PMID- 17956015
OWN - NLM
STAT- MEDLINE
DCOM- 20071220
LR  - 20131121
IS  - 0300-0729 (Print)
IS  - 0300-0729 (Linking)
VI  - 45
IP  - 3
DP  - 2007 Sep
TI  - The fungal debate: where do we stand today?
PG  - 178-89
AB  - Chronic rhinosinusitis (CRS) is an inflammatory disorder affecting the nose and 
      paranasal sinuses. Although bacteria have long been implicated as pathogens in 
      most forms of CRS, it has been recognized that fungi may be responsible for some 
      forms of CRS. Recent studies have shown that under optimal conditions, fungi can 
      be identified within the nose and paranasal sinuses of nearly every individual. 
      Considerable controversy exists concerning the proper diagnosis of and potential 
      overlap between 'allergic fungal rhinosinusitis' and 'chronic rhinosinusitis'. 
      Although the disease name 'allergic fungal rhinosinusitis' is suggestive of an 
      immunoglobulin E (IgE) mediated reaction to fungi, recent studies demonstrate the 
      presence of elevated serum IgE levels to one fungus while another fungus is 
      present in CRS mucin of the same individual, questioning the role of type I 
      hypersensitivity. Several mechanisms explaining the role of fungi in the 
      pathogenesis of CRS, all requiring additional investigations with adequate 
      controls, have been suggested and will be reviewed. Although preliminary trials 
      suggest a beneficial effect of topical and oral antifungal agents in the 
      treatment of CRS patients, several double-blind placebo controlled trials do not. 
      Presently, in the absence of convincing immunological data and evidence of 
      clinical improvement of CRS upon therapy with antifungal agents, the case against 
      the fungus remains unproven.
FAU - Ebbens, F A
AU  - Ebbens FA
AD  - Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The 
      Netherlands. f.a.ebbens@amc.uva.nl
FAU - Georgalas, C
AU  - Georgalas C
FAU - Rinia, A B
AU  - Rinia AB
FAU - van Drunen, C M
AU  - van Drunen CM
FAU - Lund, V J
AU  - Lund VJ
FAU - Fokkens, W J
AU  - Fokkens WJ
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Netherlands
TA  - Rhinology
JT  - Rhinology
JID - 0347242
RN  - 0 (Antifungal Agents)
RN  - 0 (Immunoglobulin G)
RN  - 7XU7A7DROE (Amphotericin B)
SB  - IM
MH  - Amphotericin B/therapeutic use
MH  - Antifungal Agents/therapeutic use
MH  - Eosinophilia/microbiology
MH  - Humans
MH  - Immunity, Cellular
MH  - Immunoglobulin G/immunology
MH  - Nasal Mucosa/immunology
MH  - Rhinitis/drug therapy/immunology/*microbiology
MH  - Sinusitis/drug therapy/immunology/*microbiology
MH  - Specimen Handling
MH  - T-Lymphocytes/immunology
MH  - Treatment Outcome
RF  - 75
EDAT- 2007/10/25 09:00
MHDA- 2007/12/21 09:00
CRDT- 2007/10/25 09:00
PHST- 2007/10/25 09:00 [pubmed]
PHST- 2007/12/21 09:00 [medline]
PHST- 2007/10/25 09:00 [entrez]
PST - ppublish
SO  - Rhinology. 2007 Sep;45(3):178-89.