Bacteria-reactive B cells in the nose transform into immunoglobulin-E (IgE)-producing B cells via IgG-A1-IgE class switching in individuals with chronic rhinosinusitis with nasal polyposis, according to a study published in The Journal of Allergy and Clinical Immunology. These results suggest that disease pathogenesis could be affected by allergic transformation of mucosal response to bacteria in the nose.

This study included 46 participants with chronic rhinosinusitis with nasal polyposis whose bilateral nasal polyps were collected. Specific nasal bacteria, including Haemophilus influenzae, Staphylococcus aureus, and Streptococcus pyogenes were found in approximately one-fifth of isolated IgE antibodies via plasmablasts residing in nasal polyps.

Participants with chronic rhinosinusitis with nasal polyposis showed a Th2 cell response against S pyogenes. IgE-expressing B-like and plasmablast subsets were observed on nasal polyp cell surfaces using flow cytometric analysis. Additionally, clonal connectivity of IgE with IcG and IgA1 was identified through high-throughput immunoglobulin, and nasal polyps revealed the Iε-Cα1 circle transcript.

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Researchers sought to characterize monoclonal antibodies derived from single cells in order to examine IgE reactivity of patients with chronic rhinosinusitis with nasal polyposis. In vitro examinations were performed to examine the response of T cells against specified allergens. Flow cytometry was utilized in order to characterize lymphocytes infiltrating the nasal polyps, and high-throughput immunoglobulin sequencing was employed to assess the immunoglobulins expressed within nasal polyps.

The researchers concluded that in patients with chronic rhinosinusitis with nasal polyposis “nasal bacteria-reactive B cells differentiate into IgE-producing B cells through IgG/A1-IgE class switching, suggesting that allergic conversion of the mucosal response against nasal bacteria underlies disease pathogenesis.”

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Disclosures: Dr Yamashita is a founder and board member of KOTAI Biotechnologies, Inc.


Takeda K, Sakakibara S, Yamashita K, et al. Allergic conversion of protective mucosal immunity against nasal bacteria in chronic rhinosinusitis with nasal polyposis [published online July 24, 2018]. J Allergy Clin Immunol. doi:10.1016/j.jaci.2018.07.006