Background:
There are
indications that
polyposis is somehow
related to allergic
phenomena. Fungal
sensitization in
substantial
proportions of
patients has been
cited as a trigger
of inflammatory
mechanisms involving
either an
immunoglobulin (Ig)
E-mediated reaction
to fungal
colonization or
fungal invasion of
tissues.
Objective: To
confirm whether
fungi were involved
in the development
of polyposis by
examining
sensitivity to
fungal allergens and
potential local
contamination by
fungal species.
Methods: We
performed a study of
190 patients with
polyposis and 190
controls in which we
compared the results
of skin prick tests
to 12 fungi, total
IgE, and specific
IgE to 15 fungal
extracts and nasal
fungal cultures.
Results: The
specifi c fungi
eliciting a reaction
from the largest
proportion of
patients in the skin
prick tests were
Fusarium solani
(13.7%), Penicillium
frequentans (12.6%),
Trichophyton
mentagrophytes
(11.1%), and Candida
albicans (8.4%) (P <
.001). The
proportion of
individuals that
tested positive for
fungal-specific IgE
was 22.4% (38/170)
for patients and
10.1% (19/189) for
controls (P = .04).
The respective
proportions of
positive responses
to fungal cultures
were 58.7% and 60%.
Furthermore, no
significant
differences between
patients and
controls were found
for the results of
in vitro tests with
cultured fungal
allergens.
Conclusions:
Although the
patients with
polyposis exhibited
sensitization to
fungal allergens, we
found that nasal
colonization by
fungi was similar in
patients and the
general population.
We were also unable
to fi nd a
correlation between
a positive response
to the cultures and
the presence of
fungal
allergen-specific
IgE. It therefore
seems that nasal
colonization by
fungi does not
induce fungal
sensitization.
Key words:
Chronic
rhinosinusitis.
Fungal allergy.
Fungal cultures.
Immunoglobulin
E-mediated
phenomena. Molds.
Nasosinusal
polyposis.
Pneumoallergens. |