Chronic Sinusitis: The Most Common Chronic Disease in the U.S.
An estimated 37 million people in the United States suffer from
chronic sinusitis, an inflammation of the membranes of the nose
and sinus cavity. Its incidence has been increasing steadily
over the last decade. Common symptoms are runny nose, nasal congestion,
loss of smell and headaches. Frequently the chronic inflammation
leads to polyps, small growths in the nasal passages which hinder
"Up to now, the cause of chronic sinusitis has not been known," say
the Mayo researchers: Drs. David Sherris, Eugene Kern and Jens
Ponikau of the Department of Otorhinolargygology (ENT) at Mayo
Clinic. Their report appears in the September 1999 issue of the
journal Mayo Clinic Proceedings.
"Fungus allergy was thought to be involved
in less than ten percent of cases. Our studies indicate that,
in fact, fungus
likely the cause of nearly all of these problems. And it is not
an allergic reaction, but an immune reaction."
Sinusitis Research Regarding Fungus
The researchers studied 210 patients with chronic sinusitis. Using
new methods of collecting and testing mucus from the nose, they
discovered fungus in 96 percent of the patients' mucus. They
identified a total of 40 different kinds of fungi in these patients,
with an average of 2.7 kinds per patient.
In a subset of 101 patients who had surgery to remove nasal polyps,
the researchers found eosinophils (a type of white blood cell activated
by the body's immune system) in the nasal tissue and mucus of 96
percent of the patients.
The results, the researchers say, clearly portray a disease process
in which, in sensitive individuals, the body's immune system sends
eosinophils to attack fungi and the eosinophils irritate the membranes
in the nose. As long as fungi remain, so will the irritation.
"This a potential breakthrough that offers great hope for
the millions of people who suffer from this problem," they
say. "We can now begin to treat the cause of the problem instead
of the symptoms."
As of this report release, more research is underway at Mayo Clinic
to confirm that the immune response to the fungus is the cause
of the sinus inflammation. The researchers are also working with
pharmaceutical companies to set up trials to test medications to
control the fungus. They estimate that it will be at least two
years before any treatments will be available.
Chronic Sinusitis Causes Different that Acute Sinusitis
The researchers distinguish chronic sinusitis -- sinusitis that
lasts three months or longer -- from acute sinusitis, which lasts
a month or less. They say that the cause of the acute condition
is usually a bacterial infection.
Antibiotics and over-the-counter decongestants are widely used
to treat chronic sinusitis. In most cases, antibiotics are not
effective for chronic sinusitis because they target bacteria, not
fungi. The over-the-counter drugs may offer some relief of symptoms,
but they have no effect on the inflammation.
"Medications haven't worked for chronic sinusitis because
we didn't know what the cause of the problem was," says Dr.
Sherris. "Finally we are on the trail of a treatment that
may actually work."