Relationship between staphylococcal enterotoxin superantigens and the development of chronic rhinosinusitis

Medicine (Baltimore). 2026 Jan 9;105(2):e46951. doi: 10.1097/MD.0000000000046951.

Abstract

Chronic rhinosinusitis (CRS), a common upper respiratory disease, has been closely linked to Staphylococcus aureus and its enterotoxin superantigens. However, the specific mechanisms by which staphylococcal enterotoxin superantigens contribute to CRS pathophysiology remain unclear. To investigate the association between staphylococcal enterotoxin superantigen activity and CRS. A case-control epidemiological study was conducted from February 2022 to February 2024 at Northern Jiangsu People's Hospital. Seventy-eight patients with CRS constituted the case group, and 78 patients undergoing septum surgery served as controls. CRS cases were further divided into CRS without nasal polyps (n = 42) and CRS with nasal polyps (CRSwNP, n = 36). Nasal tissue homogenates were analyzed by enzyme-linked immunosorbent assay to measure anti-SEA, anti-SEB, anti-SEC, anti-SED, and anti-SEE IgE levels. Histopathological examination of nasal polyps was performed using hematoxylin-eosin staining. Statistical analyses included the t-test or Mann-Whitney U test for group comparisons, with P < .05 considered statistically significant. Anti-SEA, anti-SEB, anti-SEC, anti-SED, and anti-SEE IgE levels were significantly higher in the observation group (2190.23 (120.47), 1722.29 (115.39), 1983.16 (103.16), 2120.14 (132.44), and 1955.17 (112.56) ng/mL, respectively) compared with controls (245.45 (67.28), 293.10 (87.03), 323.13 (121.34), 283.11 (91.13), and 302.11 (88.24) ng/mL; all P < .05). Within CRS subgroups, anti-SEB IgE was markedly higher in CRSwNP (2833.32 (167.07) ng/mL) than in CRS without nasal polyps (1862.26 (98.09) ng/mL; P < .05). Of the 36 CRSwNP cases, 8 were eosinophilic and 28 non-eosinophilic. Elevated IgE antibodies against SEA, SEB, SEC, SED, and SEE may contribute to CRS onset and progression, with anti-SEB IgE showing a particularly strong link to nasal polyp development.

Keywords: chronic sinusitis; nasal polyps; staphylococcal enterotoxin; superantigen effects.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Chronic Disease
  • Enterotoxins* / immunology
  • Female
  • Humans
  • Immunoglobulin E / blood
  • Male
  • Middle Aged
  • Nasal Polyps / immunology
  • Nasal Polyps / microbiology
  • Rhinitis* / epidemiology
  • Rhinitis* / immunology
  • Rhinitis* / microbiology
  • Rhinosinusitis
  • Sinusitis* / epidemiology
  • Sinusitis* / immunology
  • Sinusitis* / microbiology
  • Staphylococcus aureus* / immunology
  • Superantigens* / immunology

Substances

  • Enterotoxins
  • Superantigens
  • Immunoglobulin E