Fungus-specific IgG and IgE in allergic fungal rhinosinusitis

Area of Science:

• Immunology
• Allergy
• Otolaryngology

Background:

• Polypoid rhinosinusitis (PRS) is a chronic inflammatory condition.
• Allergic fungal rhinosinusitis (AFS) is a specific subtype requiring accurate diagnosis.
• Distinguishing AFS from non-AFS PRS is clinically important.

Purpose of the Study:

• To investigate fungus-specific immunoglobulins G (sIgG) and E (sIgE) in patients with PRS.
• To compare sIgG and sIgE levels in AFS, AFS-like, and non-AFS PRS.
• To evaluate the diagnostic utility of sIgE for AFS.

Main Methods:

• Prospective analysis of fungal sIgG and sIgE using a 9-mold RAST panel.
• Study included 13 AFS, 11 AFS-like, and 27 non-AFS PRS patients.
• Control groups included volunteers with allergic rhinitis and healthy individuals.

Main Results:

• All groups exhibited elevated fungal sIgG levels.
• Higher polyp severity and AFS correlated with increased fungal sIgG to more molds.
• The AFS group showed significantly higher fungal sIgE elevations (average 5 molds) compared to the non-AFS polyp group (average 0.1 molds).
• Total IgE levels were markedly higher in the AFS group (971 U/mL) versus the non-AFS polyp group (64 U/mL).

Conclusions:

• Multiple fungal sIgE elevations are sufficient for diagnosing AFS when cultures and histology are negative.
• The clinical significance of elevated fungal sIgG in PRS requires further investigation.
• Screening PRS patients with total serum IgE and RAST testing can facilitate early AFS detection.