Characteristics of Sinus Fungus Ball: A Unique Form of Rhinosinusitis.
Characteristics of Sinus Fungus Ball: A Unique Form of Rhinosinusitis.
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DOI：
10.1177/1179550618792254
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Liang KL
中科院分区：
文献类型：
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作者：
Jiang RS;Huang WC;Liang KL
本研究的目的是探讨这种独特形式的鼻窦炎的特点。对91例鼻窦真菌球患者的临床特征进行评价。38例鼻窦真菌球患者的鼻腔组织和26例对照组用于组织病理学、细胞因子/趋化因子、western blotting和遗传分析。真菌球患者女性明显多于女性，且年龄较大。真菌球以单侧表现为主（97.8%）。有真菌感染危险因素33例（36.3%）。真菌球患者鼻腔组织中可见巨噬细胞和中性粒细胞为主的细胞浸润。发现紧密连接染色（e-cadherin）和蛋白表达降低的趋势。与对照组相比，窦真菌球组织匀浆中白细胞介素8 （IL8）和粒细胞集落刺激因子（G-CSF）显著升高。真菌球患者中E-cadherin单核苷酸多态性（SNP）的发生率较高。我们发现窦真菌球患者具有强大的免疫反应，允许巨噬细胞和中性粒细胞的招募和激活。然而，窦真菌球患者可能有遗传性或获得性免疫力低下。真菌菌丝不被宿主根除，而是局限于单个窦内积累。
The purpose of this study was to investigate the characteristics of this unique form of rhinosinusitis. Ninety-one patients with sinus fungus balls were evaluated for clinical characteristics. Nasal tissues obtained from 38 patients with sinus fungus ball, along with 26 controls were used for histopathological, cytokines/chemokines, western blotting, and genetic analyses. Patients with fungus balls had significantly more females and their age was older. The presentation of fungus ball was predominantly unilateral (97.8%). Thirty-three patients (36.3%) had risk factors for fungal infection. Macrophage and neutrophil dominated cellular infiltration was found in nasal tissues of fungus ball patients. A tendency of reduced tight junction staining (e-cadherin) and protein expression was found. Interleukin 8 (IL8) and granulocyte colony stimulating factor (G-CSF) significantly increased in sinus fungus ball tissue homogenates when compared with those from controls. Higher prevalence of a single single nucleotide polymorphism (SNP) with E-cadherin was found in the patients with fungus ball. We found that patients with sinus fungus ball had robust immune responses, allowing recruitment and activation of macrophages and neutrophils. However, patients with sinus fungus ball could have genetic or acquired weakness in immunity. The fungal hyphae were localized and accumulated within single sinus instead of being eradicated by host.