Abstract
In the airway, IgE is traditionally regarded as a key mediator in
allergic diseases, such as AR and allergic asthma. However, growing
evidence demonstrates the importance of local IgE in airway inflammatory
diseases, irrespective of the presence of allergy. In this review, we
discuss the most recent evidence for IgE in chronic rhinosinusitis with
nasal polyps(CRSwNP), including the local IgE’s characteristics, the
modulation of its synthesis, and function. The levels of local IgE are
significantly elevated in polyps independently of IgE serum levels and
atopic status. Local IgE is polyclonal and functional, which is
correlated with type 2 inflammation. IgE is produced by active B cells
and is dependent on the classing switch recombination(CSR). In NPs, this
process is triggered by not only allergens but also microbial
colonization, especially the superantigen- Staphylococcus aureus.
The production of local IgE is modulated by lymphocytes(such as Tfh,
ILC2s, iTreg), cytokines(such as IL-4, IL-13, IFN-γ, TGF-β, IL-2,
IL-21), transcription factors, and B cell intrinsic factor. Due to the
central role of IgE in NPs, it is regarded as an ideal target for
therapy and has been proved to be clinically successful. Based on this
knowledge, we believe that exploring the trigger and regulatory factors
for the activation of local B cells and CSR to IgE will
provide more valuable information for us to recognize the pathological
mechanisms of local IgE and offer the possible option for new
[therapeutic](#/javascript:;) targets of NPs.