Quantitative analysis of fungal DNA in chronic rhinosinusitis.
OBJECTIVE
Fungi have been recognized as important pathogens in sinusitis; however, they are equally present in patients with and without sinusitis. The authors postulated that the quantity of fungal DNA in the nose is determinant of disease, is greater in patients with chronic rhinosinusitis, and is directly correlated to their quality of life.


METHODS
Prospective recruitment of patients with chronic rhinosinusitis.


METHODS
Objective quality of life data were collected using three validated questionnaires: the Sinonasal Outcomes Test (SNOT-20), Medical Outcomes Short-Form 36 Survey (SF-36), and Guy Marks Asthma Questionnaire (GMAQ). Endoscopically guided middle meatus mucosal samples were collected from patients with chronic rhinosinusitis and normal control subjects. Fungal-specific polymerase chain reaction was performed on each sample. Every fungal-positive sample underwent fungal-specific quantitative polymerase chain reaction analysis. Statistical analysis was used to correlate fungal DNA quantities with outcomes indices between groups.


RESULTS
Patients with chronic rhinosinusitis had a mean SNOT-20 index of 32.0 as compared with a SNOT-20 index of 17.3 (P <.01) in the normal control subjects. There were no statistical differences between the groups' indices for the SF-36 or GMAQ outcomes questionnaires. Four of 19 (21.1%) patients with chronic rhinosinusitis and 7 of 19 (36.8%) normal control subjects had positive findings for fungal DNA using polymerase chain reaction. The median relative quantity of fungal DNA to human DNA for chronic rhinosinusitis and control samples was identical (0.13) using quantitative polymerase chain reaction.


CONCLUSIONS
The quantity of fungal DNA in the middle meatus did not differ in patients with and without chronic rhinosinusitis and was not correlated with quality of life outcomes. Therefore, the quantity of fungi does not explain pathogenicity in patients with chronic rhinosinusitis. However, because of small sample size, the study must be replicated in a larger patient population.
Scheuller
Michael C
MC
Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California 94143-0342, USA.
Murr
Andrew H
AH
Goldberg
Andrew N
AN
Mhatre
Anand N
AN
Lalwani
Anil K
AK
D002908:Chronic Disease; D004271:DNA, Fungal / Q000032:analysis*; D006801:Humans; D009181:Mycoses / Q000382:microbiology*; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D011788:Quality of Life; D012220:Rhinitis / Q000382:microbiology*; D012852:Sinusitis / Q000382:microbiology*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires
D004271:DNA, Fungal