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A sheep model to investigate the role of fungal biofilms in sinusitis: fungal and bacterial synergy
Author(s) -
Boase Sam,
Valentine Rowan,
Singhal Deepti,
Tan Lor Wai,
Wormald PeterJohn
Publication year - 2011
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.20066
Subject(s) - biofilm , microbiology and biotechnology , aspergillus fumigatus , staphylococcus aureus , alternaria alternata , fungus , aspergillus , fungal sinusitis , medicine , alternaria , sinusitis , biology , bacteria , immunology , botany , genetics
Background 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. Methods 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. Results 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. Conclusion 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. © 2011 ARS‐AAOA, LLC.