Gram-negative bacterial carriage in chronic rhinosinusitis with nasal polyposis is not associated with more severe inflammation.
Int Forum Allergy Rhinol
; 5(4): 289-93, 2015 Apr.
Article
em En
| MEDLINE
| ID: mdl-25641850
ABSTRACT
BACKGROUND:
We have previously demonstrated that persistent symptoms following functional endoscopic sinus surgery for chronic rhinosinusitis (CRS) is associated with Gram-negative bacterial carriage. Mechanisms for this remain unknown. We wished to determine whether Gram-negative carriage in patients with CRS with nasal polyposis is associated with a more severe inflammatory phenomenon.METHODS:
Three hundred and thirty-seven patients with CRS with nasal polyposis (CRSwNP) previously phenotyped for genetic association studies with questionnaire, serum biomarkers, and endoscopically-obtained swab cultures were studied. These were separated according to the presence (wGN) or absence (sGN) of Gram-negative bacterial carriage; demographic parameters and available serum biomarkers (complete blood count [CBC], total immunoglobulin E [IgE]) were then compared. Subgroup analysis for Pseudomonas aeruginosa (GNwPa) and non-Pseudomonas Gram-negative bacteria (GNsPs) was performed in order to explore potentially differential roles of these bacteria.RESULTS:
Gram-negative bacterial carriage was not associated with a difference in demographic parameters or serum biomarkers. However, P. aeruginosa carriage was associated with a higher self-reported incidence of asthma (GNwPa 79%, sGN 57%; p = 0.048). Interestingly, serum IgE was increased in the non-Pseudomonas Gram-negative population (GNsPs 338 IU/mL, sGN 195 IU/mL; p = 0.026).CONCLUSION:
CRSwNP patients colonized with Gram-negative bacteria have a similar pattern of inflammation as assessed by serum biomarkers to those colonized with Gram-positive ones. Gram-negative bacteria may contribute to development of a T helper 2 (Th2) phenotype via other mechanisms, possibly via Toll-like receptor 4 (TLR4)-mediated interleukin 33 (IL-33) production. Differences in phenotype associated with Pseudomonas species carriage suggest a different behavior than other Gram-negative bacteria, supporting their importance as disease modifiers in CRSwNP.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Sinusite
/
Rinite
/
Pólipos Nasais
/
Infecções por Bactérias Gram-Negativas
/
Mediadores da Inflamação
/
Bactérias Gram-Negativas
Tipo de estudo:
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
/
Middle aged
Idioma:
En
Revista:
Int Forum Allergy Rhinol
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Canadá