Detection of Fungi in Sinus Fluid of Patients with Allergic Fungal Rhinosinusitis

We aim to develop a rapid, accurate and sensitive diagnostic assay with which to detect the surface antigens of fungi thought to be involved in allergic fungal rhinosinusitis (AFRS), by assessing the usefulness of immunofluorescence microscopy (IMF) and enzyme linked immuno-absorbent assays (ELISA)....

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Bibliographic Details
Published in:Acta oto-laryngologica 2000-01, Vol.120 (2), p.296-302
Main Authors: Karpovich-Tate, N, Dewey, F M, Smith, E J, Lund, V J, Gurr, P A, Gurr, S J
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Alternaria alternata
Antigens, Fungal - analysis
Aspergillus niger
Cladosporium
Cochliobolus
Diagnosis, Differential
Enzyme-Linked Immunosorbent Assay
Female
Humans
Male
Microscopy, Fluorescence
Middle Aged
Mycoses - diagnosis
Mycoses - pathology
Paranasal Sinuses - immunology
Paranasal Sinuses - pathology
Penicillium expansum
Predictive Value of Tests
Radioallergosorbent Test
Rhinitis, Allergic, Perennial - diagnosis
Rhinitis, Allergic, Perennial - immunology
Rhinitis, Allergic, Perennial - pathology
Sinusitis - diagnosis
Sinusitis - immunology
Sinusitis - pathology
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Summary:We aim to develop a rapid, accurate and sensitive diagnostic assay with which to detect the surface antigens of fungi thought to be involved in allergic fungal rhinosinusitis (AFRS), by assessing the usefulness of immunofluorescence microscopy (IMF) and enzyme linked immuno-absorbent assays (ELISA). The age, sex, clinical symptoms and signs, imaging (CT and/or MRI), microbiological subculture data, sinus contents, blood eosinophilia, aspergillosis precipitins, radioallergoabsorbent technology (RAST) for fungal allergens and histopathology were performed on individuals undergoing endoscopic sinus surgery for suspected AFRS. Thirteen patients were examined, and five monoclonal antibodies raised to the surface washings of various fungi were found to recognize and differentiate between fungal species implicated in sinus disease, i.e. Aspergillus niger, Alternaria alternata, Cochliobolus lunata, Penicillium expansum and Cladosporium species. The IMF microscopy proved to be a useful assay to distinguish visually between the cultured fungi, but was less useful for visualization of fungi in the patient samples. However, ELISA assays with 5 monoclonal antibodies gave clear and unambiguous data as to the presence of certain fungi within the patient samples. There is good correlation between the ELISA data and the pathology findings. This preliminary study suggests that both IMF and ELISA techniques may offer an important advance in this area.
ISSN:0001-6489
1651-2251
DOI:10.1080/000164800750001125