Role of Local Immunoglobulin E Production in the Pathophysiology of Noninvasive Fungal Sinusitis

Collins, Melanie M.; Nair, Salil; Smith, William B.; Kette, Frank; Gillis, David; Wormald, Peter John

doi:10.1097/00005537-200407000-00019

Cited by 89 publications

(84 citation statements)

References 21 publications

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“…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.…”

Section: Discussionmentioning

confidence: 96%

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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Section: Discussionmentioning

confidence: 96%

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

Suri

Bhavya

2018

Int J Otorhinolaryngol Head Neck Surg

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“…The role of TH2 inflammation and type I hypersensitivity in the pathogenesis of AFS is supported by studies that document elevated fungal specific IgE in the serum of patients with suspected AFS [45,46]. In one study, fungal specific IgE was commonly found in the mucin of affected patients [47]. Staining for major basic protein and neutrophil elastase has revealed increased amounts of these proteins in the mucin of patients with AFS suggesting that neutrophil and eosinophil degrannulation contribute to pathogenesis of AFS [48].…”

Section: Allergic Fungal Sinusitismentioning

confidence: 98%

Potential contribution of fungal infection and colonization to the development of allergy

Goldman

Huffnagle

2009

Med Mycol

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Fungi have long been recognized as an important source of allergens in patients with atopic disease. In this review, we explore the hypothesis that fungal exposures resulting in colonization or infection directly influence the tendency of an individual to develop allergic disease. According to this hypothesis, fungal exposures especially those early in life may influence the manner in which the immune response handles subsequent responses to antigen exposures. Studies detailing this potential connection between fungi have already provided important insights into the immunology of fungal-human interactions and offer the potential to provide new approaches and targets for the therapy of allergic disease. The first half of this review summarizes the data concerning fungal infections and asthma, including possible connections between fungal infections and urban asthma. The second half explores the potential role of the fungal gastrointestinal microbiota in promoting allergic inflammation.

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“…In 2004, Collins et al [39] identified fungus-specific IgE in paranasal sinus allergic mucin of patients with suspected AFRS undergoing endoscopic sinus surgery. These authors also evaluated systemic fungus-specific IgE levels in serum and detected fungus-specific IgE in sinus mucin in some patients in the absence of fungus-specific serum IgE [39].…”

Section: Localized Immunoglobulin E In Allergic Fungal Rhinosinusitismentioning

confidence: 99%

Localized immunoglobulin E expression in allergic rhinitis and nasal polyposis

Wise

Ahn

Schlosser

2009

Current Opinion in Otolaryngology & Head and Neck Surgery

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Role of Local Immunoglobulin E Production in the Pathophysiology of Noninvasive Fungal Sinusitis

Abstract: This is the first study to show that fungal-specific IgE may be demonstrated in sinus mucin. It was significantly associated with systemic fungal allergy and may play a role in a minority of fungal sinusitis patients in the absence of systemic fungal allergy.

Cited by 89 publications

References 21 publications

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

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

Potential contribution of fungal infection and colonization to the development of allergy

Localized immunoglobulin E expression in allergic rhinitis and nasal polyposis

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