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Updated: Aug 30, 2026
Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis
Published on: March 9, 2018
Local production of Aspergillus fumigatus specific immunoglobulin E in nasal polyps
M Weschta1, D Rimek, M Formanek
1Department of Oto-Rhino-Laryngology and Head and Neck Surgery, University of Ulm, Prittwitzstrasse 43, D-89075 Ulm, Germany. michael.weschta@medizin.uni-ulm.de
Background:
Aspergillus spp. play a significant role in the etiology of immunoglobulin (Ig)E mediated allergic fungal sinusitis (AFS). It is unclear whether Aspergillus spp. are also involved in nasal polyps without the characteristic clinical features of AFS.
Objectives:
The frequency of Aspergillus spp. and Aspergillus-specific IgE in nasal lavages and serum of patients with severe nasal polyps (n = 33) without clinical features of AFS should be investigated.
Study Design:
Prospective study.
Methods:
An aliquot of nasal lavage fluid was treated with dithiothreitol and examined for Aspergillus fumigatus by culture and an Aspergillus-specific polymerase chain reaction (PCR) assay. An additional aliquot of nasal fluid and serum of the same patient were tested for specific IgE (Unicap, Pharmacia, Freiburg, Germany) to recombinant Aspergillus fumigatus allergen (rAspf) 1 to 6.
Results:
All patients had negative skin prick tests for Aspergillus fumigatus. Four of 33 (12%) lavage samples were positive for Aspergillus spp. by PCR. In one of these samples, rAspf-specific IgE was detected but none in the serum. Nasal lavage and serum samples of the remaining 29 patients were negative for rAspf-specific IgE.
Conclusions:
Aspergillus spp. detection is rare in patients with severe nasal polyps without characteristic clinical features of AFS. Specific IgE in nasal secretions may be elevated in patients with negative skin prick tests and serum IgE. In these cases, immunologic mechanisms similar to AFS may be involved. Fungal etiology has been proposed to underlie severe nasal polyps in general. However, Aspergillus spp. seem not to play a significant role.
Insights
Aspergillus fungi are rarely found in severe nasal polyps without allergic fungal sinusitis (AFS) features. However, specific IgE in nasal secretions may indicate AFS-like immune responses, even with negative skin tests.
Area of Science:
- Allergen immunotherapy
- Clinical immunology
- Mycology
Background:
- Immunoglobulin (Ig)E-mediated allergic fungal sinusitis (AFS) is significantly linked to Aspergillus species.
- The role of Aspergillus in nasal polyps lacking AFS clinical indicators remains unclear.
Purpose of the Study:
- Investigate the prevalence of Aspergillus species and Aspergillus-specific IgE in nasal lavages and serum.
- Assess patients with severe nasal polyps (n=33) but without AFS clinical features.
Main Methods:
- Prospective study design.
- Nasal lavage fluid analyzed for Aspergillus fumigatus via culture and PCR.
- Specific IgE to recombinant Aspergillus fumigatus allergen (rAspf) 1-6 tested in nasal lavage and serum.
Main Results:
- Aspergillus fumigatus skin prick tests were negative in all patients.
- PCR detected Aspergillus spp. in 12% (4/33) of lavage samples.
- Specific IgE to rAspf was found in one nasal lavage, but not in serum; other patients had negative IgE in both.
Conclusions:
- Aspergillus species detection is uncommon in severe nasal polyps without AFS characteristics.
- Elevated specific IgE in nasal secretions, despite negative skin prick tests and serum IgE, may suggest AFS-like immunologic mechanisms.
- While fungal etiology is proposed for severe nasal polyps, Aspergillus species appear to play a limited role.
