The role of mucosal immunity in fungus ball of the paranasal sinuses
The role of mucosal immunity in fungus ball of the paranasal sinuses
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DOI：
10.3109/00016489.2012.659756
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发表时间：
2012-06-01
影响因子：
1.4
通讯作者：
Lee, Seung-Sin
中科院分区：
文献类型：
--
作者：
Park, Hyun Joo;Seoh, Ju-Young;Lee, Seung-Sin
结论：鼻腔真菌球免疫球蛋白(Ig)A、浆细胞和淋巴细胞水平升高，未见其他炎症细胞浸润，提示粘膜免疫可能在鼻腔真菌球发病中起重要作用。目的：检测鼻黏膜对真菌的免疫应答，以了解真菌球的发病机制。方法：选择5例上颌窦真菌球患者。从患侧鼻腔和上颌窦采集灌洗液样本。取患侧下鼻甲和上颌窦粘膜标本。测定灌洗液标本中白介素4、干扰素-γ和免疫球蛋白A水平。电子显微镜下计数粘膜固有层细胞数。结果：三组灌洗液标本间IL-4和干扰素-γ水平差异无统计学意义。然而，患侧鼻腔和上颌窦灌洗标本中的IgA水平明显高于对侧鼻腔。患侧下鼻甲和上颌窦粘膜中浆细胞和淋巴细胞较对侧下鼻甲明显增多，其他炎症细胞较少，差异无统计学意义。
Conclusion: Increased levels of immunoglobulin (Ig) A, plasma cells, and lymphocytes without infiltration of other inflammatory cells suggest that mucosal immunity may play an important role in paranasal fungus ball. Objectives: This study aimed to examine the nasal mucosal immune responses to fungi to understand the pathogenesis of fungus ball. Methods: Five patients with fungus ball of the maxillary sinus were enrolled. Lavage samples were collected from both nasal cavities and the maxillary sinus of the affected side. Mucosal samples were taken from both inferior turbinates and the maxillary sinus of the affected side. Interleukin (IL)-4, interferon (IFN)-gamma, and IgA levels in the lavage samples were measured. Cells were counted on the lamina propria of mucosa under an electron microscope. Results: No significant differences in levels of IL-4 and IFN-gamma were observed between the three groups of lavage samples. However, a significant rise in IgA levels was observed in the lavage samples from the nasal cavity and maxillary sinus of the affected side compared with that of the contralateral nasal cavity. Infiltration of plasma cells and lymphocytes in mucosal samples from the inferior turbinate and maxillary sinus of the affected side was significantly increased compared with that from the contralateral inferior turbinate, but other inflammatory cells were few and showed no difference.