title: Fungal extracts detected in eosinophilic chronic rhinosinusitis induced cytokines from the nasal polyp cells.
abstract: OBJECTIVE
  The role of fungi in chronic rhinosinusitis (CRS) is still controversial. The present study was conducted to detect and identify fungal species from the nasal polyp tissues of eosinophilic and noneosinophilic CRS, and to determine the role of fungal antigens in cytokine production.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Thirty-five specimens of nasal polyps were collected from patients with CRS and examined for fungus using culture, histology, and polymerase chain reaction analysis. The secretion of 14 cytokines stimulated by fungal extracts using dispersed nasal polyp cells (DNPCs) was determined by multiplex immunoassay.
  
  
  RESULTS
  There was no microbiological growth (including fungus) in the cultures of homogenized nasal polyps. Furthermore, Grocott methanamine silver staining for all nasal polyps showed no fungal bodies. Sixteen of 35 samples of the nasal polyps showed amplification of fungal DNA. In none of the mucosa of the sphenoid sinus was fungal DNA detected. The number of eosinophils in the nasal polyps in which fungal DNA was detected was significantly higher than in the nasal polyps in which fungal DNA was not detected (P < .01). The extract of fungus enhanced the secretion of eosinophil-associated cytokines such as interleukine (IL)-5, IL-13, IL-17A, and RANTES (regulated on activation normal T-cell expressed and secreted), and proinflammatory cytokines such as IL-6, IL-8, tumor necrosis factor-α, and granulocyte-macrophage colony-stimulating factor from DNPCs.
  
  
  CONCLUSIONS
  The present study offers direct evidence supporting that fungal elements modify the inflammatory response in the nasal polyps of eosinophilic CRS.
authors.affiliation: Department of Otorhinolaryngology, Juntendo University Faculty of Medicine, Tokyo, Japan.
authors.forename: Mikio
authors.initials: M
authors.lastname: Hirotsu
authors.forename: Akihito
authors.initials: A
authors.lastname: Shiozawa
authors.forename: Noritsugu
authors.initials: N
authors.lastname: Ono
authors.forename: Masato
authors.initials: M
authors.lastname: Miwa
authors.forename: Ken
authors.initials: K
authors.lastname: Kikuchi
authors.forename: Katsuhisa
authors.initials: K
authors.lastname: Ikeda
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D016207:Cytokines / Q000276:immunology*; D004802:Eosinophilia / Q000150:complications / Q000276:immunology* / Q000382:microbiology*; D005260:Female; D005658:Fungi / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000150:complications / Q000382:microbiology*; D011446:Prospective Studies; D012220:Rhinitis / Q000150:complications / Q000276:immunology* / Q000382:microbiology*; D012852:Sinusitis / Q000150:complications / Q000276:immunology* / Q000382:microbiology*; D055815:Young Adult
chemical_list: D016207:Cytokines
keywords: Fungus; cytokine; eosinophil; nasal polyp; polymerase chain reaction