Limits...
Bone: the final frontier for Staphylococcus aureus penetration in chronic rhinosinusitis.

Pezato R, Bottura L, de Paula Santos R, Voegels RL, Bachi AL, Gregório LC - J Otolaryngol Head Neck Surg (2013)

Bottom Line: Inferior turbinate samples from 3 patients without sinus disease, 6 ethmoid samples from patients with chronic rhinosinusitis with nasal polyposis, and 6 ethmoid samples from patients with chronic rhinosinusitis without nasal polyposis were studied.We found Staphylococcus aureus invading the nasal submucosa in patients with nasal polyposis, but no cases of Staphylococcus aureus positivity in bone.In conclusion, we cannot support the hypothesis of nasal bone as a reservoir for Staphylococcus aureus, releasing massive amounts of staphylococcal enterotoxins and eliciting an inflammatory reaction, as occurs with the nasal mucosa.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Otorhinolaryngology, University of São Paulo, São Paulo, Brazil. pezatobau@ig.com.br.

ABSTRACT

Unlabelled: The superantigenic properties of Staphylococcus aureus have been implicated in increasing the inflammatory process in airway diseases. Local formation of IgE antibodies against staphylococcal enterotoxins by secondary lymphoid tissue in nasal polyps has been demonstrated. Staphylococcus aureus is known to colonize the nasal mucosa, and has been found invading the nasal submucosa and intracellularly.

Objective: To evaluate the limits of Staphylococcus aureus invasion in the upper airway.

Material and methods: Inferior turbinate samples from 3 patients without sinus disease, 6 ethmoid samples from patients with chronic rhinosinusitis with nasal polyposis, and 6 ethmoid samples from patients with chronic rhinosinusitis without nasal polyposis were studied. A fluorescein-labeled PNA probe against Staphylococcus aureus was used to test for the presence of the bacterium in bone (after decalcification) and mucosa.

Results: We found Staphylococcus aureus invading the nasal submucosa in patients with nasal polyposis, but no cases of Staphylococcus aureus positivity in bone. In conclusion, we cannot support the hypothesis of nasal bone as a reservoir for Staphylococcus aureus, releasing massive amounts of staphylococcal enterotoxins and eliciting an inflammatory reaction, as occurs with the nasal mucosa.

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Nasal mucosa stained with hematoxylin and eosin. A, demonstrates mucus-secreting glands, hemorrhagic foci and lymphocytic infiltration in the mucosa of the inferior turbinate of a healthy subject (×400 magnification); B, lymphoplasmacytic and eosinophil infiltration of the ethmoidal mucosa in a patient with CRSsNP (×400 magnification); C, inset, pseudostratified columnar epithelium with edema of the lamina propria and lymphocytic and eosinophil infiltration of a nasal polyp in a patient with CRSwNP (×100 magnification).
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Figure 2: Nasal mucosa stained with hematoxylin and eosin. A, demonstrates mucus-secreting glands, hemorrhagic foci and lymphocytic infiltration in the mucosa of the inferior turbinate of a healthy subject (×400 magnification); B, lymphoplasmacytic and eosinophil infiltration of the ethmoidal mucosa in a patient with CRSsNP (×400 magnification); C, inset, pseudostratified columnar epithelium with edema of the lamina propria and lymphocytic and eosinophil infiltration of a nasal polyp in a patient with CRSwNP (×100 magnification).

Mentions: Hematoxylin and eosin (H&E) staining was used to assess the presence of cells in mucosa specimens and, especially, in the bone specimens after decalcification. The H&E stain demonstrated epithelium in the nasal mucosa and submucosa of our samples (Figure 2), and bone cells in the decalcified ethmoid bone and inferior turbinate specimens (Figure 3).


Bone: the final frontier for Staphylococcus aureus penetration in chronic rhinosinusitis.

Pezato R, Bottura L, de Paula Santos R, Voegels RL, Bachi AL, Gregório LC - J Otolaryngol Head Neck Surg (2013)

Nasal mucosa stained with hematoxylin and eosin. A, demonstrates mucus-secreting glands, hemorrhagic foci and lymphocytic infiltration in the mucosa of the inferior turbinate of a healthy subject (×400 magnification); B, lymphoplasmacytic and eosinophil infiltration of the ethmoidal mucosa in a patient with CRSsNP (×400 magnification); C, inset, pseudostratified columnar epithelium with edema of the lamina propria and lymphocytic and eosinophil infiltration of a nasal polyp in a patient with CRSwNP (×100 magnification).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3722010&req=5

Figure 2: Nasal mucosa stained with hematoxylin and eosin. A, demonstrates mucus-secreting glands, hemorrhagic foci and lymphocytic infiltration in the mucosa of the inferior turbinate of a healthy subject (×400 magnification); B, lymphoplasmacytic and eosinophil infiltration of the ethmoidal mucosa in a patient with CRSsNP (×400 magnification); C, inset, pseudostratified columnar epithelium with edema of the lamina propria and lymphocytic and eosinophil infiltration of a nasal polyp in a patient with CRSwNP (×100 magnification).
Mentions: Hematoxylin and eosin (H&E) staining was used to assess the presence of cells in mucosa specimens and, especially, in the bone specimens after decalcification. The H&E stain demonstrated epithelium in the nasal mucosa and submucosa of our samples (Figure 2), and bone cells in the decalcified ethmoid bone and inferior turbinate specimens (Figure 3).

Bottom Line: Inferior turbinate samples from 3 patients without sinus disease, 6 ethmoid samples from patients with chronic rhinosinusitis with nasal polyposis, and 6 ethmoid samples from patients with chronic rhinosinusitis without nasal polyposis were studied.We found Staphylococcus aureus invading the nasal submucosa in patients with nasal polyposis, but no cases of Staphylococcus aureus positivity in bone.In conclusion, we cannot support the hypothesis of nasal bone as a reservoir for Staphylococcus aureus, releasing massive amounts of staphylococcal enterotoxins and eliciting an inflammatory reaction, as occurs with the nasal mucosa.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Otorhinolaryngology, University of São Paulo, São Paulo, Brazil. pezatobau@ig.com.br.

ABSTRACT

Unlabelled: The superantigenic properties of Staphylococcus aureus have been implicated in increasing the inflammatory process in airway diseases. Local formation of IgE antibodies against staphylococcal enterotoxins by secondary lymphoid tissue in nasal polyps has been demonstrated. Staphylococcus aureus is known to colonize the nasal mucosa, and has been found invading the nasal submucosa and intracellularly.

Objective: To evaluate the limits of Staphylococcus aureus invasion in the upper airway.

Material and methods: Inferior turbinate samples from 3 patients without sinus disease, 6 ethmoid samples from patients with chronic rhinosinusitis with nasal polyposis, and 6 ethmoid samples from patients with chronic rhinosinusitis without nasal polyposis were studied. A fluorescein-labeled PNA probe against Staphylococcus aureus was used to test for the presence of the bacterium in bone (after decalcification) and mucosa.

Results: We found Staphylococcus aureus invading the nasal submucosa in patients with nasal polyposis, but no cases of Staphylococcus aureus positivity in bone. In conclusion, we cannot support the hypothesis of nasal bone as a reservoir for Staphylococcus aureus, releasing massive amounts of staphylococcal enterotoxins and eliciting an inflammatory reaction, as occurs with the nasal mucosa.

Show MeSH
Related in: MedlinePlus