In vivo and in vitro suppression of lymphocyte function in Aspergillus sinusitis

Abstract

In about 10% of patients who are operated on for chronic sinusitis, an aspergilloma is found in the affected paranasal sinus. In order to detect possible underlying immune defects, 25 patients with aspergillomas were subjected to an immunological screening program. The data obtained were compared with those of patients with non-mycotic chronic sinusitis and healthy controls. Total lymphocyte counts and immunoglobulin levels were normal in both groups with sinusitis. However, leukocyte subset analyses using membrane fluorescence revealed a significant decrease of CD11+ cells (macrophages, monocytes and natural killer-cells) in both types of sinusitis. Furthermore, a markedly enhanced frequency of CD25+ cells (interleukin 2-receptor-bearing cells), was observed in patients with the aspergillomas. Additionally, peripheral blood lymphocytes in both groups of patients showed a significant reduction in the proliferative response to both T- and B-cell mitogens, with the values for the mitogens ConA and PHA being significantly lower in the aspergilloma patients as compared to those with non-mycotic sinusitis. This lack of lymphocyte stimulation in the aspergilloma group was also manifest in skin tests to recall antigens. These first data suggest that there is an immune deficiency in patients with chronic sinusitis caused by Aspergillus fumigatus. Further studies are needed to clarify if this defect is the cause or the result of the mycotic infection.

Maxillary sinus infection related to Aspergillus: case report and recent updates

“…Recently, fungal rhinosinusitis incidence increased due to the spread of different pathogens, the aging of the population, and the presence of comorbidities and chronic diseases, such as diabetes and immunological diseases requiring long-term steroid therapy immunosuppressive treatments (12). In a study by Loidolt et al (13), approximately the frequency of fungal rhinosinusitis was 10% of all patients who underwent surgical treatment due to chronic sinusi-tis. Innovation in medical technology, including advancements in radiological imaging and diagnostic endoscopy, allowed to define the disease classification, diagnosis, and management (8).…”

Atypical fungal maxillar sinusitis - case report

“…In the recent years, there is an upward trend of fungal sinusitis. Loidolt et al (3) observed, that around 10% of all patients operated due to chronic sinusitis suffered from fungal infection. Diagnostics of fungal sinusitis is repeatedly slowed because its clinical picture does not differ significantly from the clinical picture of bacterial inflammations.…”

Serum Immunoglobulins and IgG Subclass Levels in Sinus Mycetoma

“…2,9 On the other hand, sinus mycetoma can affect healthy subjects with competent immune systems. 10 Loidolt et al 6 reported that aspergilloma of the paranasal sinuses is associated with immunological dysfunction involving both B and T cells. However, diminished lymphocyte stimulation could result from mycotic infection.…”

“…It is usually seen in immunocompetent subjects 5 . However, suppression of lymphocyte function has been reported in some patients with sinus mycetoma 6 . To clarify the immunologic aspects of sinus mycetoma, serum immunoglobulins and IgG subclass levels were measured in sinus mycetoma patients and compared with those of ordinary chronic rhinosinusitis patients with or without nasal polyps.…”