Evidence for intranasal antinuclear autoantibodies in patients with chronic rhinosinusitis with nasal polyps.
Evidence for intranasal antinuclear autoantibodies in patients with chronic rhinosinusitis with nasal polyps.
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DOI：
10.1016/j.jaci.2011.08.037
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发表时间：
2011-12
期刊：
影响因子：
--
通讯作者：
Schleimer RP
中科院分区：
文献类型：
--
作者：
Tan BK;Li QZ;Suh L;Kato A;Conley DB;Chandra RK;Zhou J;Norton J;Carter R;Hinchcliff M;Harris K;Peters A;Grammer LC;Kern RC;Mohan C;Schleimer RP
慢性鼻窦炎伴鼻息肉（CRSwNP）是鼻道和鼻旁窦的炎性病症，其特征在于具有升高的BAFF、B淋巴细胞和免疫球蛋白水平的Th2偏向性炎症。由于高水平的BAFF与自身免疫性疾病相关，我们评估了CRS患者自身免疫性的证据。本研究的目的是调查CRS患者的鼻窦组织中是否存在自身抗体。从CRS患者和对照受试者中收集标准化鼻组织标本，并使用多重自身抗体微阵列、ELISA和免疫荧光法测定鼻组织中免疫球蛋白的产生、自身抗体水平、免疫球蛋白的组织分布和抗体的结合潜力。与对照组织和来自非息肉样CRS（CRSsNP）的发炎组织相比，在鼻息肉组织中发现升高水平的几种特异性自身抗体（p<0.05）。特别是，在鼻息肉中，特别是在来自需要翻修手术以防止复发的患者的鼻息肉中，发现核靶向自身抗体如抗dsDNA IgG和伊加抗体的水平升高（p<0.05）。直接免疫荧光染色显示IgG的弥漫性上皮和上皮下沉积和伊加分泌浆细胞的数量增加，在对照鼻组织中未观察到。自身抗体，特别是针对核抗原的抗体，在鼻息肉中以局部升高的水平存在。自身抗体的存在表明鼻息肉的微环境促进了自身反应性B细胞克隆的扩增。虽然这些抗体的致病性仍有待阐明，但抗dsDNA抗体升高的存在与需要重复手术的临床上更具侵袭性的CRSwNP形式相关。
Chronic rhinosinusitis with nasal polyps (CRSwNP) is an inflammatory condition of the nasal passage and paranasal sinuses characterized by Th2 biased inflammation with elevated levels of BAFF, B-lymphocytes, and immunoglobulins. Since high levels of BAFF are associated with autoimmune diseases, we assessed for evidence of autoimmunity in patients with CRS. The objective of this study was to investigate for the presence of autoantibodies in sinonasal tissue from patients with CRS. Standardized nasal tissue specimens were collected from patients with CRS and control subjects and assayed for immunoglobulin production, autoantibody levels, tissue distribution of immunoglobulins and binding potential of antibodies in nasal tissue using a multiplexed autoantibody microarray, ELISA and immunofluoresence. Elevated levels of several specific autoantibodies were found in nasal polyp tissue in comparison with control tissue and inflamed tissue from non-polypoid CRS (CRSsNP) (p<0.05). In particular, nuclear-targeted autoantibodies such as anti-dsDNA IgG and IgA antibodies were found at elevated levels in nasal polyps (p<0.05) and particularly in nasal polyps from patients requiring revision surgery for recurrence. Direct immunofluorescence staining demonstrated diffuse epithelial and sub-epithelial deposition of IgG and increased numbers of IgA secreting plasma cells not seen in control nasal tissue. Autoantibodies, particularly those against nuclear antigens, are present at locally elevated levels in nasal polyps. The presence of autoantibodies suggests that the microenvironment of a nasal polyp promotes the expansion of self-reactive B-cell clones. While the pathogenicity of these antibodies remains to be elucidated, the presence of elevated anti-dsDNA antibodies is associated with a clinically more aggressive form of CRSwNP requiring repeated surgery.
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影响因子：
12.4
作者：
Gevaert, P;Holtappels, G;Bachert, C
通讯作者：
Bachert, C
DOI：
10.1073/pnas.0608397104
发表时间：
2006-12-26
影响因子：
11.1
作者：
Kowal, Czeslawa;DeGiorgio, Lorraine A.;Diamond, Betty
通讯作者：
Diamond, Betty
DOI：
10.2500/ajr.2006.20.2880
发表时间：
2006-07-01
期刊：
AMERICAN JOURNAL OF RHINOLOGY
影响因子：
--
作者：
Conley, David B.;Tripathi, Anju;Kern, Robert C.
通讯作者：
Kern, Robert C.
影响因子：
14.2
作者：
Kato, Atsushi;Peters, Anju;Schleimer, Robert P.
通讯作者：
Schleimer, Robert P.
影响因子：
2.6
作者：
Patadia M;Dixon J;Conley D;Chandra R;Peters A;Suh LA;Kato A;Carter R;Harris K;Grammer L;Kern R;Schleimer R
通讯作者：
Schleimer R