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A group led by Mayo Clinic researchers has identified that over-reactive immune responses to airborne fungi could trigger the stuffy noses and airway inflammation among sufferers of chronic rhinosinusitis. These findings could 1 day result in a brand new, longer-lasting treatment.
“It’s time for you to identify there is a higher sensitivity to airborne fungi in certain patients, and consequently we have to get rid of or decrease the fungal exposure,” says lead investigator Hirohito Kita, M.D.
In today’s electronic version of the Journal of Allergy and Clinical Immunology http://www2.us.elsevierhealth.com/scripts/om.dll/serve?action=searchDB&searchDBfor=home&id=ai , the Mayo Clinic scientists and a colleague from the University of Utah conclude that certain species of airborne fungus produce spores and by-products, that when inhaled, prompt irregular and damaging immune responses. The responses, in turn, produce the congestion and inflammation. Chronic rhinosinusitis costs society about $5.6 billion a year. And that doesn’t include an estimated $70 million in annual lost work days, as well like a diminished quality of life.
Implications of Research
“The fungi we’re talking about are very common,” Dr. Kita. “They are airborne fungi found anywhere inside the United States. Now that we know the role from the fungi, we can work toward reducing the potential role with the fungi through such treatments as nasal irrigations (flushing with water) that clear the fungi, or prescription of antifungal medicines taken by mouth.”
Preliminary results show that the irrigation therapy relieves symptoms. Larger, multicenter studies are needed before this therapy can move into general use. But the results are encouraging because they support the idea that reducing fungal publicity in sensitive individuals could offer a brand new remedy option to victims worldwide.
Background
Chronic rhinosinusitis is 1 with the most common persistent illnesses while in the United States. Its symptoms include persistent stuffy nose, thick mucus production and loss of smell. Though chronic rhinosinusitis causes significant discomfort and health problems, it is not well understood. Viruses, bacteria and allergic reactions all have been researched and debated as potential mechanisms driving the responses. The immune system mounts different kinds of responses for different invaders — a bacterium gets attacked by a different cell or system than an allergy-prompting particle, for example. That’s why it’s critical to determine the key mechanisms while in the immune response to persistent rhinosinusitis, allowing scientists to design treatments to relieve the distressing symptoms.
The Mayo Clinic work is the first to provide data for the role of airborne fungi in persistent rhinosinusitis and to show that several immune system branches appear to collaborate in response to the fungi — resulting in an abnormally enhanced response that causes troublesome inflammation and congestion. The research team’s data show that specific cells in 90 percent of chronic rhinosinusitis sufferers produce an enhanced immune-system response to 1 fungus in particular, Alternaria. Another kind of common fungus, Cladosporium, also provoked an abnormally enhanced immune response.
Mayo Clinic scientists previously used antifungal therapies to treat patients with chronic sinusitis, which marked a new medical approach. These new findings serve to further support this perspective and will prompt additional research.
The Investigation
Researchers tested blood from 18 individuals with persistent rhinosinusitis and 15 healthy persons to evaluate how specific immune system cells responded to common airborne fungi. The immune systems of those with chronic rhinosinusitis reacted more robustly than those of healthy folks. In fact, when exposed to Alternaria, 1 branch of the immune system’s response was five times greater in the chronic rhinosinusitis individuals than within the healthy volunteers.
The research team investigated the body’s responses to this fungal exposure by measuring components within the two branches in the adaptive immune system. The adaptive immune system takes several days to mount a response to foreign invaders. The two branches of the adaptive immune system are: one) a cell-directed branch that involves special cells known as T lymphocytes and 2) the humoral branch, which works primarily through cells known as B lymphocytes.
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Research Group Members and Support
In addition to Dr. Kita, the Mayo Clinic research group includes Seung-Heon Shin, M.D.; Jens Ponikau, M.D.; David Sherris, M.D.; David Congdon, M.D.; Evangelo Frigas, M.D.; Henry Homburger, M.D.; and Mark Swanson. The University of Utah collaborator was Gerald Gleich, M.D. Their work was supported by a grant from your National Institute for Allergy and Infectious Diseases and by the Mayo Foundation.
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Contact: Bob Nellis
newsbureau@mayo.edu
507-284-5005
Mayo Clinic
http://www.mayo.edu