Fungal-Specific Humoral Response in Eosinophilic Mucus Chronic Rhinosinusitis

Pant, Harshita; Kette, Frank; Smith, William B.; Wormald, Peter John; Macardle, Peter J.

doi:10.1097/01.mlg.0000161341.00258.54

Cited by 85 publications

(77 citation statements)

References 15 publications

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“…Orlandi et al, 369 however, replicated the methods of Shin et al 368 and had opposing results. They found that IL-5 levels correlated strongly with fungal-specific IgE, but did not correlate with fungal-specific IgG as described by Shin et al 368 In a study performed by Pant et al, 370 IgG1 and IgG3 isotypes to fungi were identified in CRS patients with eosinophilic mucin. The effect was independent of IgE sensitivity to fungus.…”

Section: S55mentioning

confidence: 78%

“…359,1078 This has stirred debate regarding AFRS pathophysiology. 370,1072,1076 CRSwNP, including AFRS, often involves a Th2-predominant immune response with eosinophilic inflammation. 1071,1079,1080 Theoretically, the primary stimulus in AFRS is a Type I IgE-mediated hypersensitivity to ubiquitous fungal allergens.…”

Section: Viiig Crswnp and Afrs: Differences In Pathophysiologymentioning

confidence: 99%

“…1073,1075,1076,1081,1083,1084 Interestingly, correlation between fungal species in mucin and systemic fungal allergy was poor in 1 Australian study. 370 Clinically, AFRS tends to be a more severe form of CRSwNP. Characteristic CT scan findings include increased density of material within sinus cavities and expansion or erosion of paranasal sinus bony walls.…”

Section: Viiig Crswnp and Afrs: Differences In Pathophysiologymentioning

confidence: 99%

“…1071,1073,1074 Elevated IgG3 levels specific to Alternaria alternata and Aspergillus fumigatus distinguished eosinophilic RS, including AFRS, from control groups. 370 Staphylococcus aureus is a common organism in polypoid RS, and may modify these disease processes as a direct pathogen or via superantigen production. 903,925,1084,1093,1094 S. aureus colonization is more prevalent in AFRS vs other CRSwNP subtypes.…”

Section: Viiig Crswnp and Afrs: Differences In Pathophysiologymentioning

confidence: 99%

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International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

554

888

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Background:The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications, yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). Methods:Evidence-based reviews with recommendations (EBRRs) were developed for scores of topics, using previously reported methodology. Where existing evidence was insufficient for an EBRR, an evidence-based review (EBR) was produced. The sections were then synthesized and the entire manuscript was then reviewed by all authors for consensus. Results:The resulting ICAR:RS document addresses multiple topics in RS, including acute RS (ARS), chronic RS (CRS) with and without nasal polyps (CRSwNP and CRSsNP), recurrent acute RS (RARS), acute exacerbation of CRS (AE-CRS), and pediatric RS. Conclusion:As a critical review of the RS literature, ICAR:RS provides a thorough review of pathophysiology and evidence-based recommendations for medical and surgical treatment. It also demonstrates the significant gaps in our understanding of the pathophysiology and optimal management of RS. Too o en the foundation upon which these recommendations are based is comprised of lowerlevel evidence. It is our hope that this summary of the evidence in RS will point out where additional research efforts may be directed. C 2016 ARS-AAOA, LLC. Key Words:rhinosinusitis; chronic rhinosinusitis; acute rhinosinusitis; recurrent acute rhinosinusitis; evidence-based medicine; systematic review; endoscopic sinus surgery List of Abbreviations Used

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Section: S55mentioning

confidence: 78%

Section: Viiig Crswnp and Afrs: Differences In Pathophysiologymentioning

confidence: 99%

Section: Viiig Crswnp and Afrs: Differences In Pathophysiologymentioning

confidence: 99%

Section: Viiig Crswnp and Afrs: Differences In Pathophysiologymentioning

confidence: 99%

See 2 more Smart Citations

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

Orlandi

Kingdom

Hwang

et al. 2016

Int Forum Allergy Rhinol

554

888

View full text Add to dashboard Cite

show abstract

“…18 Pant et al in his study demonstrated the significance of humoral immunity in the pathogenesis of AFRS. 19 He studied patients with eosinophilic mucin CRS, polypoid rhinosinusitis with or without fungal elements. He stated that elevated levels of fungal-specific IgG3, rather than total serum IgE, is more specific in diagnosing AFRS.…”

Section: Discussionmentioning

confidence: 99%

Allergic fungal rhinosinusitis: an overview on pathogenesis, early diagnosis and management

Suri

Bhavya

2018

Int J Otorhinolaryngol Head Neck Surg

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Background: The objective of the study was to evaluate the criteria for diagnosing allergic fungal rhinosinusitis and to maintain permanent drainage and ventilation, while preserving the integrity of the mucosa. Methods: This is a prospective study of 50 patients with allergic fungal sinusitis with or without polyposis all of whom were treated with endoscopic debridement. Mucous sample collection, nasal secretion culture, surgical specimen handling, and histological evaluation of surgical specimens are described. All patients treated with endoscopic sinus surgery, debridement, post-operative use of steroids and antifungal therapy. Results: Fungal mucin was found in all 50 cases, histology and fungal cultures confirmed the diagnosis. Out of 50 patients, 29 were females and 21 were males, with a mean age of 32 years. The most common symptom was nasal discharge 41 (82%) cases, nasal obstruction in 38 (76%) cases, headache and facial pain in 32 (72%) cases, 7 (14%) patients had bronchial asthma. Symptoms of nasal obstruction and nasal discharge were improved in 46 (92%) cases. All preoperative versus postoperative changes in AFRS associated complaints reached statistical significance of p value <0.001 except in patients with asthma. Conclusions: Comprehensive management with endoscopic sinus surgery, oral steroids and antifungals reduces the recurrence or need for revision surgery. Long term follow up is very important.

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