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Fungal DNA is present in tissue specimens of patients with chronic rhinosinusitis
Jan Gosepath1, Juergen Brieger, Konstantin Vlachtsis
1Department of Otolaryngology, Head and Neck Surgery, University of Mainz, School of Medicine, Mainz, Germany.
Background:
It has been postulated that fungal organisms might represent the immunologic target initiating and maintaining the disease process in patients with chronic rhinosinusitis (CRS). The presence of fungi in nasal mucus has been established by different groups, but so far it has not been shown how the immune system could even recognize such extramucosal--extracorporal--fungal targets. The aim of this study was to determine whether fungal DNA is present in tissue specimens taken from patients with polypoid CRS.
Methods:
Twenty-seven surgical specimens were collected from patients suffering from CRS. Fifteen surgical specimens from healthy ethmoidal mucosa served as controls. A second set of controls consisted of five surgical specimens of acoustic neuroma, which were included to rule out contamination within the protocol. All paranasal tissue samples were treated and rinsed carefully with a solution of Dithiothreitol to digest any nasal mucus and ensure that only tissue was examined. A highly sensitive two-step polymerase chain reaction (PCR) was applied to detect fungal DNA, using one universal primer for unspecific detection of fungal DNA and a second primer pair specific for Alternaria.
Results:
Fungal DNA was detected in all 27 CRS specimens equally with both PCR primers. Controls from healthy paranasal mucosa were positive using the panfungal primers in 10 of 15 cases but were all negative for Alternaria DNA. PCR was negative for fungal DNA in all five neuroma specimens.
Conclusions:
Fungal DNA can be detected within sinonasal tissue specimens of patients suffering from CRS. These findings need to be discussed with respect to the proposed hypothesis of the immune system recognizing extramucosal organisms and initiating an immune response in sensitized patients.
Insights
Fungal DNA was found in all chronic rhinosinusitis (CRS) tissue samples, suggesting fungi may trigger immune responses in this condition. This study investigated fungal presence in CRS tissues using sensitive DNA detection methods.
Area of Science:
- Otolaryngology
- Immunology
- Mycology
Background:
- Chronic rhinosinusitis (CRS) may involve an immune response to fungal organisms.
- Previous studies confirmed fungi in nasal mucus, but tissue-level presence and immune recognition remain unclear.
Purpose of the Study:
- To investigate the presence of fungal DNA within sinonasal tissue specimens from patients with CRS.
- To determine if fungal DNA is detectable directly within the affected tissue.
Main Methods:
- Surgical tissue specimens from 27 CRS patients and controls (healthy ethmoid mucosa, acoustic neuroma) were analyzed.
- Tissue samples were meticulously processed to remove mucus, ensuring only tissue was examined.
- A highly sensitive two-step polymerase chain reaction (PCR) was employed to detect fungal DNA, including specific primers for Alternaria.
Main Results:
- Fungal DNA was detected in all 27 CRS tissue specimens using both universal and specific PCR primers.
- Healthy mucosa controls showed fungal DNA in 10 of 15 cases with universal primers, but were negative for Alternaria.
- Acoustic neuroma controls were consistently negative for fungal DNA, indicating protocol specificity.
Conclusions:
- Fungal DNA is detectable within the sinonasal tissue of patients diagnosed with CRS.
- These findings support the hypothesis that extramucosal fungi may act as immunologic targets in CRS patients.
- Further research is warranted to explore the immune system's recognition of these fungal targets in sensitized individuals.
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