Role of Fungal and Bacterial Superantigen in the Pathogenesis of Chronic Rhinosinusitis with Polyps

Shin, Seung Heon

Review

Journal of Rhinology 2008;15(2):98-102.
Published online November 30, 2008.

Role of Fungal and Bacterial Superantigen in the Pathogenesis of Chronic Rhinosinusitis with Polyps

Seung Heon Shin

Department of Otolaryngology, College of Medicine, Daegu Catholic University, Daegu, Korea. hsseung@cu.ac.kr

비용성 만성부비동염의 발병에 있어 진균과 세균 초항원의 역할

신승헌

대구가톨릭대학교 의과대학 이비인후과학교실

Abstract

Chronic rhinosinusitis (CRS) is an inflammatory disorder with numerous predisposing factors, including genetics, anatomic anomalies, bacteria, and fungus. CRS with nasal polyps can be distinguished by an eosinophilic type inflammation with a high concentration of IgE. Recent studies have implicated exposure to superantigens derived from Staphylococcus aureus and Alternaria as possible causes for the pahophysiology of nasal polyps. Superantigens are microbial toxins that bind to human leukocyte antigen class II histocompatibility molecules on antigen-presenting cells and T cell receptors on T cells simultaneously, bypassing classical antigen specificity. T lymphocyte sensitization to superantigen with production of the T-helper 2 cytokines has been proposed as a key step in the initiation of nasal polyps. This review summarize the current evidence for an active role of fungal and bacterial superantigens in CRS with nasal polyps. However, therapeutic approaches are so far limited and empirical, and need further improvement.

Key Words: Chronic rhinosinusitis;Sinusitis;Nasal polyp;Bacteria;Fungus;Superantigen