Further observations on the role of @entity794 exotoxins and IgE in the pathogenesis of XXXX .

@entity1 @entity32 @entity137 @entity1127 @entity794 @entity56 @entity1412 @entity480
OBJECTIVES/HYPOTHESIS: Recent studies have suggested that @entity794 secrete exotoxins that may act as superantigens and upregulate the variable beta region of lymphocytes in @entity1412 ( @entity1412 ). The aim of this study was to add further information for correlating the presence of staphylococcal species and the upregulation of the V(b) region of both nasal polyp lymphocytes and peripheral blood lymphocytes. Furthermore, IgE-mediated @entity56 directed against these exotoxins produces an additional independent immunologic mechanism in upregulating the inflammatory response in the lateral wall of the nose in @entity1412 . STUDY DESIGN: Prospective study. METHODS: Nasal @entity1127 were harvested from 38 @entity1 with @entity1412 . Eleven @entity1 were studied for the correlation of exotoxin from staphylococcal species and the variable beta region of lymphocytes in both the nasal polyp lymphocytes and corresponding peripheral blood lymphocytes. Eight additional @entity1 with @entity1412 were studied for local and systemic IgE-mediated immunity directed against @entity794 exotoxins. Flow cytometry was used to analyze the V(b) repertoire of polyp-derived CD3-positive lymphocytes from 11 @entity1 . @entity794 was isolated from nine @entity1 , and coagulase-negative @entity794 was isolated from two @entity1 in whom at least 1   10(6) T cells could be isolated from their @entity480 . A quantitative assay for IgE was developed to study the levels of this immunoglobulin directed against @entity794 exotoxins in both the nasal polyp and the peripheral blood lymphocytes of 11 @entity1 and in the nasal mucus and serum of eight additional @entity1 . RESULTS: Eleven @entity1 had T-cell V(b) clonal expansion. @entity794 exotoxin upregulated the corresponding V(b) region of lymphocytes in both the nasal polyp T cells as well as the T cells from the peripheral blood in nine @entity1 , and two @entity1 with coagulase-negative @entity794 also demonstrated upregulation of the V(b) region in the @entity480 in the absence of exotoxins. In one @entity1 , in vivo exotoxin was isolated, which correlated with the in vitro isolation from the organism itself. IgE directed against staphylococcal enterotoxin B (SEB) and @entity137 toxin was significantly elevated in the sera of @entity1 with @entity1412 (P < .0001) as compared with the sera of age-related healthy control subjects; IgE directed against staphylococcal enterotoxin A and SEB (P = .0047) was significantly elevated in the mucus of eight @entity1 with @entity1412 as compared with the nasal mucus of healthy controls. CONCLUSIONS: This study augments our understanding of the potential role of @entity794 exotoxins behaving as superantigens in the lateral wall of the nose in @entity1412 . Furthermore, local nasal IgE directed against these exotoxins may create a @entity32 in the lateral wall of the nose. These two immunologic mechanisms are independent but may be additive in the inflammatory process in @entity1412 .
