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Mayo Clinic - Mayo Clinic Study Implicates Fungus as Cause of Chronic Sinusitis
Mayo Clinic Rochester
Mayo Clinic Study Implicates Fungus as Cause of Chronic
Sinusitis
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. (See
graph.)
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
http://www.mayo.edu/comm/mcr/news_773.html (1 of 3)8/4/2005 7:44:12 PM
Mayo Clinic - Mayo Clinic Study Implicates Fungus as Cause of Chronic Sinusitis
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.
Contact: e-mail: newsbureau@mayo.edu
l Also see Statement for Patients
l Full-text report from Mayo Clinic Proceedings
http://www.mayo.edu/comm/mcr/news_773.html (2 of 3)8/4/2005 7:44:12 PM
Mayo Clinic - Mayo Clinic Study Implicates Fungus as Cause of Chronic Sinusitis
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