Dr. Kern said that because 78% of the patients in that study also had asthma, there are questions about fungi’s precise role. At heart, that is the single most important piece of evidence in support of the fungal hypothesis, he said. But if you remember, the vast majority of those patients also had asthma. So you’re taking blood from a patient with asthma-how do you know which is causing the response, asthma or polypoid sinusitis?
Explore This IssueJune 2009
Dr. Kern also said that Dr. Ponikau’s studies involved massive amounts of antigens, far more than would ever be experienced at the epithelial surface.
So it’s difficult to say that they are specific responses in the sense of relevance to the clinical state, he said.
Dr. Ponikau said later that his lab tested many different concentrations of fungal antigens before carrying out the study; they found that 50 mcg/mL was optimal, and that using a lesser or greater concentration didn’t work as well. He added that nobody knows the actual concentration of the antigen on the T-cells in vivo in CRS patients.
The debate is likely to continue.
In the end, Dr. Kern said, It comes down, I guess, to being a believer or not.
©2009 The Triological Society