Ozan GÖKDOĞAN, Ayşe KALKANCI, Yusuf KIZIL, Utku AYDİL, İlker AKYILDIZ, Kayhan ÇAĞLAR, Sabri USLU

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

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

Anahtar Kelimeler:

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

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

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,

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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.