Is chronic sinusitis an immune disorder?

Researchers at the University at Buffalo and the Mayo Clinic have shown that chronic sinusitis is an immune disorder caused by fungus.

Earlier there was a lack of knowledge about the causes of chronic sinusitis. Without a specific target for intervention, physicians often simply treated the secondary bacterial infections.

The report was presented (March 23, 2004) at the annual meeting of the American Academy of Allergy, Asthma and Immunology in San Francisco. The research was conducted while David A. Sherris was at the Mayo Clinic.

Additional researchers on the study, all from the Mayo Clinic, were Jens U. Ponikau, M.D., Amy Weaver, Evangelo Frigas, M.D., and Hirohito Kita, M.D.

The research was supported by grants from the National Institutes of Health and the Mayo Foundation for Education and Research.

According to the research finding common airborne fungi lodge in the mucus lining of the sinuses in most people, but initiate an immune response only in individuals prone to chronic sinusitis. The immune response causes the fungi to be attacked, which leads to damage of the sinus membranes, resulting in full-blown symptoms.

"We hope this study will lead to the first treatment aimed at the root cause of chronic sinusitis, rather than a treatment just to mask the symptoms," said David A. Sherris, M.D., interim chair of the UB Department of Otolaryngology.

Through a randomized, placebo-controlled, double-blind pilot trial using the fungicide Amphotericin-B applied intranasally, the researchers found that the treatment group showed a significant decrease in the inflammatory thickening of the sinus membranes compared to the control group.

Inflammation in the mucus also decreased significantly in those receiving the drug, compared to placebo, and 70 percent of patients on the medication had a decrease in the amount of nasal swelling, results showed.

The University at Buffalo is a premier research-intensive public university, the largest and most comprehensive campus in the State University of New York.