Natural immunity to dust mites in patients with chronic rhinosinusitis.

Chronic rhinosinusitis is an extremely common clinical problem of which the etiology is poorly understood. To understand the role of common environmental antigens in this disease, natural immunity to antigens derived from the house dust mite was evaluated in 22 adults with chronic rhinosinusitis and compared to a carefully matched group of patients with chronic asthma or to a group of normal individuals. Allergic reactivity to dust mites was very common in patients with chronic rhinosinusitis, with 68% exhibiting a positive immediate skin test reaction and 41% exhibiting elevated levels of mite-specific serum IgE; 72% of patients with rhinosinusitis also exhibited markedly elevated levels of mite-specific serum IgG, which were present in both mite-allergic and nonallergic patients. IgG titers were much higher in the group with rhinosinusitis than in patients with asthma, whereas allergic reactivity to dust mites was significantly higher in the patients with asthma. Mite-specific immunity was low or absent in the group of normal individuals. These findings demonstrate that natural immunity to dust mites is very common in patients with chronic rhinosinusitis and suggest that immunity to mites may be involved in this syndrome. Furthermore, the data indicate that there may be significant differences in the ability of patients with rhinosinusitis or asthma to produce mite-specific antibodies of the IgG class.