Equipped with world-leading technologies and extensive experience in the field of antifungal drug discovery, Creative Biolabs offers multiple high-quality services to exploit more effective drug candidates as antifungal reagents. These potential antifungal drugs can be applied in the treatment of numerous fungal diseases. Now, we are able to offer antifungal drug discovery services to develop new drug candidates for the treatment of allergic fungal rhinosinusitis.
What is Allergic Fungal Rhinosinusitis?
Allergic fungal rhinosinusitis (AFRS) is a noninvasive fungal disease of the sinuses with an incidence of between 6-9% of all rhinosinusitis requiring surgery. It is now recognized as a distinct form of chronic rhinosinusitis (CRS). Studies have shown that AFRS results from chronic, intense allergic inflammation directed against colonizing fungi. Patients with AFRS show evidence of allergy to one or more fungi. Generally, AFRS is characterized by the presence of allergic fungal mucin, which is a thick, tenacious, eosinophilic secretion with characteristic histologic findings. This mucin is grossly and microscopically similar to that found in the lungs of patients with allergic bronchopulmonary aspergillosis (ABPA), and this pulmonary correlate helped guide the early understanding of the pathogenesis of AFRS.
Fig.1 Sinus CT (bone window) of an AFS patient. Allergic mucin (arrow). (Schubert, 2009)
Symptoms of AFRS
AFRS is the most common form of FRS. It occurs in young men who are immunocompetent. Generally, people suffer from allergic rhinitis and nasal polyposis often present with signs and symptoms of nasal airway obstruction, allergic rhinitis nasal congestion, rhinorrhoea, postnasal drip, and headache.
Diagnosis of AFRS
Allergic fungal mucin normally is first encountered at surgery. Therefore, recognition of its presence is the initial step in establishing an accurate diagnosis of allergic fungal sinusitis (AFS). To date, numerous methods have been applied to the diagnosis of AFRS, including laboratory studies, CT scanning, MRI and Histologic findings. For laboratory studies, elevated total immunoglobulin E (IgE) values (more than 1000 U/mL) has been proposed as a useful indicator of allergic fungal sinusitis (AFS) clinical activity (normal values are < 50 U/mL). Moreover, heterogeneous areas of signal intensity within paranasal sinuses filled with allergic fungal mucin can also be identified on computed tomography (CT) scans.
Treatment of AFRS
Until now, treatment of AFRS by antifungal drugs is limited or zero. Surgical intervention eradication of all allergic mucin and simultaneously providing permanent drainage and aeration of the affected sinuses is the cornerstone of management. In addition, post-operative nasal corticosteroids probably reduce recurrence. Saline douching may also assist in mucous clearance. Immunotherapy may have some roles in minimizing recurrence. Therefore, it is urgent to develop more effective antifungal drugs to treat AFRS.
During the past years, numerous approaches have been developed for the exploiting of new antifungal reagents. Aided by our top technology and professional scientists, Creative Biolabs is capable of providing comprehensive antifungal drug discovery package services to accelerate the development of global customers’ programs. In addition to AFRS, we are also committed to exploiting more antifungal drugs for the treatment of other fungal infections. For more information, please feel free to contact us.
Reference
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