Anti-fungus drug useful for sinus

Treatment with a nasal spray containing the anti-fungal drug amphotericin B reduces the swelling and inflammation that occurs with chronic rhinosinusitis, a common cause of stuffy nose and facial pain. Amphotericin B is an old drug that can cause serious side effects, particularly to the kidneys. However, when given as a nasal spray, the drug does not get absorbed, effectively avoiding these effects. Fungi appear to play a key role in chronic rhinosinusitis by causing certain immune cells to show up in the mucous layer of the nose. Once there, the cells release toxic compounds that damage the fungi, but also the surrounding nasal tissue. Researchers from the Mayo Clinic in Rochester, Minnesota, studied 30 patients to conclude that fungi are involved in the development of chronic rhinosinusitis. Compared with inactive placebo, 6 months of treatment with amphotericin B nasal spray led to a significant reduction in mucous swelling, as determined by CT scans and other tests. Moreover, such therapy seemed to reduce the number of immune cells present. The researchers reasoned that if the immune cells are in the mucous membranes because of the fungi, then maybe reducing the fungi would reduce the inflammation caused by the immune cells and ultimately improve the patient's symptoms. The hypothesis that fungi are involved in chronic rhinosinusitis is controversial and remains to be determined why only certain people develop the condition when nasal fungi are so common. Larger studies are needed.

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