[Treatment of sino-nasal polyposis by Candida albicans immunotherapy: apropos of 4 cases].
The NSP is an inflammatory chronic disease of the mucous of nose and sinuses. None etiological treatment is known up to now. The aim of this study is to consider a model of autoallergy as etiology for NSP proven by specific immunotherapy (STI) to Candida albicans (CA).


METHODS
Four NSP treated by SIT to Candida albicans are reported. The patients are treated either by subcutaneous injections or sublingual drops. The frequency is one injection per week or a few drops per day (absorbed extract on calcium phosphate or aqueous Stallergenes).


RESULTS
The cumulated doses varies from 465 Index of Concentration (IC) to 117500 IC on a period of 3 to 4 years. The results are evaluated according the rhino-sinusal semeiology, the intensity of symptoms, and the stage of polyposis. The SIT is also active on both a late and an immediate components for the symptoms, and the cutaneous tests. The results are significant 60% to 80% of improvement. The viral or bacterial infections reactivate both types of hypersensitivity and they are prevented by SIT. The nasal hyperactivity observed as a more advanced non specific stage of the PNS is also improved by ITS. In two of the clinical cases, the pollenogenic seasonal obstruction is added to the nasal perennial obstruction in a sharp manner. The pollenogenic allergy is also improved after SIT to CA without any other associated SIT.


CONCLUSIONS
The model of autoallergy already proven as etiology for atopic dermatitis can serve as a base of exploration of PNS. That is showing the presence of IgE antibody corresponding to intracellular proteinic autoallergens having an analogy to environment allergens. The allergy to Candida albicans can thus be considered as an etiology of the PNS.
Bénoliel
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P
D000328:Adult; D000485:Allergens / Q000008:administration & dosage / Q000276:immunology / Q000627:therapeutic use*; D000946:Antigens, Fungal / Q000008:administration & dosage / Q000276:immunology / Q000627:therapeutic use*; D001324:Autoantigens / Q000276:immunology; D001327:Autoimmune Diseases / Q000209:etiology / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D002176:Candida albicans / Q000276:immunology*; D003429:Cross Reactions; D003876:Dermatitis, Atopic / Q000276:immunology; D003888:Desensitization, Immunologic; D015521:Ethmoid Sinusitis / Q000150:complications / Q000628:therapy; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D008297:Male; D008875:Middle Aged; D018716:Molecular Mimicry; D009298:Nasal Polyps / Q000209:etiology / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D009364:Neoplasm Recurrence, Local; D010255:Paranasal Sinus Neoplasms / Q000209:etiology / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D011127:Polyps / Q000209:etiology / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D012221:Rhinitis, Allergic, Perennial / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications* / Q000628:therapy; D012882:Skin Tests
D000485:Allergens; D000946:Antigens, Fungal; D001324:Autoantigens; D007073:Immunoglobulin E