{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T20:14:28Z","timestamp":1773173668075,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2011,7,4]],"date-time":"2011-07-04T00:00:00Z","timestamp":1309737600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2011,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate a potential mechanism by which superantigens could induce glucocorticoid insensitivity in chronic rhinosinusitis (CRS) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Sinonasal polyps were obtained from CRS patients with nasal polyps (CRSwNP; 20 without recurrence, 18 with recurrent NP followed for 1.5\u20102.0 years) and nasal mucosa from 16 CRS patients without nasal polyps (CRSsNP). Specimens were tested by enzyme\u2010linked immunosorbent assay for staphylococcal exotoxins (SEs) including SEA, SEB, SEC, SED, and toxic shock syndrome toxin type\u20101 (TSST\u20101) and assessed by immunohistochemistry for glucocorticoid receptor (GR) \u03b1 and \u03b2, and the GR\u03b2\/GR\u03b1 ratio was analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In CRSwNP, 13 of 18 (72.22%) subjects with subsequently recurrent NP, 11 of 20 (55.00%) subjects without NP recurrence, and 1 of 16 (6.25%) CRSsNP subjects with positive reactions for SEs were obtained. There were no positive results in controls. The expressions of GR\u03b2 in 3 CRS groups and controls were significantly different (all <jats:italic>P<\/jats:italic> &lt;. 05), and a similar increasing tendency of the GR\u03b2\/GR\u03b1 ratio was found among groups besides the comparison of CRSwNP versus recurrent NP groups (<jats:italic>P<\/jats:italic> =. 053). Furthermore, there was a clear trend of increased GR\u03b2 expression in the enzyme\u2010linked immunosorbent assay (ELISA)\u2013positive samples compared with ELISA\u2010negative samples. Concerning GR\u03b1, the expression was enhanced significantly just in toxin\u2010positive recurrent NP versus controls (<jats:italic>P<\/jats:italic> =. 048), but the relative induction of GR\u03b2 was much higher, thereby leading to a higher GR\u03b2\/GR\u03b1 ratio.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Bacterial superantigens may contribute to glucocorticoid insensitivity through induction of GR\u03b2, which appears to be a marker of steroid insensitivity in CRSwNP.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599811413859","type":"journal-article","created":{"date-parts":[[2011,7,4]],"date-time":"2011-07-04T22:41:57Z","timestamp":1309819317000},"page":"717-722","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Superantigen\u2010Induced Glucocorticoid Insensitivity in the Recurrence of Chronic Rhinosinusitis with Nasal Polyps"],"prefix":"10.1002","volume":"145","author":[{"given":"Mingming","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Provincial Hospital affiliated to Shandong University Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of General Surgery Provincial Hospital affiliated to Shandong University Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Hospital of the University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guanggang","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Provincial Hospital affiliated to Shandong University Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Provincial Hospital affiliated to Shandong University Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haibo","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Provincial Hospital affiliated to Shandong University Jinan 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