Mayo Clinic Study Implicates Fungus As Cause Of Chronic Sinusitis

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Mayo Clinic Study Implicates Fungus As Cause Of Chronic Sinusitis

_http://www.sciencedaily.com/releases/1999/09/990910080344.htm_

(http://www.sciencedaily.com/releases/1999/09/990910080344.htm)

 

ScienceDaily (Sep. 10, 1999) — **We can now begin to treat the cause of the

problem instead of the symptoms**.

 

ROCHESTER, MINN. -- Mayo Clinic researchers say they have found the cause of

most chronic sinus infections -- an immune system response to fungus. They

say this discovery opens the door to the first effective treatment for this

problem, the most common chronic disease in the United States.

 

 

An estimated 37 million people in the United States suffer from chronic

sinusitis, an inflammation of the membranes of the nose and sinus cavity. Its

incidence has been increasing steadily over the last decade. Common symptoms

are

runny nose, nasal congestion, loss of smell and headaches. Frequently the

chronic inflammation leads to polyps, small growths in the nasal passages which

hinder breathing.

**Up to now, the cause of chronic sinusitis has not been known,** say the

Mayo researchers: Drs. David Sherris, Eugene Kern and Jens Ponikau , Mayo

Clinic ear, nose and throat specialists. Their report appears in the September

issue of the journal Mayo Clinic Proceedings.

**Fungus allergy was thought to be involved in less than ten percent of

cases,** says Dr. Sherris. **Our studies indicate that, in fact, fungus is

likely

the cause of nearly all of these problems. And it is not an allergic

reaction, but an immune reaction.**

The researchers studied 210 patients with chronic sinusitis. Using new

methods of collecting and testing mucus from the nose, they discovered fungus

in

96 percent of the patients' mucus. They identified a total of 40 different

kinds of fungi in these patients, with an average of 2.7 kinds per patient.

In a subset of 101 patients who had surgery to remove nasal polyps, the

researchers found eosinophils (a type of white blood cell activated by the

body's

immune system) in the nasal tissue and mucus of 96 percent of the patients.

The results, the researchers say, clearly portray a disease process in

which, in sensitive individuals, the body*s immune system sends eosinophils to

attack fungi and the eosinophils irritate the membranes in the nose. As long as

fungi remain, so will the irritation.

**This a potential breakthrough that offers great hope for the millions of

people who suffer from this problem,** says Dr. Kern. **We can now begin to

treat the cause of the problem instead of the symptoms.**

More research is underway at Mayo Clinic to confirm that the immune response

to the fungus is the cause of the sinus inflammation. The researchers are

also working with pharmaceutical companies to set up trials to test medications

to control the fungus. They estimate that it will be at least two years

before a treatment will be widely available.

The researchers distinguish chronic sinusitis -- sinusitis that lasts three

months or longer -- from acute sinusitis, which lasts a month or less. They

say that the cause of the acute condition is usually a bacterial infection.

Antibiotics and over-the-counter decongestants are widely used to treat

chronic sinusitis. In most cases, antibiotics are not effective for chronic

sinusitis because they target bacteria, not fungi. The over-the-counter drugs

may

offer some relief of symptoms, but they have no effect on the inflammation.

**Medications haven*t worked for chronic sinusitis because we didn't know

what the cause of the problem was,** says Dr. Ponikau. **Finally we are on the

trail of a treatment that may actually work.**

Thousands of kinds of single-cell fungi (molds and yeasts) are found

everywhere in the world. Fungal spores (the reproductive part of the organism)

become airborne like pollen. Some people develop allergies to fungi. The new

evidence from the Mayo study suggests that many people also develop a different

kind of immune system response.

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