Evidence for intranasal antinuclear autoantibodies in patients with chronic rhinosinusitis with nasal polyps

Bruce K. Tan, Quan Zhen Li, Lydia Suh, Atsushi Kato, David B. Conley, Rakesh K. Chandra, Jinchun Zhou, James Norton, Roderick Carter, Monique Hinchcliff, Kathleen Harris, Anju Peters, Leslie C. Grammer, Robert C. Kern, Chandra Mohan, Robert P. Schleimer

Research output: Contribution to journalArticle

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Abstract

Background: Chronic rhinosinusitis (CRS) with nasal polyps is an inflammatory condition of the nasal passage and paranasal sinuses characterized by T H2-biased inflammation with increased levels of B-cell activating factor of the TNF family (BAFF), B lymphocytes, and immunoglobulins. Because high levels of BAFF are associated with autoimmune diseases, we assessed for evidence of autoimmunity in patients with CRS. Objectives: The objective of this study was to investigate the presence of autoantibodies in sinonasal tissue from patients with CRS. Methods: 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 with a multiplexed autoantibody microarray, ELISA, and immunofluorescence. Results: Increased levels of several specific autoantibodies were found in nasal polyp tissue in comparison with levels seen in control tissue and inflamed tissue from patients with CRS without nasal polyps (P <.05). In particular, nuclear-targeted autoantibodies, such as anti-dsDNA IgG and IgA antibodies, were found at increased levels in nasal polyps (P <.05) and particularly in nasal polyps from patients requiring revision surgery for recurrence. Direct immunofluorescence staining demonstrated diffuse epithelial and subepithelial deposition of IgG and increased numbers of IgA-secreting plasma cells not seen in control nasal tissue. Conclusions: Autoantibodies, particularly those against nuclear antigens, are present at locally increased 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. Although the pathogenicity of these antibodies remains to be elucidated, the presence of increased anti-dsDNA antibody levels is associated with a clinically more aggressive form of CRS with nasal polyps requiring repeated surgery.

Original languageEnglish (US)
JournalJournal of Allergy and Clinical Immunology
Volume128
Issue number6
DOIs
StatePublished - Dec 2011

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Nasal Polyps
Autoantibodies
Nose
B-Cell Activating Factor
Immunoglobulins
Paranasal Sinuses
Antibodies
B-Lymphocytes
Direct Fluorescent Antibody Technique
Nuclear Antigens
Tissue Distribution
Plasma Cells
Autoimmunity
Reoperation
Immunoglobulin A
Autoimmune Diseases
Fluorescent Antibody Technique
Virulence
Anti-Idiotypic Antibodies
Clone Cells

Keywords

  • autoantibodies
  • autoimmunity
  • biomarker
  • Chronic rhinosinusitis
  • nasal polyps
  • sinusitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Evidence for intranasal antinuclear autoantibodies in patients with chronic rhinosinusitis with nasal polyps. / Tan, Bruce K.; Li, Quan Zhen; Suh, Lydia; Kato, Atsushi; Conley, David B.; Chandra, Rakesh K.; Zhou, Jinchun; Norton, James; Carter, Roderick; Hinchcliff, Monique; Harris, Kathleen; Peters, Anju; Grammer, Leslie C.; Kern, Robert C.; Mohan, Chandra; Schleimer, Robert P.

In: Journal of Allergy and Clinical Immunology, Vol. 128, No. 6, 12.2011.

Research output: Contribution to journalArticle

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 2011, 'Evidence for intranasal antinuclear autoantibodies in patients with chronic rhinosinusitis with nasal polyps', Journal of Allergy and Clinical Immunology, vol. 128, no. 6. https://doi.org/10.1016/j.jaci.2011.08.037
Tan, Bruce K. ; Li, Quan Zhen ; Suh, Lydia ; Kato, Atsushi ; Conley, David B. ; Chandra, Rakesh K. ; Zhou, Jinchun ; Norton, James ; Carter, Roderick ; Hinchcliff, Monique ; Harris, Kathleen ; Peters, Anju ; Grammer, Leslie C. ; Kern, Robert C. ; Mohan, Chandra ; Schleimer, Robert P. / Evidence for intranasal antinuclear autoantibodies in patients with chronic rhinosinusitis with nasal polyps. In: Journal of Allergy and Clinical Immunology. 2011 ; Vol. 128, No. 6.
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abstract = "Background: Chronic rhinosinusitis (CRS) with nasal polyps is an inflammatory condition of the nasal passage and paranasal sinuses characterized by T H2-biased inflammation with increased levels of B-cell activating factor of the TNF family (BAFF), B lymphocytes, and immunoglobulins. Because high levels of BAFF are associated with autoimmune diseases, we assessed for evidence of autoimmunity in patients with CRS. Objectives: The objective of this study was to investigate the presence of autoantibodies in sinonasal tissue from patients with CRS. Methods: 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 with a multiplexed autoantibody microarray, ELISA, and immunofluorescence. Results: Increased levels of several specific autoantibodies were found in nasal polyp tissue in comparison with levels seen in control tissue and inflamed tissue from patients with CRS without nasal polyps (P <.05). In particular, nuclear-targeted autoantibodies, such as anti-dsDNA IgG and IgA antibodies, were found at increased levels in nasal polyps (P <.05) and particularly in nasal polyps from patients requiring revision surgery for recurrence. Direct immunofluorescence staining demonstrated diffuse epithelial and subepithelial deposition of IgG and increased numbers of IgA-secreting plasma cells not seen in control nasal tissue. Conclusions: Autoantibodies, particularly those against nuclear antigens, are present at locally increased 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. Although the pathogenicity of these antibodies remains to be elucidated, the presence of increased anti-dsDNA antibody levels is associated with a clinically more aggressive form of CRS with nasal polyps requiring repeated surgery.",
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AU - Tan, Bruce K.

AU - Li, Quan Zhen

AU - Suh, Lydia

AU - Kato, Atsushi

AU - Conley, David B.

AU - Chandra, Rakesh K.

AU - Zhou, Jinchun

AU - Norton, James

AU - Carter, Roderick

AU - Hinchcliff, Monique

AU - Harris, Kathleen

AU - Peters, Anju

AU - Grammer, Leslie C.

AU - Kern, Robert C.

AU - Mohan, Chandra

AU - Schleimer, Robert P.

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KW - nasal polyps

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