Am J Otolaryngol Head Neck Surg | Volume 8, Issue 1 | Research Article | Open Access
Ahmed Ragab1, Anwar Abd ELatty1*, Iman A. Ahmedy2, Yasmin A.H.S Youni2, Heba Y Elkholy3 and Asmaa M. Abdel Tawab4
1Department of Otorhinolaryngology, Faculty of Medicine, Menoufia University, Menoufia, Egypt 2Department of Clinical Pathology, Faculty of Medicine, Menoufia University, Menoufia, Egypt 3Hematology Unit, Department of Internal Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt 4Department of Chest, Faculty of Medicine, Menoufia University, Menoufia, Egypt
*Correspondance to: Anwar Abd Elatty Ibrahim
Fulltext PDFObjectives: To assess the role of platelet soluble CD40L in the Invasive Mucormycosis Fungal Rhinosinusitis (IMFRS) pathogenesis with its related immunological and coagulation pathways dysfunctions. Methods: This prospective case-control study included 124 subjects divided into four groups: first group was control group of 27 patients, 29 patients confirmed with COVID-19 patients and recently diagnosed type 2 Diabetes Mellitus (T2DM), 33 patients confirmed with COVID-19 and recently diagnosed T2DM with IMFRS, and 35 patients confirmed with COVID-19 but they were non diabetic group. RT-PCR for COVID-19 was done for all patients. The diagnosis of mucormycosis was established via histopathological examination of the affected nose and paranasal sinus tissue. Immunophenotyping assessment of NK cells (CD16, CD56) and T-cell subtypes CD3, CD8, and CD4. Interferon-gamma and soluble CD40 Ligand were estimated. Results: sCD40L was the highest in IMFRS patients and correlated positively with HBA1c, MPV, PDW, INR and D-dimer. Natural killer cells percentage was lower, whereas CD56 and CD16 expression were higher in all 3 diseased groups. CD16 expression was significantly higher in IMFRS than COVID-19 diabetic patients. IMFRS patients displayed the lowest CD3, CD8 and CD4 lymphocytes expression. Interferon gamma was higher in all diseased groups with non-significant differences comparing any two groups of diseased patients. Conclusion: sCD40L significantly increased in IMFRS group in comparison with all groups. That could be obvious that fungal infection had precipitating factor to dampen the innate and adaptive immune system, by decreasing natural killer cells, CD3, CD8, and CD4 percentages.
Invasive fungal rhinosinusitis; Mucormycosis; sCD40L; Platelets
Platelets Soluble-CD40L a Bridge Between Coagulopathy and Host Defence Dysfunction in Patients with Invasive Fungal Rhinosinusitis.