Background: Recent investigations have shown that Staphylococcus aureus enterotoxins might be associated with inflammatory mucosal changes seen in chronic rhinosinusitis with nasal polyps (CRSwNP) or nasal polyposis (NP). Their involvement in disease maintenance is still unclear. The aim of this study was to determine the presence of immunoglobulin E specific to Staphylococcus aureus enterotoxin A (SEA-IgE) in the serum of CRSwNP patients and its involvement in the concomitant presence of asthma. Methods: The study group consisted of 70 participants: 32 with CRSwNP without asthma, 13 with CRSwNP with asthma and 25 controls without an inflammatory disease of the nose/paranasal sinuses. A detailed medical history was obtained, and a clinical examination and skin prick test were performed. The diagnosis of CRSwNP was confirmed by nasal endoscopy and computed tomography. The levels of total immunoglobulin E (IgE) and SEA-IgE in the serum were measured using ImmunoCAP assays. Results: Comparing CRSwNP patients with and without asthma, the patients with asthma had more severe symptoms, and higher endoscopic and radiological scores than those without asthma. SEAIgE values were significantly higher in the CRSwNP group than in the control group. The presence of SEA-IgE antibodies was not associated with the presence of asthma. Conclusion: Much controversy exists about the role of Staphylococcus aureus enterotoxins (SE) in the pathogenesis of NP. Although serum SEA-IgE values did not reach the established cut-off level, they were significantly higher in CRSwNP patients than in the control group. This may suggest that SE might be involved in CRSwNP pathogenesis or amplify inflammation in patients with CRSwNP. Serum SEA-IgE is not a reliable indicator of the concomitant presence of asthma in patients with NP.
Aleksić et al. (Wed,) studied this question.