title: The role of mucosal immunity in fungus ball of the paranasal sinuses.
abstract: CONCLUSIONS
  Increased levels of immunoglobulin (Ig)A, plasma cells, and lymphocytes without infiltration of other inflammatory cells suggest that mucosal immunity may play an important role in paranasal fungus ball.
  
  
  OBJECTIVE
  This study aimed to examine the nasal mucosal immune responses to fungi to understand the pathogenesis of fungus ball.
  
  
  METHODS
  Five patients with fungus ball of the maxillary sinus were enrolled. Lavage samples were collected from both nasal cavities and the maxillary sinus of the affected side. Mucosal samples were taken from both inferior turbinates and the maxillary sinus of the affected side. Interleukin (IL)-4, interferon (IFN)-γ, and IgA levels in the lavage samples were measured. Cells were counted on the lamina propria of mucosa under an electron microscope.
  
  
  RESULTS
  No significant differences in levels of IL-4 and IFN-γ were observed between the three groups of lavage samples. However, a significant rise in IgA levels was observed in the lavage samples from the nasal cavity and maxillary sinus of the affected side compared with that of the contralateral nasal cavity. Infiltration of plasma cells and lymphocytes in mucosal samples from the inferior turbinate and maxillary sinus of the affected side was significantly increased compared with that from the contralateral inferior turbinate, but other inflammatory cells were few and showed no difference.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Park
authors.forename: Ju-Young
authors.initials: JY
authors.lastname: Seoh
authors.forename: Ki-Hwan
authors.initials: KH
authors.lastname: Han
authors.forename: Kyung Ray
authors.initials: KR
authors.lastname: Moon
authors.forename: Seung-Sin
authors.initials: SS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D018928:Immunity, Mucosal / Q000502:physiology*; D007070:Immunoglobulin A / Q000276:immunology / Q000378:metabolism; D007371:Interferon-gamma / Q000378:metabolism; D015847:Interleukin-4 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D017817:Nasal Lavage Fluid / Q000737:chemistry / Q000166:cytology / Q000276:immunology; D010256:Paranasal Sinuses / Q000276:immunology* / Q000378:metabolism / Q000382:microbiology; D010950:Plasma Cells / Q000276:immunology / Q000378:metabolism; D012852:Sinusitis / Q000276:immunology* / Q000378:metabolism / Q000382:microbiology; D013601:T-Lymphocytes / Q000276:immunology*
chemical_list: D007070:Immunoglobulin A; D015847:Interleukin-4; D007371:Interferon-gamma