in upper airway disease. Curr Opin Allergy Clin Immunol. 2008;8(1):34–8. This was a review paper regarding the role of enterotoxins from S. aureus in the pathophysiology of nasal polyps.PubMedCrossRef
41.
go back to reference • Bernstein JM, Allen C, Rich G, et al. Further observations on the role of Staphylococcus aureus exotoxins and IgE in the pathogenesis of nasal polyposis. Laryngoscope 2010 (online, ahead of print). Patients with CRSwNP have increased levels of staphylococcal superantigen–specific IgE in nasal mucosa and systemically compared with healthy controls. The authors hypothesize that this may demonstrate a pathophysiologic mechanism for development of polyps. • Bernstein JM, Allen C, Rich G, et al. Further observations on the role of Staphylococcus aureus exotoxins and IgE in the pathogenesis of nasal polyposis. Laryngoscope 2010 (online, ahead of print). Patients with CRSwNP have increased levels of staphylococcal superantigen–specific IgE in nasal mucosa and systemically compared with healthy controls. The authors hypothesize that this may demonstrate a pathophysiologic mechanism for development of polyps.
42.
go back to reference • Patadia M, Dixon J, Conley D, et al. Evaluation of the presence of B-cell attractant chemokines in chronic rhinosinusitis. Am J Rhinol Allergy. 2010;24(1):11–6. B-cell–attracting chemokines are present in increased amounts in the polyp tissue of patients with CRSwNP as opposed to the turbinate tissue of patients with CRSsNP and healthy controls.PubMedCrossRef • Patadia M, Dixon J, Conley D, et al. Evaluation of the presence of B-cell attractant chemokines in chronic rhinosinusitis. Am J Rhinol Allergy. 2010;24(1):11–6. B-cell–attracting chemokines are present in increased amounts in the polyp tissue of patients with CRSwNP as opposed to the turbinate tissue of patients with CRSsNP and healthy controls.PubMedCrossRef
43.
go back to reference • Faith A, Singh N, Chevretton E. Counter regulation of the high affinity IgE receptor, FcεRI, on human airway dendritic cells by IL-4 and IL-10. Allergy. 2009;64(11):1602–7. High-affinity IgE receptor has increased expression on the airway dendritic cells of atopic patients compared with nonatopic patients. Cross-linking of the receptor and IgE induces proinflammatory cytokines in atopic patients and anti-inflammatory cytokines in nonatopic patients.PubMedCrossRef • Faith A, Singh N, Chevretton E. Counter regulation of the high affinity IgE receptor, FcεRI, on human airway dendritic cells by IL-4 and IL-10. Allergy. 2009;64(11):1602–7. High-affinity IgE receptor has increased expression on the airway dendritic cells of atopic patients compared with nonatopic patients. Cross-linking of the receptor and IgE induces proinflammatory cytokines in atopic patients and anti-inflammatory cytokines in nonatopic patients.PubMedCrossRef
44.
go back to reference • Milovanovic M, Drozdenko G, Weise C, et al. Interleukin-17A promotes IgE production in human B cells. J Invest Dermatol. 2010;130(11):2621–8. This was an in vitro study demonstrating that in the presence of IL-4 and CD40 ligand, IL-17 induces IgE synthesis and the upregulation of IgE-producing cells.PubMedCrossRef • Milovanovic M, Drozdenko G, Weise C, et al. Interleukin-17A promotes IgE production in human B cells. J Invest Dermatol. 2010;130(11):2621–8. This was an in vitro study demonstrating that in the presence of IL-4 and CD40 ligand, IL-17 induces IgE synthesis and the upregulation of IgE-producing cells.PubMedCrossRef
45.
go back to reference • Ciprandi G, Filaci G, Fenoglio D. Th17 cells and allergic rhinitis: is there clinical relevance? Otolaryngol Head Neck Surg. 2010;143(4):604–5. Increased level of local IL-17 is correlated with clinical allergic disease severity.PubMedCrossRef • Ciprandi G, Filaci G, Fenoglio D. Th17 cells and allergic rhinitis: is there clinical relevance? Otolaryngol Head Neck Surg. 2010;143(4):604–5. Increased level of local IL-17 is correlated with clinical allergic disease severity.PubMedCrossRef
46.
go back to reference • Wang H, Mobini R, Fang Y, et al. Allergen challenge of peripheral blood mononuclear cells from patients with seasonal allergic rhinitis increases IL-17RB, which regulates basophil apoptosis and degranulation. Clin Exp Allergy. 2010;40(8):1194–202. After allergen exposure in vitro, IL-17RB gene expression is increased to the greatest extent of all genes, and IL-17 promotes IgE-regulated degranulation of basophils.PubMedCrossRef • Wang H, Mobini R, Fang Y, et al. Allergen challenge of peripheral blood mononuclear cells from patients with seasonal allergic rhinitis increases IL-17RB, which regulates basophil apoptosis and degranulation. Clin Exp Allergy. 2010;40(8):1194–202. After allergen exposure in vitro, IL-17RB gene expression is increased to the greatest extent of all genes, and IL-17 promotes IgE-regulated degranulation of basophils.PubMedCrossRef
Metadata
Title
The Role of IgE Production in the Pathophysiology of Rhinitis and Rhinosinusitis
Authors
Elizabeth K. Hoddeson
Sarah K. Wise
Publication date
01-06-2011
Publisher
Current Science Inc.
Published in
Current Allergy and Asthma Reports / Issue 3/2011
Print ISSN: 1529-7322
Electronic ISSN: 1534-6315
DOI
https://doi.org/10.1007/s11882-011-0181-z

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