Fungal airway diseases are chronic eosinophilic mucosal inflammatory disorders driven by hypersensitivity responses to extramucosal fungi extracts1. Staphylococcus aureus, a prodigious superantigen producer, is commonly cultured from fungal sinus surgeries1,2. Although the role of superantigens in chronic rhinosinusitis has recently been recognized3,4, similar immunological mechanisms in fungal airway disease need to be explored1,5-7. Superantigens as a cofactor in fungal disease immunopathogenesis will open new horizons in treatment.



References:

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2.Bachert C, Gevaert P, van Cauwenberge P.Staphylococcus aureus superantigens and airway disease. Curr Allergy Asthma Rep. 2002 May;2(3):252-8.

3.Zhang N, G Holtappels, P Gevaert, J Patou, Dhaliwal B, Gould H, C Bachert. Mucosal tissue polyclonal IgE is functional in response to allergen and SEB. Allergy 2010;66:141-8

4.Bachert C, Nan Zhang, Gabriele Holtappels, Lizzi De Lobel, Kristel van Steen. Differentiation of upper airway inflammation based on T effector cell subtypes and impact of Staphylococcus aureus enterotoxins on asthma co-morbidity. JACI 2010;126:962-8

5.Douglas R, Bruhn M, Tan LW, Ooi E, Psaltis A, Wormald PJ.Response of peripheral blood lymphocytes to fungal extracts and staphylococcal superantigen B in chronic rhinosinusitis. Laryngoscope. 2007 Mar;117(3):411-4.

6.Corriveau MN, Zhang N, Holtappels G, Van Roy N, Bachert C. Detection of Staphylococcus aureus in Nasal Tissue with Peptide Nucleic Acid – Fluorescence In Situ Hybridization. Am J Rhinol Allergy 2009;23:461-465

7.Foreman A, G Holtappels, AJ Psaltis, J Jervis-Bardy, J Field, PJ Wormald, C Bachert. Adaptive immune responses in Staphylococcus aureus biofilm associated chronic rhinosinusitis. Allergy 2011