Creative Biolabs is at the forefront of antifungal drug discovery. Having worked in this field for many years, now we are able to provide a full range of high-quality drug candidate exploiting services to help worldwide patients fight against invasive fungal rhinosinusitis.
What is Invasive Fungal Rhinosinusitis?
Invasive fungal rhinosinusitis (IFRS) is a general term that describes any fungal infection of the sinuses where hyphae invade through tissue planes. According to histopathological evidence of tissue invasion by fungi, IFRS can be divided into acute invasive fungal rhinosinusitis (AIFRS) and chronic invasive fungal rhinosinusitis (CIFRS). The chronic invasive category includes a subcategory, namely chronic granulomatous invasive fungal rhinosinusitis (CGIFRS). Generally, AIFRS occurs in immunocompromised hosts, especially in patients with hematologic neoplasm, type 1 diabetes mellitus (in the setting of ketoacidosis) AIDS, and chronic systemic steroid use, while CIFRS usually appears in people with a mildly immunocompromised system (e.g., diabetes or corticosteroid therapy) and even in people who are immunocompetent.
Symptoms of IFRS
Symptoms of IFRS are different. For AIFRS, the most common presenting symptoms include epistaxis, fever, facial and periorbital pain, swelling, nasal congestion, rhinorrhea, and headache. Less common are ophthalmologic complaints, including decreased visual acuity or ophthalmoplegia. However, symptoms of CIFRS include sinus pain, nasal discharge, and fever. A headache, seizures, neurologic deficits and maxillofacial soft tissue swelling also occur when the disease is complicated by intracranial or maxillofacial extension.
Diagnosis of IFRS
In recent years, numerous methods have been applied in the diagnosis of IFRS. Early nasal endoscopy and initiation of appropriate therapy are necessary to improve the poor prognosis. Due to the nonspecific nature of many of the imaging findings, CT-imaging alone cannot be relied on to make the diagnosis and a high index of clinical suspicion is required to make the diagnosis. Particularly, the diagnosis of AIFRS includes histopathologic identification of tissue-invasive fungal forms, which is often performed during intraoperative consultation (frozen section). What’s more, CT or MRI is useful for planning the extent of surgical debridement, and following progress, although the radiation exposure can mount up rapidly if CT is used.
Treatment of IFRS
IFRS can be treated with a combination of surgical debridement and antifungal medications. Generally, reversing the underlying disease process and immunosuppression is critical to successful treatment in these cases. Open surgery is frequently needed in cases of intraorbital extension or intracranial involvement. As an adjuvant to surgery, antifungal agents may reduce the chance of recurrence. Commonly, intravenous antifungal is an important component of the medical treatment, with liposomal amphotericin B the empiric drug of choice.
In the past years, the role of antifungal therapy is not well established. Though it works to some extent, the most effective antifungal agent and optimal duration of therapy have not been determined. Therefore, it is of great need to develop more effective antifungal drugs for the treatment of IFRS. With the help of advanced platform and experienced scientists, Creative Biolabs is dedicated to offering antifungal drug discovery services for the treatment of multiple fungal diseases, which includes but not limited to IFRS. If you are interested in the services we can provide, please feel free to contact us for more detailed information.
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