Rhinosinusitis and asthma: a link for asthma severity

Curr Allergy Asthma Rep. 2010 May;10(3):194-201. doi: 10.1007/s11882-010-0096-0.

Abstract

The term rhinosinusitis describes an inflammation of the mucosal lining of the nose and sinuses; however, recent evidence points to the need to differentiate patients with chronic rhinosinusitis without nasal polyps from those with nasal polyps. Asthma comorbidity is especially common in nasal polyp disease and may be associated with aspirin-exacerbated respiratory disease. Of interest, asthma comorbidity is uncommon in some parts of the world but common in others. A further analysis of the inflammatory patterns also revealed that nasal polyps do not represent one single entity; interleukin (IL)-5-positive nasal polyps can be differentiated from IL-5-negative forms by different inflammatory patterns (predominance of eosinophils vs neutrophils). Staphylococcus aureus superantigens frequently colonize IL-5-positive nasal polyps and may amplify the eosinophilic inflammation, induce a polyclonal local IgE formation, and increase the risk of asthma comorbidity. Recent findings in severe asthma patients confirm the role of superantigens in lower airway disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Antigens, Bacterial / immunology
  • Asthma, Aspirin-Induced / complications
  • Asthma, Aspirin-Induced / epidemiology
  • Asthma, Aspirin-Induced / immunology*
  • Asthma, Aspirin-Induced / therapy*
  • Comorbidity
  • Eosinophils / immunology
  • Humans
  • Immunoglobulin E / immunology*
  • Interleukin-5 / immunology*
  • Nasal Mucosa / immunology
  • Nasal Polyps / complications
  • Nasal Polyps / immunology*
  • Nasal Polyps / therapy*
  • Neutrophils / immunology
  • Paranasal Sinuses / immunology
  • Rhinitis / complications
  • Rhinitis / epidemiology
  • Rhinitis / immunology*
  • Rhinitis / therapy*
  • Risk Factors
  • Sinusitis / complications
  • Sinusitis / epidemiology
  • Sinusitis / immunology*
  • Sinusitis / therapy*
  • Staphylococcal Infections / complications
  • Staphylococcal Infections / immunology*
  • Staphylococcal Infections / therapy*
  • Staphylococcus aureus / immunology
  • Superantigens / immunology*

Substances

  • Anti-Bacterial Agents
  • Antigens, Bacterial
  • Interleukin-5
  • Superantigens
  • Immunoglobulin E