Anti-phospholipid antibodies are elevated and functionally active in chronic rhinosinusitis with nasal polyps.

Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology 2022 Aug

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Polyps from patients with chronic rhinosinusitis with nasal polyps (CRSwNP) contain increased levels of autoreactive antibodies, B cells and fibrin deposition. Anti-phospholipid antibodies (APA) are autoantibodies known to cause thrombosis but have not been implicated in chronic rhinosinusitis (CRS). To compare APA levels (anti-cardiolipin, anti-phosphatidylethanolamine (anti-PE), and anti-β2 -glycoprotein (anti-B2GP)) in nasal polyp (NP) tissue with tissue from control and CRS without nasal polyp (CRSsNP) patients, we tested whether NP antibodies affect coagulation, and correlate APAs with anti-dsDNA IgG and markers of coagulation. Patient specimens were assayed for APA IgG, anti-dsDNA IgG and thrombin-anti-thrombin (TaT) complex by ELISA. Antibodies from a subset of specimens were tested for modified activated partial thromboplastin time (aPTT) measured on an optical-mechanical coagulometer. Anti-cardiolipin IgG in NP was 5-fold higher than control tissue (p < .0001). NP antibodies prolonged aPTT compared to control tissue antibodies at 400 µg/mL (36.7 s vs. 33.8 s, p = .024) and 600 µg/mL (40.9 s vs. 34.7 s, p = .0037). Anti-PE IgG antibodies were increased in NP (p = .027), but anti-B2GP IgG was not significantly higher (p = .084). All APAs correlated with anti-dsDNA IgG levels, which were also elevated (R = .77, .71 and .54, respectively, for anti-cardiolipin, anti-PE, and anti-B2GP; all p < .001), but only anti-cardiolipin (R = .50, p = .0185) and anti-PE (R = 0.45, p = .037) correlated with TaT complex levels. APA IgG antibodies are increased in NP and correlate with autoreactive tissue antibodies. NP antibodies have in vitro anti-coagulant activity similar to those observed in anti-phospholipid syndrome, suggesting that they may have pro-coagulant effects in polyp tissue. © 2022 The Authors. Clinical & Experimental Allergy published by John Wiley & Sons Ltd.

Citation

Jacob G Eide, Jeffanie Wu, Whitney W Stevens, Junqin Bai, Songwang Hou, Julia H Huang, Jacob Rosenberg, Paul Utz, Stephanie Shintani-Smith, David B Conley, Kevin C Welch, Robert C Kern, Kathryn E Hulse, Anju T Peters, Leslie C Grammer, Ming Zhao, Paul Lindholm, Robert P Schleimer, Bruce K Tan. Anti-phospholipid antibodies are elevated and functionally active in chronic rhinosinusitis with nasal polyps. Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology. 2022 Aug;52(8):954-964