Adaptive immune responses in Staphylococcus aureus biofilm-associated chronic rhinosinusitis
Adaptive immune responses in Staphylococcus aureus biofilm-associated chronic rhinosinusitis
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DOI：
10.1111/j.1398-9995.2011.02678.x
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发表时间：
2011-11-01
期刊：
影响因子：
12.4
通讯作者：
Bachert, C.
中科院分区：
文献类型：
--
作者：
Foreman, A.;Holtappels, G.;Bachert, C.
背景：慢性鼻窦炎（CRS）的发病机制目前是一个激烈争论的领域。最近，生物膜被认为是这种疾病的潜在环境触发因素。特别是，金黄色葡萄球菌生物膜似乎是当前治疗模式难以抵抗的严重疾病的预测因子。然而，生物膜与宿主免疫激活之间的直接因果关系目前尚缺乏。本研究旨在记录金黄色葡萄球菌生物膜相关CRS的适应性免疫反应，以及葡萄球菌超抗原和金黄色葡萄球菌生物膜在该疾病炎症构成中的相对作用。方法：共招募疾病受试者53例，对照组15例。收集鼻黏膜，以测定金黄色葡萄球菌和流感嗜血杆菌的生物膜，总抗原和超抗原特异性IgE的存在，并测量表征t辅助途径的细胞因子。结果：金黄色葡萄球菌生物膜与超级抗原在CRS患者中显著相关，提示生物膜可能是超级抗原洗脱菌的病灶。金黄色葡萄球菌生物膜的存在与嗜酸性粒细胞炎症有关，在整个CRS谱中，在宿主适应性免疫反应（嗜酸性阳离子蛋白和IL-5升高）的t辅助(2)偏斜的背后。这可以区别于导致IgE诱导的超抗原效应。结论：这项研究提供了新的证据，证明金黄色葡萄球菌生物膜与t细胞对T-helper2途径的反应偏差之间存在联系，而T-helper2途径独立于超抗原活性。需要进一步的研究来证实这种关联的因果关系。
Background: The etiopathogenesis of chronic rhinosinusitis (CRS) is currently an area of intense debate. Recently, biofilms have been proposed as a potential environmental trigger in this disease. In particular, Staphylococcus aureus biofilms appear to be a predictor of severe disease recalcitrant to current treatment paradigms. However, direct causal links between biofilms and host immune activation are currently lacking. This study aimed to document both the adaptive immune responses that characterize S. aureus biofilm-associated CRS and the relative contributions of staphylococcal superantigens and S. aureus biofilms in the inflammatory make-up of this disease.Methods: A total of 53 disease subjects and 15 controls were recruited. Sinonasal mucosa was collected for the determination of S. aureus and Haemophilus influenzae biofilms and presence of total and superantigen-specific IgE and for the measurement of cytokines that characterize the T-helper pathways.Results: Staphylococcus aureus biofilms and superantigens are significantly associated in CRS patients, suggesting the biofilm may be a nidus for superantigen-eluting bacteria. The presence of S. aureus biofilms is associated with eosinophilic inflammation, across the spectrum of CRS, on the back of a T-helper(2) skewing of the host's adaptive immune response (elevated Eosinophilic Cationic Protein and IL-5). This can be distinguished from the superantigenic effect resulting in the induction of IgE.Conclusion: This study provides novel evidence of a link between S. aureus biofilms and skewing of the T-cell response toward the T-helper2 pathway that is independent of superantigen activities. Further research is required to confirm the cause-effect relationship of this association.