Skip to main content

Humoral Primary Immunodeficiencies in Chronic Rhinosinusitis

Current Allergy and Asthma Reports volume 15, Article number: 46 (2015) Cite this article

Abstract

Chronic rhinosinusitis (CRS) may be the primary presenting symptom for primary immunodeficiencies (PID). PID can affect the humoral or the cellular immune system. This paper provides an overview of PID which affect the humoral immune system, with details around the diagnostic criteria, the epidemiology, the subtypes, the clinical manifestations, underlying molecular mechanisms, methods to screen for PID and the management of CRS in the context of PID. A high clinical suspicion of PID is required when assessing patients with CRS who are refractory to maximal medical therapy.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3

Abbreviations

CRS:

Chronic rhinosinusitis

CVID:

Common variable immunodeficiency

Ig:

Immunoglobulin

SAD:

Specific antibody deficiency

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Fokkens WJ, Lund VJ, Mullol J, Bachert C et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2012. Rhinology. 2012; 50(S23).

  2. Alromaih S, Mfuna-Endam L, Bosse Y, Mouhim AF, et al. CD8A gene polymorphisms predict severity factors in chronic rhinosinusitis. Int Forum Allergy Rhinol. 2013;3(8):605–11.

    PubMed  Article  Google Scholar 

  3. Bernatowska E, Mikoluc B, Krezeski A, Piatosa B, et al. Chronic rhinosinusitis in primary antibody immunodeficient patients. Int J Pediatr Otorhinolaryngol. 2006;70:1587–92.

    PubMed  Article  Google Scholar 

  4. Ocampo CJ, Peters AT. Antibody deficiency in chronic rhinosinusitis: epidemiology and burden of illness. Am J Rhinol Allergy. 2013;27:34–8. (double bullet point) Excellent and thorough review on the four most common primary immunodeficiencies, their relation with chronic rhinosinusitis and treatment options.

    PubMed Central  PubMed  Article  Google Scholar 

  5. Srinvasa BT, Alizadehfar R, Desrosiers M, Shuster J, et al. Adult primary immune deficiency: what are we missing? Am J Med. 2012;125:779–86. (single bullet point) The study highlights the importance of maintaining a high level of clinical suspicion to identify patients with primary immunodeficiencies.

    Article  Google Scholar 

  6. Baraniuk JN, Maibach H. Pathophysiological classification of chronic rhinosinusitis. Respir Res. 2005;6(149):1–14.

    Google Scholar 

  7. Al-Herz W, Bousfiha A, Casanova JL, Chatila T, et al. Primary immunodeficiency diseases: an update on the classification from the International Union of Immunological Societies Expert Committee for Primary Immunodeficiency. Front Immunol. 2014;5:162. (single bullet point) Thorough update on the new classification of primary immunodeficiencies.

    PubMed Central  PubMed  Google Scholar 

  8. Joshi AY, Iyer VN, Hagan JB, St. Sauver JL, et al. Incidence and temporal trends of primary immunodeficiency: a population-based cohort study. Mayo Clin Proc. 2009;84(1):16–22.

    PubMed Central  PubMed  Article  Google Scholar 

  9. Kobrynski L, Powell RW, Bowen S. Prevalence and morbidity of primary immunodeficiency diseases, United States 2001–2007. J Clin Immunol. 2014;34(8):954–61.

    PubMed  Article  Google Scholar 

  10. Frieri M. Good’s syndrome, CVID, and selective antibody deficiency in patients with chronic rhinosinusitis. Curr Allergy Asthma Rep. 2014;14:438. (single bullet point) Review of primary immunodeficiencies and their relation to CRS.

    PubMed  Article  Google Scholar 

  11. Hagan JB, Park MA, Kita H, Campeau NG. Reduced immunoglobulin M is associated with sinus mucosal thickening, osteitis and sinus surgery in patients with common variable immunodeficiency. Int Arch Allergy Immunol. 2010;152:81–6.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  12. Urschel S, Kayikci L, Wintergerst U, Notheis G, Jansson A, Belohradsky BH. Common variable immunodeficiency disorders in children: delayed diagnosis despite typical clinical presentation. J Pediatr. 2009;154(6):888–94.

    PubMed  Article  Google Scholar 

  13. http://primaryimmune.org/about-primary-immunodeficiencies/specific-disease-types/specific-antibody-deficiency/. Accessed February 12, 2015.

  14. Rael EL, Marshall RT, McClain JJ. The hyper-IgE syndromes: lessons in nature. From bench to bedside. WAO J. 2012;5:79–87.

    CAS  Google Scholar 

  15. Saremnto Jr KMA, Tomita S, Gurgel JDC. Association between nasal polyposis, Dubowitz syndrome and hyper IgE syndrome. Int J Pediatr Otorhinolaryngol. 2008;72:711–4.

    Article  Google Scholar 

  16. Chee L, Graham SM, Carothers DG, Ballas ZK. Immune dysfunction in refractory sinusitis in a tertiary care setting. Laryngoscope. 2001;111(2):233–5.

    CAS  PubMed  Article  Google Scholar 

  17. Cook MC, Tangye SG. Primary immune deficiencies affecting lymphocyte differentiation: lessons from the spectrum of resulting infections. Int Immunol. 2009;21(9):1003–11.

    CAS  PubMed  Article  Google Scholar 

  18. Frieri M. Complement-related diseases. Allergy Asthma Proc. 2002;23:319–24.

    PubMed  Google Scholar 

  19. van de Ven AA, Compeer EB, van Montfrans JM, et al. B-cell defects in common variable immunodeficiency: BCR signaling, protein clustering and hardwired gene mutations. Crit Rev Immunol. 2011;31:85–98.

    PubMed  Article  Google Scholar 

  20. Park JH, Resnick ES, Cunningham-Rundles C. Perspectives on common variable immune deficiency. Ann N Y Acad Sci. 2012;1246:41–9.

    Article  Google Scholar 

  21. May A, Zielen S, von Ilberg C, Weber A. Eur Arch Otorhinolaryngol. 1999;256:445–9.

    CAS  PubMed  Article  Google Scholar 

  22. Vanlerberghe L, Joniau S, Jorissen M. The prevalence of humoral immunodeficiency in refractory rhinosinusitis: a retrospective analysis. B-ENT. 2006;2:161–6.

    CAS  PubMed  Google Scholar 

  23. Casanova JL, Abel L. The human model: a genetic dissection of immunity to infection in natural conditions. Nat Rev Immunol. 2004;4:55–66.

    CAS  PubMed  Article  Google Scholar 

  24. LaRosa DF, Patel CS. Clinical characteristics of adult patients with isolated low IgG and abnormal response to Pneumovax. J Allergy Clin Immunol. 2012;129(Issue 2, Supplement):AB83.

    Google Scholar 

  25. Khalid AN, Mace JC, Smith TL. Outcomes of sinus surgery in ambulatory patients with immune dysfunction. Am J Rhinol Allergy. 2010;24:230–3. (single bullet point) Article emphasizes that the surgical outcomes in patients with chronic rhinosinusitis and primary immunodeficiency after endoscopic sinus surgery does not differ from those patients without primary immunodeficiency.

    PubMed Central  PubMed  Article  Google Scholar 

Download references

Acknowledgments

The authors have received no grants or financial support in association with this material.

Compliance with Ethics Guidelines

ᅟ

Conflict of Interest

This material has never been published and is not currently under evaluation in any other peer-reviewed publication. The authors declare that they have no competing interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Centre Hospitalier Université de Montréal (CHUM), Université de Montréal, Pavillon Hôtel-Dieu, 3840 Avenue St Urbain, Montréal, QC, H2W 1T8, Canada

    Smriti Nayan & Martin Desrosiers

  2. Cambridge Memorial Hospital, Cambridge, ON, Canada

    Smriti Nayan

  3. Department of Pediatrics & Division of Allergy and Clinical Immunology, Montreal Children’s Hospital, Montreal General Hospital, Lakeshore General Hospital, McGill University, Montreal, QC, Canada

    Reza Alizadehfar

  4. Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC, Canada

    Martin Desrosiers

  5. Department of Otolaryngology-Head and Neck Surgery, Montreal General Hospital, McGill University, Montreal, QC, Canada

    Martin Desrosiers

Authors
  1. Smriti Nayan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Reza Alizadehfar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Martin Desrosiers
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Smriti Nayan.

Additional information

This article is part of the Topical Collection on Rhinosinusitis

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Nayan, S., Alizadehfar, R. & Desrosiers, M. Humoral Primary Immunodeficiencies in Chronic Rhinosinusitis. Curr Allergy Asthma Rep 15, 46 (2015). https://doi.org/10.1007/s11882-015-0547-8

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11882-015-0547-8

Keywords

  • Primary immunodeficiencies
  • Humoral
  • Antibody
  • Chronic rhinosinusitis