Aim: To compare serum IgG immune response against respiratory pathogens in patients with chronic airway disease( CRS/NP and asthma) with and without sensitivity to aspirin ,and to refer the sensitization to severity of chronic rhinosinusitis
Methods: We recruited 73 patients with CRS/NP and asthma with ( 43 patients) and without ( 30 patients ) hypersensitivity to aspirin . The extent of mucosal hypertrophy in paranasal sinuses was assessed by CT scans and the sense of smell was valuated with “sniffing smell” test . Serum IgG immunoglobulin levels against respiratory pathogens : Respiratory Syncytial Virus (RSV), Adenowirus (ADV) , Parainfluenza virus ( PIV) and Mycoplasma pneumoniae were determined by ELISA .
Results:
Patients with ASA-hypersensitivity had history of significantly more nasal polypectomies (p=0.002) , lower smell test score (p=0.03) and higher mean paranasal CT score ( p =0.03) as compared to ASA-tolerant patients, reflecting higher severity of the upper airway disease. The percentage of positive serological testing to respiratory pathogens was very high in the whole group of patients with CRS/NP and asthma ( RSV -95.8% ; ADV- 95.9%, PIV- 84.9% and Mycoplasma pneumonieae- 100% patients ) without any difference between ASA-sensitive and ASA-tolerant subjects. Patients with ASA-sensitivity had significantly lower concentrations of PIV- specific IgG ( mean 188.67±34.46 U/ml versus 207.56±30.036 U/ml ; p<0,04) as compared to ASA-tolerant subjects . There was a significant trend ( p<0,048 ) for lower PIV –specific IgG concentrations with increased number of polypectomies . No correlation of IgG immunoglobulin concentrations for other pathogens with the number of polypectomies, paranasal sinuses CT score or presence of smell were observed .
Conclusions: Patients with CRS/NP and asthma had high frequency of IgG immunoglobulin against common respiratory pathogens . Serum IgG immune response to paramyxoviruses may be related to the recurrence of nasal polyps and the presence of aspirin sensitivity .