Department of Otorhinolaryngology, Head and Neck Surgery, University of Adelaide and Flinders University, Adelaide, Australia.
Int Forum Allergy Rhinol. 2011 Sep-Oct;1(5):340-7. doi: 10.1002/alr.20066. Epub 2011 May 10.
The role of fungi in the spectrum of chronic rhinosinusitis (CRS) is poorly understood. Fungal biofilms have recently been discovered in CRS patients. We have developed an animal model for the investigation of sinonasal fungal biofilms. The role of type I hypersensitivity and pathogenic bacteria is presented.
Thirty sheep were sensitized with fungal antigens-Aspergillus fumigatus and Alternaria alternata, or control. Endoscopic surgery was performed to expose both frontal sinus ostia-1 was occluded. Fungi with or without Staphylococcus aureus were inoculated into the sinus. Skin-prick tests assessed for fungal allergy. Fungal and S. aureus biofilms, histology, and culture rates were assessed.
Forty-five percent of experimental sheep were sensitized to fungal antigen. Only 1 sinus inoculated with fungus developed minimal fungal biofilm. Eighty percent developed fungal biofilm when S. aureus was co-inoculated. The presence of hypersensitivity to fungus was not related to fungal biofilm development.
Significant fungal biofilm only occurred when S. aureus was the co-inoculum. Hypersensitivity was not requisite. The relationship of S. aureus to fungal biofilms is of great clinical interest. Fungi may be opportunistic pathogens that simply require inflamed mucosa with weakened innate defenses; alternatively, a cross-kingdom synergy could be contributing to fungal proliferation.
真菌在慢性鼻-鼻窦炎（CRS）中的作用尚未被充分认识。最近在 CRS 患者中发现了真菌生物膜。我们已经开发了一种用于研究鼻窦真菌生物膜的动物模型。本研究介绍了 I 型超敏反应和致病性细菌的作用。
30 只绵羊用真菌抗原（烟曲霉和交链孢霉）或对照物致敏。进行内窥镜手术以暴露额窦窦口-1 个被阻塞。将真菌与或不与金黄色葡萄球菌接种到鼻窦中。皮肤点刺试验评估真菌过敏。评估真菌和金黄色葡萄球菌生物膜、组织学和培养率。
45%的实验绵羊对真菌抗原致敏。仅 1 个鼻窦接种真菌后，仅形成最小的真菌生物膜。当金黄色葡萄球菌共同接种时，80%的鼻窦形成真菌生物膜。对真菌的超敏反应的存在与真菌生物膜的形成无关。
只有当金黄色葡萄球菌作为共同接种物时才会出现显著的真菌生物膜。超敏反应不是必需的。金黄色葡萄球菌与真菌生物膜之间的关系具有重要的临床意义。真菌可能是机会性病原体，仅需要有炎症的黏膜和减弱的先天防御；或者，跨界协同作用可能导致真菌增殖。
