Immunopathologic Study of Chronic Sinusitis: A Proposal for Atopic and Non-Atopic IgE-Activated Mast Cell Allergic Inflammation

Abstract

Paranasal sinus mucosa was examined in this study for mast cell membrane-bound IgE. The study material was from 54 patients identified in hospital records as having one of the following diagnoses: chronic sinusitis, chronic sinusitis with asthma, or chronic sinusitis with associated nasal polyps. Formalin-fixed tissue samples taken during endoscopic sinus surgery were routinely processed and examined with hematoxylin and eosin stains. Additional sectioned tissue was analyzed by fluorescence microscopy for mast cells after the use of anti-IgE and anti-tryptase antisera; 45% of the cases of chronic sinusitis, 50% of the cases of chronic sinusitis with polyposis, and 69% of the cases of chronic sinusitis with asthma exhibited 10 or more IgE-positive mast cells in the sinus mucosa. Significant numbers of individuals with chronic sinusitis have coexistent allergic disorders. Some individuals in this study who were not allergic by hospital record review also manifested IgE-positive mast cells in the sinus mucosa; a basis for this finding is proposed.