Immunologic response to fungus is not universally associated with chronic rhinosinusitis.
In the December 2009 issue of this journal, Orlandi et al presented a study in which peripheral blood mononuclear cells (PBMCs) from chronic rhinosinusitis (CRS) patients (5 from Texas, 5 from Utah) and seven nonhealthy controls were stimulated with fungal extracts. Despite the small numbers, they confirmed important aspects of previous studies: 1) CRS patients' PBMCs react to certain fungal stimuli by producing significantly (P < 0.05) higher amounts of interleukin (IL)-5 and IL-13 when compared to controls; 2) CRS patients have an enhanced humoral response (significantly elevated immunoglobulin [Ig] G levels to Alternaria); and 3) CRS patients react independently from an IgE-mediated allergy, as evidenced by that fact that nonallergic CRS patients also produced IL-5 in response to fungal stimuli. Unfortunately, the authors chose not to highlight their positive results. They emphasized what they failed to demonstrate, specifically an immune response to fungi above a certain threshold in some patients (Utah) with milder CRS. However, these results are potentially explained by the different methods used, and care should be applied when interpreting their results.
Ponikau
Jens U
JU
Department of Otorhinolaryngology, Gromo Institute & Sinus Center, University at Buffalo, The State University of New York, Buffalo, NY 14209, USA. jponikau@buffalo.edu
Sherris
David A
DA
Kern
Eugene B
EB
D002908:Chronic Disease; D018450:Disease Progression; D005658:Fungi / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D007111:Immunity, Cellular; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D018793:Interleukin-13 / Q000096:biosynthesis; D015848:Interleukin-5 / Q000096:biosynthesis; D009000:Monocytes / Q000276:immunology* / Q000378:metabolism; D012220:Rhinitis / Q000276:immunology* / Q000378:metabolism / Q000382:microbiology; D012852:Sinusitis / Q000276:immunology* / Q000378:metabolism / Q000382:microbiology
D007074:Immunoglobulin G; D018793:Interleukin-13; D015848:Interleukin-5; D007073:Immunoglobulin E