[Homestead] Sinusitis---everyman's disease

Tvoivozhd tvoivozd at infionline.net
Mon Oct 11 18:01:43 EDT 2004


Now you will be able to get rid of it.


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University At Buffalo <http://www.buffalo.edu/>
/Date/:  
	
2004-03-30

	
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    Researchers Show Chronic Sinusitis Is Immune Disorder; Antifungal
    Medicine Effective Treatment

BUFFALO, N.Y. -- Researchers at the University at Buffalo and the Mayo 
Clinic have shown that chronic sinusitis is an immune disorder caused by 
fungus, opening up a promising new avenue for treating this ubiquitous 
and debilitating condition, for which there is no FDA-approved therapy.

	
*Related News Stories*
	

*Mayo Clinic Study Implicates Fungus As Cause Of Chronic Sinusitis* 
<http://www.sciencedaily.com/releases/1999/09/990910080344.htm> 
(September 10, 1999) -- Mayo Clinic researchers say they have found the 
cause of most chronic sinus infections -- an immune system response to 
fungus. They say this discovery opens the door to the first effective 
treatment ... > /full story/ 
<http://www.sciencedaily.com/releases/1999/09/990910080344.htm>

*Gene Alterations For Cystic Fibrosis May Also Account For Chronic Sinus 
Problems In Some* 
<http://www.sciencedaily.com/releases/2000/10/001011071550.htm> (October 
16, 2000) -- Gene alterations known to cause the inherited disorder 
cystic fibrosis (CF), which is characterized by mucous membrane 
abnormalities in the lungs, appear also to contribute to chronic sinus 
problems ... > /full story/ 
<http://www.sciencedaily.com/releases/2000/10/001011071550.htm>

*Diagnosing Chronic Fatigue? Check For Sinusitis* 
<http://www.sciencedaily.com/releases/2003/08/030814072847.htm> (August 
14, 2003) -- A new study published in the August 11 issue of the 
Archives of Internal Medicine demonstrates a possible link between 
unexplained chronic fatigue and sinusitis, two conditions previously not 
... > /full story/ 
<http://www.sciencedaily.com/releases/2003/08/030814072847.htm>

/> more *related stories 
<http://www.sciencedaily.com/related.php?filename=040324072619>*/

Results of their research suggest that common airborne fungi lodge in 
the mucus lining of the sinuses in most people, but initiate an immune 
response only in individuals prone to chronic sinusitis. The immune 
response causes the fungi to be attacked, which leads to damage of the 
sinus membranes, resulting in full-blown symptoms.

"We hope this study will lead to the first treatment aimed at the root 
cause of chronic sinusitis, rather than a treatment just to mask the 
symptoms," said David A. Sherris, M.D., interim chair of the UB 
Department of Otolaryngology.

Sherris presented the study findings today (March 23, 2004) at the 
annual meeting of the American Academy of Allergy, Asthma and Immunology 
in San Francisco. The research was conducted while Sherris was at the 
Mayo Clinic.

Through a randomized, placebo-controlled, double-blind pilot trial using 
the fungicide Amphotericin-B applied intranasally, the researchers found 
that the treatment group showed a significant decrease in the 
inflammatory thickening of the sinus membranes compared to the control 
group.

Inflammation in the mucus also decreased significantly in those 
receiving the drug, compared to placebo, and 70 percent of patients on 
the medication had a decrease in the amount of nasal swelling, results 
showed.

"We showed in 1999 that fungal organisms were present in the mucus of 96 
percent of patients who had surgery for chronic sinusitis, and that 
inflammatory cells were clumped around the fungi, which indicated to us 
that the condition was an immune disorder caused by fungus, " said 
Sherris. "But many doctors didn't believe us."

"Next, we conducted various immunologic studies and an open trial using 
the fungicide treatment and found that 75 percent of patients improved 
on the new therapy. Now we have similar results from a randomized, 
blinded trial with a control group, which is the 'gold standard' in drug 
testing. Our next step is to conduct a multi-center trial using 
antifungals, which we hope will lead to FDA approval of antifungal 
treatment for this chronic disease."

Chronic sinusitis, a disease of the nasal passages and the surrounding 
sinus cavities, is thought to affect 16.8 percent of the adult 
population of the U.S. It causes long-term nasal congestion, production 
of thick mucus, loss of sense of smell and creates an environment for 
opportunistic bacterial infections that exacerbate those symptoms. 
Sherris said studies have shown that chronic sinusitis exceeds even 
congestive heart failure in its adverse effects on quality of life.

Little is known about the causes of this disease. Without a specific 
target for intervention, physicians often simply treated the secondary 
bacterial infections in hopes of providing a modicum of relief.

The current trial involved 24 patients with chronic sinusitis who were 
randomly assigned to receive the treatment or a placebo. Neither the 
patients nor the investigators knew who received the drug or the 
inactive agent. The final analysis involved data from 10 treatment 
patients and 14 controls, all of whom were in the trial for six months.

Researchers took CT scans (special x-rays of the sinuses) at baseline 
and at 6 months. They also graded patients' inflammation by direct exam 
with an endoscope in the nose at the start of the study, and at 3 and 6 
months.

The CT scans showed that the treatment group had a mean 8.8 percent 
decrease in inflammatory mucus thickening, while the placebo group had 
an increase of 2.5 percent. Sherris said 70 percent of patients in the 
treatment group also showed significant improvement when their nasal 
passages were viewed through an endoscope, while the placebo group 
showed no change. Markers of inflammation in the mucus also decreased 
significantly in the treatment group, compared to the placebo group.

Additional researchers on the study, all from the Mayo Clinic, were Jens 
U. Ponikau, M.D., Amy Weaver, Evangelo Frigas, M.D., and Hirohito Kita, M.D.

The research was supported by grants from the National Institutes of 
Health and the Mayo Foundation for Education and Research.

The University at Buffalo is a premier research-intensive public 
university, the largest and most comprehensive campus in the State 
University of New York






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