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[Antifungal immunity in patients with chronic rhinosinusitis with nasal polyps]
R M Pestova1, L F Aznabaeva1,2, E E Savelieva1
1Bashkir State Medical University, Ufa, Russia.
Objective:
To evaluate the characteristics of antifungal immunity in patients with bilateral chronic rhinosinusitis with nasal polyps.
Material And Methods:
The study included 74 patients with bilateral chronic rhinosinusitis with nasal polyps and a control group consisting of 30 almost healthy individuals. All patients underwent surgery and were divided into two groups: Group I - with liquid secretion (n=39), Group II - with thick secretion in the paranasal sinuses (n=35). All participants underwent mycological examination, levels of specific antifungal antibodies IgG and IgE in the serum were assessed by ELISA, and rhinocytograms of the middle nasal meatus were analyzed.
Results:
The results demonstrated that fungal growth in the swabs was detected in all groups within acceptable limits (<105 CFU/mL). The incidence was comparable between groups. The spectrum of fungal flora differed significantly: Candida species predominated in the control group and among patients with thick mucin, while the Aspergillus genus was more prevalent among patients with liquid mucin (p<0.05). In carriers of Candida fungi in the group of patients with thick mucin, the concentration of specific antibodies was higher - IgE (p<0.05) and IgG (p>0.05). Carriage of Aspergillus species was not accompanied by the development of an antibody-mediated immune response. According to the rhinocytogram data, all patients with polypoid rhinosinusitis exhibited reduced neutrophil content. In the group with thick mucin, low neutrophil content was accompanied by eosinophilia in the mucosal lining (p<0.05).
Conclusion:
The study of antifungal immunity in patients with chronic rhinosinusitis with nasal polyps revealed the formation of an immune response predominantly to Candida species, which was more pronounced in patients with thick mucus. Specific immunoglobulins of classes G and E were formed even in individuals with low fungal colonization and were accompanied by eosinophilia in the nasal mucosa. Aspergillus carriage was not accompanied by activation of a specific antibody response.
