ReviewAmerican journal of rhinology & allergy2023
New Developments in Allergic Fungal Rhinosinusitis Pathophysiology and Treatment.
Review in American journal of rhinology & allergy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 25 citations in OpenAlex.
- Manuka Honey Sinus Irrigation Versus Systemic Itraconazole in Allergic Fungal Rhinosinusitis: Randomised Clinical Trial for Efficacy and Safety.Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery · 2026Trial
- A Case of Allergic Fungal Sinusitis-Like Syndrome: Clinical and Immunopathological Comparison With Allergic Bronchopulmonary Aspergillosis.Journal of rhinology : official journal of the Korean Rhinologic Society · 2026Article
- Demographic and Comorbidity Associations With Disease Severity and Bony Dehiscence in AFRS.Laryngoscope investigative otolaryngology · 2026Article
- Indoor and Outdoor Fungal Allergens and Impacts on Respiratory Allergic Disease.The journal of allergy and clinical immunology. In practice · 2025Review
- Postoperative Recurrence in Allergic Fungal Rhinosinusitis: A Single Center Experience.Cureus · 2025Article
- The Ayurvedic Management of Fungal Sinusitis in Standalone Settings: A Case Report.Clinical case reports · 2025Article
- Clinical characteristics and treatment of unilateral allergic fungal rhinosinusitis: a retrospective case series and literature review.Frontiers in allergy · 2025Article
- Review
- Exploring the role of candidalysin in the pathogenicity ofAmerican journal of translational research · 2024Article
- Allergic Fungal Otomastoiditis: A Case Report.Cureus · 2023Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAllergic fungal rhinosinusitis (AFRS) is an endotype of chronic rhinosinusitis (CRS) with nasal polyps characterized by eosinophilic mucin laden with fungal hyphae entrapped in expanded sinus cavities with an exaggerated hypersensitivity to fungal elements. The last decade has elucidated fungi-driven inflammatory pathways contributing to the pathophysiology of chronic inflammatory respiratory diseases. In addition, novel therapeutic biologic options have become available for CRS over the last several years.
objectiveTo review the current literature examining AFRS, focusing on recent developments in our understanding of its pathophysiology and implications for treatment options.
methodsReview article.
resultsFungi-driven respiratory inflammation has been linked to fungal proteinases and toxin activity. In addition, AFRS patients demonstrate a local sinonasal immunodeficiency in antimicrobial peptides and hence limited antifungal activity, along with an exaggerated type 2 inflammatory response, highlighting a possible imbalanced type 1, type 2, and type 3 profile. The elucidation of these dysregulated molecular pathways has highlighted novel potential therapeutic targets. As such, the clinical management of AFRS, which once included surgery and extended courses of oral corticosteroids, is transitioning away from long courses of oral corticosteroids to incorporate novel delivery mechanisms of topical therapeutic targets and biologics for recalcitrant disease.
conclusionAFRS is an endotype of CRS with nasal polyps (CRSwNP) for which the molecular pathways leading to its inflammatory dysfunction are beginning to be illuminated. In addition to affecting treatment options, these understandings may shape necessary changes to diagnostic criteria and the extrapolated effects of environmental changes on AFRS. More critically, a better appreciation of fungi-driven inflammatory pathways may have implications for the understanding of broader CRS inflammation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.