Chronic rhinosinusitis and superantigens

Effects on nasal polyp tissue consistent with local exposure to superantigens are seen in about 50% of patients with chronic rhinosinusitis and nasal polyps. It has been hypothesized that polyp formation is potentiated by chronic TH2 stimulation and cytokine release in response to local superantigen production. However, superantigens probably do not cause polyps, as a similar phenotypic picture can be demonstrated in their absence. Superantigens play no clear role in TH1 polyps such as that seen in cystic fibrosis. Superantigens should be considered to be disease modifiers rather than causative agents in patients with chronic rhinosinusitis and nasal polyps. The presence of superantigens can stimulate polyp formation and growth by accentuating and dysregulating the local mucosal immune response.