The Experts below are selected from a list of 276 Experts worldwide ranked by ideXlab platform
Cynthia S. Mabry - One of the best experts on this subject based on the ideXlab platform.
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Allergic Fungal sinusitis: the role of immunotherapy.
Otolaryngologic Clinics of North America, 2000Co-Authors: Richard L. Mabry, Cynthia S. MabryAbstract:The role of surgery and anti-inflammatory therapy (such as corticosteroids) in the management of allergic Fungal sinusitis is accepted fairly universally. Although once thought to be contraindicated in the treatment of allergic Fungal sinusitis, specific immunotherapy with Fungal antigens has been shown to be extremely beneficial to these patients, when combined with surgery and adjunctive medical management. Recurrences have been prevented and systemic corticosteroid requirements virtually eliminated in an experience that now spans over 4 years.
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treatment of allergic Fungal sinusitis a comparison trial of postoperative immunotherapy with specific Fungal antigens
Laryngoscope, 1998Co-Authors: Randy J Folker, Richard L. Mabry, Bradley F. Marple, Cynthia S. MabryAbstract:Objective: To determine the effect of immunotherapy (IT) with Fungal antigens on clinical outcome in patients with allergic Fungal sinusitis (AFS). Study Design: Prospective case control. Methods : In this comparison study, 22 patients meeting the diagnostic criteria of allergic Fungal sinusitis (AFS) were evaluated after a mean of 33 months' therapy. All received similar treatment consisting of endoscopic sinus surgery, corticosteroids, and antibiotics as needed for complicating purulent sinusitis. Eleven patients received postoperative immunotherapy (IT) with Fungal and nonFungal antigens to which sensitivity had been demonstrated, while the remaining 11 received no immunotherapy. Results: The effect of IT was to significantly improve patient outcome as assessed objectively by an AFS endoscopic mucosal staging system (P <.001) and a sinusitis-specific quality-of-life scale, the Chronic Sinusitis Survey (P = .002). In addition, IT was shown to reduce reliance on systemic (P <.001) and topical nasal (P =.043) corticosteroid therapy to control disease. Follow-up was similar in the two groups and was not a determinant of differences in outcome (P =.7). Conclusions: Results from this study indicate that specific IT with Fungal antigens improves patient outcome in AFS.
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Treatment of allergic Fungal sinusitis: a comparison trial of postoperative immunotherapy with specific Fungal antigens.
The Laryngoscope, 1998Co-Authors: Randy J Folker, Richard L. Mabry, B F Marple, Cynthia S. MabryAbstract:To determine the effect of immunotherapy (IT) with Fungal antigens on clinical outcome in patients with allergic Fungal sinusitis (AFS). Prospective case control. In this comparison study, 22 patients meeting the diagnostic criteria of allergic Fungal sinusitis (AFS) were evaluated after a mean of 33 months' therapy. All received similar treatment consisting of endoscopic sinus surgery, corticosteroids, and antibiotics as needed for complicating purulent sinusitis. Eleven patients received postoperative immunotherapy (IT) with Fungal and nonFungal antigens to which sensitivity had been demonstrated, while the remaining 11 received no immunotherapy. The effect of IT was to significantly improve patient outcome as assessed objectively by an AFS endoscopic mucosal staging system (P < .001) and a sinusitis-specific quality-of-life scale, the Chronic Sinusitis Survey (P = .002). In addition, IT was shown to reduce reliance on systemic (P < .001) and topical nasal (P = .043) corticosteroid therapy to control disease. Follow-up was similar in the two groups and was not a determinant of differences in outcome (P = .7). Results from this study indicate that specific IT with Fungal antigens improves patient outcome in AFS.
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Treatment of allergic Fungal sinusitis : A comparison trial of postoperative immunotherapy with specific Fungal antigens
The Laryngoscope, 1998Co-Authors: Randy J Folker, Richard L. Mabry, Bradley F. Marple, Cynthia S. MabryAbstract:Objective: To determine the effect of immunotherapy (IT) with Fungal antigens on clinical outcome in patients with allergic Fungal sinusitis (AFS). Study Design: Prospective case control. Methods : In this comparison study, 22 patients meeting the diagnostic criteria of allergic Fungal sinusitis (AFS) were evaluated after a mean of 33 months' therapy. All received similar treatment consisting of endoscopic sinus surgery, corticosteroids, and antibiotics as needed for complicating purulent sinusitis. Eleven patients received postoperative immunotherapy (IT) with Fungal and nonFungal antigens to which sensitivity had been demonstrated, while the remaining 11 received no immunotherapy. Results: The effect of IT was to significantly improve patient outcome as assessed objectively by an AFS endoscopic mucosal staging system (P
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immunotherapy in the treatment of allergic Fungal sinusitis
Otolaryngology-Head and Neck Surgery, 1997Co-Authors: Richard L. Mabry, Scott C Manning, Cynthia S. MabryAbstract:Recommendations to withhold immunotherapy with Fungal antigens from patients with allergic Fungal sinusitis (AFS) have been based primarily on retrospectively reviewed, anecdotal case reports and theoretical considerations. A study that was approved by the investigational review board of our institution is ongoing in our department to administer immunotherapy with relevant Fungal antigens to patients with histologically proven AFS. After 1 year, no instances of worsening of symptoms as a result of this therapy have been observed. Objective measurement of improvement has been difficult, but our initial clinical impression is that this treatment regimen has resulted in significant reduction in the reaccumulation of crusts and allergic mucin within the sinuses, has led to a reduction in the use of topical nasal steroids, and has made systemic steroid therapy unnecessary, thereby improving the quality of life of the patient. A further study of immunotherapy for patients with AFS is recommended, and suggestions for modification of the current protocol are presented. (Otolaryngol Head Neck Surg 1997;116:31-5.)
Richard L. Mabry - One of the best experts on this subject based on the ideXlab platform.
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Allergic Fungal sinusitis: the role of immunotherapy.
Otolaryngologic Clinics of North America, 2000Co-Authors: Richard L. Mabry, Cynthia S. MabryAbstract:The role of surgery and anti-inflammatory therapy (such as corticosteroids) in the management of allergic Fungal sinusitis is accepted fairly universally. Although once thought to be contraindicated in the treatment of allergic Fungal sinusitis, specific immunotherapy with Fungal antigens has been shown to be extremely beneficial to these patients, when combined with surgery and adjunctive medical management. Recurrences have been prevented and systemic corticosteroid requirements virtually eliminated in an experience that now spans over 4 years.
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treatment of allergic Fungal sinusitis a comparison trial of postoperative immunotherapy with specific Fungal antigens
Laryngoscope, 1998Co-Authors: Randy J Folker, Richard L. Mabry, Bradley F. Marple, Cynthia S. MabryAbstract:Objective: To determine the effect of immunotherapy (IT) with Fungal antigens on clinical outcome in patients with allergic Fungal sinusitis (AFS). Study Design: Prospective case control. Methods : In this comparison study, 22 patients meeting the diagnostic criteria of allergic Fungal sinusitis (AFS) were evaluated after a mean of 33 months' therapy. All received similar treatment consisting of endoscopic sinus surgery, corticosteroids, and antibiotics as needed for complicating purulent sinusitis. Eleven patients received postoperative immunotherapy (IT) with Fungal and nonFungal antigens to which sensitivity had been demonstrated, while the remaining 11 received no immunotherapy. Results: The effect of IT was to significantly improve patient outcome as assessed objectively by an AFS endoscopic mucosal staging system (P <.001) and a sinusitis-specific quality-of-life scale, the Chronic Sinusitis Survey (P = .002). In addition, IT was shown to reduce reliance on systemic (P <.001) and topical nasal (P =.043) corticosteroid therapy to control disease. Follow-up was similar in the two groups and was not a determinant of differences in outcome (P =.7). Conclusions: Results from this study indicate that specific IT with Fungal antigens improves patient outcome in AFS.
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comprehensive management of allergic Fungal sinusitis
American Journal of Rhinology, 1998Co-Authors: Bradley F. Marple, Richard L. MabryAbstract:In little more than a decade, allergic Fungal sinusitis has gone from a medical curiosity to one of the more perplexing problems to challenge the otorhinolaryngologist. These patients are typically immunocompetent adolescents or young adults with pansinusitis (unilateral and bilateral) and polyposis, atopy, and characteristic radiographic findings. Allergic mucin contained within the sinuses demonstrates numerous eosinophils and Charcot-Leyden crystals, and Fungal stains show the presence of noninvasive hyphae. Fungal cultures may or may not be positive. We have found the following approach to allergic Fungal sinusitis to be most effective: 1) Adequate preoperative evaluation and medical preparation; 2) Meticulous exenterative surgery; 3) Closely supervised immunotherapy with relevant Fungal and non-Fungal antigens; 4) Medical management including topical and systemic corticosteroids as needed; 5) Irrigation and self-cleansing by the patient; and 6) Close clinical follow-up with endoscopically guided debridement when necessary.
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Treatment of allergic Fungal sinusitis: a comparison trial of postoperative immunotherapy with specific Fungal antigens.
The Laryngoscope, 1998Co-Authors: Randy J Folker, Richard L. Mabry, B F Marple, Cynthia S. MabryAbstract:To determine the effect of immunotherapy (IT) with Fungal antigens on clinical outcome in patients with allergic Fungal sinusitis (AFS). Prospective case control. In this comparison study, 22 patients meeting the diagnostic criteria of allergic Fungal sinusitis (AFS) were evaluated after a mean of 33 months' therapy. All received similar treatment consisting of endoscopic sinus surgery, corticosteroids, and antibiotics as needed for complicating purulent sinusitis. Eleven patients received postoperative immunotherapy (IT) with Fungal and nonFungal antigens to which sensitivity had been demonstrated, while the remaining 11 received no immunotherapy. The effect of IT was to significantly improve patient outcome as assessed objectively by an AFS endoscopic mucosal staging system (P < .001) and a sinusitis-specific quality-of-life scale, the Chronic Sinusitis Survey (P = .002). In addition, IT was shown to reduce reliance on systemic (P < .001) and topical nasal (P = .043) corticosteroid therapy to control disease. Follow-up was similar in the two groups and was not a determinant of differences in outcome (P = .7). Results from this study indicate that specific IT with Fungal antigens improves patient outcome in AFS.
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Treatment of allergic Fungal sinusitis : A comparison trial of postoperative immunotherapy with specific Fungal antigens
The Laryngoscope, 1998Co-Authors: Randy J Folker, Richard L. Mabry, Bradley F. Marple, Cynthia S. MabryAbstract:Objective: To determine the effect of immunotherapy (IT) with Fungal antigens on clinical outcome in patients with allergic Fungal sinusitis (AFS). Study Design: Prospective case control. Methods : In this comparison study, 22 patients meeting the diagnostic criteria of allergic Fungal sinusitis (AFS) were evaluated after a mean of 33 months' therapy. All received similar treatment consisting of endoscopic sinus surgery, corticosteroids, and antibiotics as needed for complicating purulent sinusitis. Eleven patients received postoperative immunotherapy (IT) with Fungal and nonFungal antigens to which sensitivity had been demonstrated, while the remaining 11 received no immunotherapy. Results: The effect of IT was to significantly improve patient outcome as assessed objectively by an AFS endoscopic mucosal staging system (P
Randy J Folker - One of the best experts on this subject based on the ideXlab platform.
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treatment of allergic Fungal sinusitis a comparison trial of postoperative immunotherapy with specific Fungal antigens
Laryngoscope, 1998Co-Authors: Randy J Folker, Richard L. Mabry, Bradley F. Marple, Cynthia S. MabryAbstract:Objective: To determine the effect of immunotherapy (IT) with Fungal antigens on clinical outcome in patients with allergic Fungal sinusitis (AFS). Study Design: Prospective case control. Methods : In this comparison study, 22 patients meeting the diagnostic criteria of allergic Fungal sinusitis (AFS) were evaluated after a mean of 33 months' therapy. All received similar treatment consisting of endoscopic sinus surgery, corticosteroids, and antibiotics as needed for complicating purulent sinusitis. Eleven patients received postoperative immunotherapy (IT) with Fungal and nonFungal antigens to which sensitivity had been demonstrated, while the remaining 11 received no immunotherapy. Results: The effect of IT was to significantly improve patient outcome as assessed objectively by an AFS endoscopic mucosal staging system (P <.001) and a sinusitis-specific quality-of-life scale, the Chronic Sinusitis Survey (P = .002). In addition, IT was shown to reduce reliance on systemic (P <.001) and topical nasal (P =.043) corticosteroid therapy to control disease. Follow-up was similar in the two groups and was not a determinant of differences in outcome (P =.7). Conclusions: Results from this study indicate that specific IT with Fungal antigens improves patient outcome in AFS.
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Treatment of allergic Fungal sinusitis: a comparison trial of postoperative immunotherapy with specific Fungal antigens.
The Laryngoscope, 1998Co-Authors: Randy J Folker, Richard L. Mabry, B F Marple, Cynthia S. MabryAbstract:To determine the effect of immunotherapy (IT) with Fungal antigens on clinical outcome in patients with allergic Fungal sinusitis (AFS). Prospective case control. In this comparison study, 22 patients meeting the diagnostic criteria of allergic Fungal sinusitis (AFS) were evaluated after a mean of 33 months' therapy. All received similar treatment consisting of endoscopic sinus surgery, corticosteroids, and antibiotics as needed for complicating purulent sinusitis. Eleven patients received postoperative immunotherapy (IT) with Fungal and nonFungal antigens to which sensitivity had been demonstrated, while the remaining 11 received no immunotherapy. The effect of IT was to significantly improve patient outcome as assessed objectively by an AFS endoscopic mucosal staging system (P < .001) and a sinusitis-specific quality-of-life scale, the Chronic Sinusitis Survey (P = .002). In addition, IT was shown to reduce reliance on systemic (P < .001) and topical nasal (P = .043) corticosteroid therapy to control disease. Follow-up was similar in the two groups and was not a determinant of differences in outcome (P = .7). Results from this study indicate that specific IT with Fungal antigens improves patient outcome in AFS.
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Treatment of allergic Fungal sinusitis : A comparison trial of postoperative immunotherapy with specific Fungal antigens
The Laryngoscope, 1998Co-Authors: Randy J Folker, Richard L. Mabry, Bradley F. Marple, Cynthia S. MabryAbstract:Objective: To determine the effect of immunotherapy (IT) with Fungal antigens on clinical outcome in patients with allergic Fungal sinusitis (AFS). Study Design: Prospective case control. Methods : In this comparison study, 22 patients meeting the diagnostic criteria of allergic Fungal sinusitis (AFS) were evaluated after a mean of 33 months' therapy. All received similar treatment consisting of endoscopic sinus surgery, corticosteroids, and antibiotics as needed for complicating purulent sinusitis. Eleven patients received postoperative immunotherapy (IT) with Fungal and nonFungal antigens to which sensitivity had been demonstrated, while the remaining 11 received no immunotherapy. Results: The effect of IT was to significantly improve patient outcome as assessed objectively by an AFS endoscopic mucosal staging system (P
Luis Carrasco - One of the best experts on this subject based on the ideXlab platform.
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Fungal infection in cerebrospinal fluid from some patients with multiple sclerosis.
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2013Co-Authors: Diana Pisa, Ruth Alonso, F. J. Jiménez-jiménez, Luis CarrascoAbstract:Multiple sclerosis (MS) is the prototypical inflammatory disease of the central nervous system and spinal cord, leading to axonal demyelination of neurons. Recently, we have found a correlation between Fungal infection and MS in peripheral blood of patients. The present work provides evidence of Fungal infection in the cerebrospinal fluid (CSF) of some MS patients. Thus, Fungal antigens can be demonstrated in CSF, as well as antibodies reacting against several Candida species. Comparison was made between CSF and blood serum for the presence of Fungal antigens (proteins) and antibodies against different Candida spp. Analyses of both CSF and serum are complementary and serve to better evaluate for the presence of disseminated Fungal infection. In addition, PCR analyses indicate the presence of DNA from different Fungal species in CSF, depending on the patient analyzed. Overall, these findings support the notion that Fungal infection can be demonstrated in CSF from some MS patients. This may constitute a risk factor in this disease and could also help in understanding the pathogenesis of MS.
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Fungal infection in patients with serpiginous choroiditis or acute zonal occult outer retinopathy
Journal of Clinical Microbiology, 2008Co-Authors: Diana Pisa, Marta Ramos, Patricia Garcia, Remberto Escoto, Rafael I Barraquer, Susana Molina, Luis CarrascoAbstract:The etiologies of a number of retinopathies, including serpiginous choroiditis and acute zonal occult outer retinopathy (AZOOR), remain uncertain. Recently, we provided evidence that AZOOR is caused by Candida famata infection. The purpose of this article was to investigate the presence of Fungal infection in five patients affected with serpiginous choroiditis and five patients with diagnosis of AZOOR. To assess the presence of Fungal infection the presence of antibodies in human serum samples against C. famata, C. albicans, C. parapsilosis, C. glabrata and C. krusei was analyzed. In addition, quantitative PCR was carried out to detect Fungal genomes in whole blood. Finally, the presence of Fungal antigens in the serum samples of patients was investigated. Three AZOOR patients presented high antibody titers against Candida spp., while antibodies against Candida spp. were observed in serum samples from four patients with serpiginous choroiditis. Fungal genomes in peripheral blood were evidenced in serum samples from one AZOOR and four serpiginous choroiditis patients. Fungal antigens were also apparent in the serum of different patients. Our findings indicate that there was evidence of disseminated Fungal infection in most patients examined.
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Evolution of antibody response and Fungal antigens in the serum of a patient infected with Candida famata.
Journal of Medical Microbiology, 2007Co-Authors: Diana Pisa, Marta Ramos, Patricia Garcia, Susana Molina, Luis CarrascoAbstract:The presence of Fungal antibodies and antigens in the serum of a patient diagnosed in 1996 with acute zonal occult outer retinopathy caused by Candida famata infection was examined. Antibodies against C. famata increased until 1999–2000 when antiFungal treatment was initiated. The antibodies were detected by ELISA and immunofluorescence analysis using C. famata. These antibodies were not immunoreactive against several Candida species tested. Positive immunofluorescence was obtained with IgM, but not IgA, IgG or IgE. Moreover, the IgM response disappeared several months after treatment with antiFungal compounds, despite the fact that C. famata antigens were present in the blood. Finally, a sensitive test was developed to assay for the presence of C. famata antigens in serum based on the immunodetection of Fungal antigens transferred to a nitrocellulose membrane and incubated with rabbit antibodies raised against C. famata. According to this method, the infection diminished with antiFungal treatment.
Diana Pisa - One of the best experts on this subject based on the ideXlab platform.
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evidence for Fungal infection in cerebrospinal fluid and brain tissue from patients with amyotrophic lateral sclerosis
International Journal of Biological Sciences, 2015Co-Authors: Ruth Alonso, Diana Pisa, Ana Isabel Marina, Esperanza Morato, Alberto Rabano, Izaskun Rodal, Luis E CarrascoAbstract:Among neurogenerative diseases, amyotrophic lateral sclerosis (ALS) is a fatal illness characterized by a progressive motor neuron dysfunction in the motor cortex, brainstem and spinal cord. ALS is the most common form of motor neuron disease; yet, to date, the exact etiology of ALS remains unknown. In the present work, we have explored the possibility of Fungal infection in cerebrospinal fluid (CSF) and in brain tissue from ALS patients. Fungal antigens, as well as DNA from several fungi, were detected in CSF from ALS patients. Additionally, examination of brain sections from the frontal cortex of ALS patients revealed the existence of immunopositive Fungal antigens comprising punctate bodies in the cytoplasm of some neurons. Fungal DNA was also detected in brain tissue using PCR analysis, uncovering the presence of several Fungal species. Finally, proteomic analyses of brain tissue demonstrated the occurrence of several Fungal peptides. Collectively, our observations provide compelling evidence of Fungal infection in the ALS patients analyzed, suggesting that this infection may play a part in the etiology of the disease or may constitute a risk factor for these patients.
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Fungal infection in cerebrospinal fluid from some patients with multiple sclerosis.
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2013Co-Authors: Diana Pisa, Ruth Alonso, F. J. Jiménez-jiménez, Luis CarrascoAbstract:Multiple sclerosis (MS) is the prototypical inflammatory disease of the central nervous system and spinal cord, leading to axonal demyelination of neurons. Recently, we have found a correlation between Fungal infection and MS in peripheral blood of patients. The present work provides evidence of Fungal infection in the cerebrospinal fluid (CSF) of some MS patients. Thus, Fungal antigens can be demonstrated in CSF, as well as antibodies reacting against several Candida species. Comparison was made between CSF and blood serum for the presence of Fungal antigens (proteins) and antibodies against different Candida spp. Analyses of both CSF and serum are complementary and serve to better evaluate for the presence of disseminated Fungal infection. In addition, PCR analyses indicate the presence of DNA from different Fungal species in CSF, depending on the patient analyzed. Overall, these findings support the notion that Fungal infection can be demonstrated in CSF from some MS patients. This may constitute a risk factor in this disease and could also help in understanding the pathogenesis of MS.
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Fungal infection in patients with serpiginous choroiditis or acute zonal occult outer retinopathy
Journal of Clinical Microbiology, 2008Co-Authors: Diana Pisa, Marta Ramos, Patricia Garcia, Remberto Escoto, Rafael I Barraquer, Susana Molina, Luis CarrascoAbstract:The etiologies of a number of retinopathies, including serpiginous choroiditis and acute zonal occult outer retinopathy (AZOOR), remain uncertain. Recently, we provided evidence that AZOOR is caused by Candida famata infection. The purpose of this article was to investigate the presence of Fungal infection in five patients affected with serpiginous choroiditis and five patients with diagnosis of AZOOR. To assess the presence of Fungal infection the presence of antibodies in human serum samples against C. famata, C. albicans, C. parapsilosis, C. glabrata and C. krusei was analyzed. In addition, quantitative PCR was carried out to detect Fungal genomes in whole blood. Finally, the presence of Fungal antigens in the serum samples of patients was investigated. Three AZOOR patients presented high antibody titers against Candida spp., while antibodies against Candida spp. were observed in serum samples from four patients with serpiginous choroiditis. Fungal genomes in peripheral blood were evidenced in serum samples from one AZOOR and four serpiginous choroiditis patients. Fungal antigens were also apparent in the serum of different patients. Our findings indicate that there was evidence of disseminated Fungal infection in most patients examined.
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Evolution of antibody response and Fungal antigens in the serum of a patient infected with Candida famata.
Journal of Medical Microbiology, 2007Co-Authors: Diana Pisa, Marta Ramos, Patricia Garcia, Susana Molina, Luis CarrascoAbstract:The presence of Fungal antibodies and antigens in the serum of a patient diagnosed in 1996 with acute zonal occult outer retinopathy caused by Candida famata infection was examined. Antibodies against C. famata increased until 1999–2000 when antiFungal treatment was initiated. The antibodies were detected by ELISA and immunofluorescence analysis using C. famata. These antibodies were not immunoreactive against several Candida species tested. Positive immunofluorescence was obtained with IgM, but not IgA, IgG or IgE. Moreover, the IgM response disappeared several months after treatment with antiFungal compounds, despite the fact that C. famata antigens were present in the blood. Finally, a sensitive test was developed to assay for the presence of C. famata antigens in serum based on the immunodetection of Fungal antigens transferred to a nitrocellulose membrane and incubated with rabbit antibodies raised against C. famata. According to this method, the infection diminished with antiFungal treatment.
