Re: Chronic sinusitis+fungus

[Guest guest]

Beth, I couldn't get the article without being a subscriber, and it seems the

Mayo Clinic does not have the patent info. Can you tell us whether the article

says if/when the treatment will become

available for sale? Thanks.

Roxy

Beth O'Donnell wrote:

> In today's Wall Street Journal (4.30.03), there is a front page article

> about Jens Ponikau, M.D. of the Mayo Clinic, receiving a patent on a

> treatment for chronic sinusitis with an antifungal drug, amphotericin B,

> used nasally. You can do a Google search with the doctor's name for more

> details.

>

> Beth

>

>

> This list is intended for patients to share personal experiences with each

other, not to give medical advice. If you are interested in any treatment

discussed here, please consult your doctor.

>

>

[Guest guest]

Roxy - I'm unable to download it from the WSJ site either, but below is an

abstract from a PubMed search. This is an excerpt from the article today:

" At this point, there's nothing to stop a doctor from prescribing a

standard antifungal drug such as amphotericin B for sinusitis. But few doctors

are familiar with the treatment, and a pharmacist would have to prepare the drug

- which comes in a variety of forms, from ointments to pills - so that it could

be taken nasally. The Mayo Clinic says it doesn't plan to police individual

doctors who might prescribe generic antifungals. "

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

2464951 & dopt=Abstract

J Allergy Clin Immunol 2002 Dec;110(6):862-6 Related Articles, Links

Intranasal antifungal treatment in 51 patients with chronic rhinosinusitis.

Ponikau JU, Sherris DA, Kita H, Kern EB.

Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic Rochester,

Rochester, MN 55905, USA.

BACKGROUND: Chronic rhinosinusitis (CRS) is the most common chronic disease that

is frequently refractory to treatment. OBJECTIVE: We sought to establish the

safety and demonstrate the clinical efficacy of intranasal antifungal drug

therapy in patients with CRS in a pilot trial. METHODS: A prospective open-label

trial used amphotericin B as a medical treatment in 51 randomly selected

patients with CRS. The antifungal agent was applied intranasally as 20 mL of a

100 microg/mL solution twice daily. The outcome was measured by using their

symptoms and by using an endoscopic scoring system in all patients. In addition,

pretreatment and posttreatment coronal computed tomographic scans of the nose

and sinuses were available for evaluation in 13 patients. RESULTS: By using

amphotericin B, improvement of sinusitis symptoms was observed in 38 (75%) of 51

patients. Endoscopically, 18 (35%) of 51 patients became disease free, and an

additional 20 (39%) of 51 had improvement of at least one stage (P <.001). No

effect was seen in 13 (25%) of 51 patients. The available computed tomographic

scans before and after treatment demonstrated a significant reduction in the

inflammatory mucosa thickening that had occluded the paranasal sinuses (P <.0001

in maxillary sinus). CONCLUSION: This open-label pilot trial demonstrates that

direct mucoadministration of an antifungal drug appears to be both safe and

effective in the treatment of patients with CRS. Therefore controlled and

blinded trials are indicated to clarify the novel role of intranasal antifungal

drugs in the treatment of CRS.

Beth, I couldn't get the article without being a subscriber, and it seems the

Mayo Clinic does not have the patent info. Can you tell us whether the article

says if/when the treatment will become

available for sale? Thanks.

Roxy

Beth O'Donnell wrote:

> In today's Wall Street Journal (4.30.03), there is a front page article

> about Jens Ponikau, M.D. of the Mayo Clinic, receiving a patent on a

> treatment for chronic sinusitis with an antifungal drug, amphotericin B,

> used nasally. You can do a Google search with the doctor's name for more

> details.

[Guest guest]

Roxy and Beth,

Here (below, after your post quotes) is an abstract on their trial of this

treatment. It seems to contain enough info for any doctor to do it ... ?

Having had nose probs for hundreds of years, I am keen to do something

about mine so thanks for the info.

n

>Beth, I couldn't get the article without being a subscriber, and it seems

>the Mayo Clinic does not have the patent info. Can you tell us whether

>the article says if/when the treatment will become

>available for sale? Thanks.

>Roxy

>

>Beth O'Donnell wrote:

>

> > In today's Wall Street Journal (4.30.03), there is a front page article

> > about Jens Ponikau, M.D. of the Mayo Clinic, receiving a patent on a

> > treatment for chronic sinusitis with an antifungal drug, amphotericin B,

> > used nasally. You can do a Google search with the doctor's name for more

> > details.

> >

> > Beth

------------------------------------

Allergy Clin Immunol 2002 Dec;110(6):862-6

Intranasal antifungal treatment in 51 patients with chronic rhinosinusitis.

Ponikau JU, Sherris DA, Kita H, Kern EB.

Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic

Rochester, Rochester, MN 55905, USA.

BACKGROUND: Chronic rhinosinusitis (CRS) is the most common chronic disease

that is frequently refractory to treatment. OBJECTIVE: We sought to

establish the safety and demonstrate the clinical efficacy of intranasal

antifungal drug therapy in patients with CRS in a pilot trial. METHODS: A

prospective open-label trial used amphotericin B as a medical treatment in

51 randomly selected patients with CRS. The antifungal agent was applied

intranasally as 20 mL of a 100 microg/mL solution twice daily. The outcome

was measured by using their symptoms and by using an endoscopic scoring

system in all patients. In addition, pretreatment and posttreatment coronal

computed tomographic scans of the nose and sinuses were available for

evaluation in 13 patients. RESULTS: By using amphotericin B, improvement of

sinusitis symptoms was observed in 38 (75%) of 51 patients. Endoscopically,

18 (35%) of 51 patients became disease free, and an additional 20 (39%) of

51 had improvement of at least one stage (P <.001). No effect was seen in

13 (25%) of 51 patients. The available computed tomographic scans before

and after treatment demonstrated a significant reduction in the

inflammatory mucosa thickening that had occluded the paranasal sinuses (P

<.0001 in maxillary sinus). CONCLUSION: This open-label pilot trial

demonstrates that direct mucoadministration of an antifungal drug appears

to be both safe and effective in the treatment of patients with CRS.

Therefore controlled and blinded trials are indicated to clarify the novel

role of intranasal antifungal drugs in the treatment of CRS.

PMID: 12464951 [PubMed - indexed for MEDLINE]

--------------------------------------

n

Canberra, Australia

http://members.austarmetro.com.au/~julian/photo-an/photo-an.htm

[Guest guest]

On Wed, 30 Apr 2003 20:35:41

Beth O'Donnell wrote:

> Roxy - I'm unable to download it from the WSJ >site either, but below is

an abstract...

---------------------------------------------

Beth and Roxy:

I'm a bit behind in reading the posts, so I apologize if someone has already

posted the full article. It is rather long.

Al C.

------------------------------------------------

With New Patent, Mayo Clinic Owns a Cure for the Sniffles

Center's Sweeping Rights for Treatment

That Isn't Yet Proven Angers Others

By PETER LANDERS

ROCHESTER, Minn. -- Jens Ponikau of the Mayo Clinic says he has made a

breakthrough in treating one of America's most common diseases. Now Mayo has

made a breakthrough of its own: It locked up the rights to that discovery.

The disease is chronic inflammation of the sinuses, which leaves some 32 million

Americans with a persistent stuffy nose. Dr. Ponikau, a 37-year-old German

citizen, believes the condition is caused by an immune response to common fungi

in the air. In his nine-year quest to prove his ideas, colleagues have called

him crazy. Even his father, an ear, nose and throat doctor in Hof, Germany,

suggested that Dr. Ponikau drop his research and return to the family clinic.

The Mayo Clinic is adding a modern twist to this age-old tale of a maverick

scientist challenging established medicine. Tuesday, the nonprofit clinic

captured an unusually broad patent that could give it a chokehold over a new

generation of treatments for chronic sinus inflammation, or sinusitis.

The patent, in effect, blocks others from selling an antifungal agent to treat

the condition without Mayo's approval. That adds to a similarly broad patent

Mayo received in 2001 for treatment of chronic asthma, a disease that Dr.

Ponikau says has the same cause. Mayo filed both patents, which received little

public notice, in October 1998.

Broad patents such as Mayo's, called " method patents, " are rare for a basic

reason: Researchers very rarely claim to have discovered the root causes of a

disease. In most cases, researchers seek to patent only specific treatments.

Approval by the patent office doesn't mean that a product is considered safe or

effective -- just that the rights to that product are protected.

The new patent may add to the growing debate about nonprofits' role as

handmaidens to the drug companies, doing the high-risk basic research that

shareholders won't pay for. Some critics fear nonprofits will grow so enamored

of that role that they will neglect research without commercial potential.

Meanwhile, the patent is also likely to add to the already fierce criticism of

Dr. Ponikau and Mayo by some doctors, who accuse the clinic of blocking future

innovation by stifling research. " That is ethically wrong, " says Berrylin J.

Ferguson, a sinus specialist at the University of Pittsburgh.

Dr. Ponikau and Mayo executives disagree. They say they sought the broadest

possible patents because they wanted to be sure that they could attract a

pharmaceutical company to license the patents and bring the advances to

patients. As is typical at research institutions, the clinic owns the patents

obtained by employees such as Dr. Ponikau, although he is eligible for a portion

of future royalties.

" Nobody will put the resources behind this if you don't have a patent, " says Dr.

Ponikau. " This whole thing will die if we don't do this. " Mayo will soon enter

negotiations to license its patents, and officials say they're looking for a

drug company that can sell an antifungal spray world-wide.

The Food and Drug Administration has yet to approve any drugs for chronic

sinusitis, although it is common for doctors to prescribe inhaled steroids or

antihistamines. America's 17 million asthmatics do have several FDA-approved

drugs, but these merely relieve the symptoms of the disease and many have severe

side effects, such as glaucoma and weight gain. Asthma kills more than 4,000

people each year in the U.S.

Dr. Ponikau says his quest to solve the sinusitis mystery goes back to an

assignment he received in 1994 during a six-month stint at Mayo. Eugene Kern, a

veteran ear, nose and throat expert at Mayo, asked him to do a report on a

handful of seemingly anomalous cases in which fungi -- a common class of

organism that includes molds and yeasts -- were detected in patients with

chronically inflamed sinuses. The problem: Many patients had symptoms that

suggested an immune response to fungi, but actual fungi were detected in only 3%

to 4% of them. Dr. Ponikau headed home to his father's small ear, nose and

throat clinic in Hof convinced that fungi must exist in more patients.

The answer lay in an unorthodox area of investigation: human mucus.

Traditionally, pathologists have studied sinusitis by examining the excised

tissue of patients who undergo sinus surgery. In such surgery, doctors usually

suction out the mucus first and discard it. By removing the mucus, which traps

dust and other particles in the airways, " you destroy the evidence, " says Dr.

Ponikau, chuckling at the way scientists sometimes miss clues right under their

noses. " You won't believe what we all did to make sure we didn't find anything. "

At the Hof clinic, Dr. Ponikau took liquefied mucus samples and ran them through

a centrifuge that would force any fungi to drift to the bottom. When he put the

solution on a bed of nutrients, fungi grew like crazy, proving they had been

present in the original mucus.

He proceeded to offer a few patients at the clinic an antifungal solution. Soon

noses that had been stuffed for years cleared up. Dr. Ponikau called Dr. Kern at

the Mayo Clinic and told him of the results. " Buy an airplane ticket and get

here right away! " Dr. Kern remembers responding.

Dr. Ponikau persuaded his then-girlfriend to go with him to Minnesota. (Today

they are married with two children and have settled in Rochester.) He had less

luck convincing his father, Joachim, that it was the right move. According to

Dr. Ponikau, his father wanted to know: " Why don't you get a real job? " The

elder Dr. Ponikau says he was concerned that his son would " toil for years

researching something no one would take seriously ... even though he might have

the right idea. "

Soon after returning to Mayo in 1996 as a full-time researcher, Dr. Ponikau came

upon what looked like a fatal flaw in his theory: The fungi were present not

only in sick people but also in healthy ones. Sherris, a Mayo ear, nose

and throat doctor who would become Dr. Ponikau's closest collaborator, feared

the research was at a dead end and joked with Dr. Ponikau that Mayo might as

well put the " crazy German " on a boat back home.

But, Dr. Ponikau wondered, if the fungi were harmless bystanders, why did the

antifungal treatments seem to help his patients in Hof? Once again, the answer

lay in the patients' mucus. When Dr. Ponikau put samples under an electron

microscope, he discovered white blood cells called eosinophils clustering around

the fungi. These cells, which help fight off infection, were well-known to occur

in the sinus tissue of patients, but the reason for their presence wasn't known.

Dr. Ponikau realized that the white blood cells were marching through the sinus

tissue to get to the open space of the sinus, a gathering space for fungi that

the patients inhaled. Once there, the white blood cells fired off toxins to

subdue the fungi -- but the toxins also were destroying the outer lining of the

sinus tissue, clearing the way for a bacterial infection that caused

inflammation. Dr. Ponikau then looked at the mucus of healthy people. The

eosinophil cells were absent, meaning the destructive immune-system response

never got started.

In 1999, Dr. Ponikau published his theory, and many specialists scoffed. " I

think it's fundamentally flawed, " Dr. Ferguson of the University of Pittsburgh

told the Washington Post.

Many veteran nose doctors believe Dr. Ponikau's theory accounts for only a small

fraction of sinusitis cases. They think other factors are more likely to be

responsible, such as bacterial infections with other causes and different kinds

of immune responses. Ralph Metson of the Massachusetts Eye and Ear Infirmary

says he's tried antifungal agents on some patients, and " I've not been impressed

with the improvement. "

Dr. Ponikau insists that some veteran doctors are stuck in old textbooks and

want to keep up demand for sinus surgery. The procedure, which removes sinus

tissue to give a patient more breathing room, can cost $10,000 or more. " It's

such a step out of the box, " he says. " We're telling everybody else they've been

wrong for 30 years. "

Dr. Ponikau has won over one of the field's biggest guns -- Heinz Stammberger, a

pioneer in sinus surgery at Austria's University of Graz. Dr. Stammberger says

that when he first read the Mayo paper in 1999, he assumed the report of fungus

everywhere was a mistake. But when his lab replicated the results, he changed

his mind. " We're talking about a significant group of patients, " he now says,

adding that Dr. Ponikau's research is " the most exciting step in many, many

years. "

Mayo doctors have now prescribed their antifungal agents to more than 1,000

patients, making it a standard treatment for chronic sinusitis at the clinic,

although the method isn't approved by the FDA. A study published last year by

the Mayo team showed that a common, generic antifungal drug, amphotericin B,

reduced nasal obstruction in 38 of 51 patients, removing it completely in 25

cases. (Daily doses of the drug are needed to prevent recurrence.) A larger

placebo-controlled double-blind trial is now under way at Mayo. Long-term

effects of the treatment, including potential side effects, aren't known yet.

Side effects of amphotericin B -- when used in other treatments -- could include

fever and vomiting.

At this point, there's nothing to stop a doctor from prescribing a standard

antifungal drug such as amphotericin B for sinusitis. But few doctors are

familiar with the treatment, and a pharmacist would have to prepare the drug --

which comes in a variety of forms, from ointments to pills -- so that it could

be taken nasally. The Mayo Clinic says it doesn't plan to police individual

doctors who might prescribe generic antifungals.

Recently, Dr. Ponikau has been working on an even more explosive theory -- that

chronic asthma is essentially the same disease as chronic sinusitis, and can

also be cured with an antifungal spray. The theory sprang from anecdotal reports

by Mayo patients who said that the antifungal solution for their sinuses cleared

up their lungs, too. In asthma, airways in the lungs become inflamed and filled

with mucus. It is usually treated with steroids or other drugs to control the

inflammation.

Dr. Ponikau says his research shows why that is happening. In a conference room

down the hall from Mayo's busy ear, nose and throat clinic, he displays an

electron-microscope photo of white blood cells attacking fungi in the sinuses

and another photo of the same event in the lungs. The two photos look virtually

identical.

Few asthma doctors know of the new research, but it is likely to face broad

skepticism. Most specialists believe asthma has multiple, overlapping causes --

meaning an antifungal agent wouldn't help much. " If you fix one thing, can you

fix asthma? Highly unlikely, " says Meyer Kattan, an asthma expert at New York's

Mount Sinai Medical Center.

Dr. Ponikau agrees that asthma can be triggered by a specific allergy, say to

dogs or dust mites, but thinks the root cause in chronic cases is the immune

response to fungi, which he says sensitizes the lungs to intruders. He

acknowledges that he needs to publish papers on his studies before scientists

will take the idea seriously.

In 2001, Dr. Ponikau obtained a patent that gives the Mayo Clinic exclusive

rights to market any drug that uses an antifungal agent to treat chronic asthma.

Some leading doctors who know about the asthma patent, and the similar sinusitis

one, accuse Mayo of putting profits ahead of scientific progress. At a meeting

of specialists last year in New York, Dr. Ponikau and Lanza, president of

the American Rhinologic Society and head of nose and sinus disorders at the

Cleveland Clinic, had a hallway tete-a-tete. As both men remember it, Dr. Lanza

accused Dr. Ponikau of withholding information from other doctors to protect his

patents. Dr. Ponikau denied that and said Dr. Lanza didn't understand American

capitalism. " If you don't like it, maybe Russia is a better place to live, " Dr.

Ponikau remembers snapping. (Dr. Lanza says he doesn't recall the remark.)

Dr. Lanza today says he thinks Dr. Ponikau's research is promising but worries

that Mayo has an incentive to hype its discoveries. " You basically have an

inherent conflict of interest, " he says. " Anyone who denies it would be lying to

themselves and everyone else. "

Mayo officials say getting broad patents and licensing them to a big

pharmaceutical company is the only way to make sure Dr. Ponikau's research

reaches patients quickly. Dr. Ponikau and Mayo executives cite the case of Robin

Warren and Barry Marshall, two Australians who made one of medicine's biggest

discoveries of the 1980s by proving that the bacterium helicobacter pylori is

responsible for most stomach ulcers. The two doctors never patented their

discovery, and it took 10 years for antibiotic treatment to sink in among

doctors because drug companies -- which already sold profitable but

less-effective medicines -- didn't pick up on the idea.

Dr. Ponikau, for his part, says he could have made several times his

researcher's salary as a sinus surgeon back home in Hof. " I'm doing this out of

a passion, " he says. " Not many people have a chance to make a significant change

for the better. "

____________________________________________________________

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[Guest guest]

Al,

Thanks for posting this. Commments below.

> Beth and Roxy:

> I'm a bit behind in reading the posts, so I apologize if someone

has already posted the full article. It is rather long.

>

> Al C.

> ------------------------------------------------

> With New Patent, Mayo Clinic Owns a Cure for the Sniffles

>

> Center's Sweeping Rights for Treatment

> That Isn't Yet Proven Angers Others

> By PETER LANDERS

> Dr. Ponikau realized that the white blood cells were marching

through the sinus tissue to get to the open space of the sinus, a

gathering space for fungi that the patients inhaled. Once there, the

white blood cells fired off toxins to subdue the fungi -- but the

toxins also were destroying the outer lining of the sinus tissue,

clearing the way for a bacterial infection that caused inflammation.

Dr. Ponikau then looked at the mucus of healthy people. The

eosinophil cells were absent, meaning the destructive immune-system

response never got started.

Rich's comment: This is really interesting! Could this be how the

coagulase-negative staphylocci, which usually aren't very

pathological, can cause problems?

> Dr. Ponikau has won over one of the field's biggest guns -- Heinz

Stammberger, a pioneer in sinus surgery at Austria's University of

Graz. Dr. Stammberger says that when he first read the Mayo paper in

1999, he assumed the report of fungus everywhere was a mistake. But

when his lab replicated the results, he changed his mind. " We're

talking about a significant group of patients, " he now says, adding

that Dr. Ponikau's research is " the most exciting step in many, many

years. "

Rich's comment: I think so, too!

>

> At this point, there's nothing to stop a doctor from prescribing a

standard antifungal drug such as amphotericin B for sinusitis. But

few doctors are familiar with the treatment, and a pharmacist would

have to prepare the drug -- which comes in a variety of forms, from

ointments to pills -- so that it could be taken nasally. The Mayo

Clinic says it doesn't plan to police individual doctors who might

prescribe generic antifungals.

Rich's comment: This sounds like something that would be worth

trying for a lot of PWCs who have sinus issues.

>

> Recently, Dr. Ponikau has been working on an even more explosive

theory -- that chronic asthma is essentially the same disease as

chronic sinusitis, and can also be cured with an antifungal spray.

Rich's comment: That would really be revolutionary!

>

> Mayo officials say getting broad patents and licensing them to a

big pharmaceutical company is the only way to make sure Dr.

Ponikau's research reaches patients quickly. Dr. Ponikau and Mayo

executives cite the case of Robin Warren and Barry Marshall, two

Australians who made one of medicine's biggest discoveries of the

1980s by proving that the bacterium helicobacter pylori is

responsible for most stomach ulcers. The two doctors never patented

their discovery, and it took 10 years for antibiotic treatment to

sink in among doctors because drug companies -- which already sold

profitable but less-effective medicines -- didn't pick up on the

idea.

I think this is a really good point. Unless there is the potential

for somebody to make money, it just isn't going to happen in our

economy. Rather than bemoan this situation, we should try to use it

to advantage. I think there need to be better ways to limit the

extraction of unreasonable profits from treating sick people, but

there does need to be an incentive to attract the investment needed

to get such a treatment out there.

Rich

[Guest guest]

Does anyone know what the antifungal drug is and how it is

admininstered? I am going on 16 years of the below mentioned sinus

condition (perhaps). And Mayo has never done anything good for us.

Mike C.

In , " HW Lien " <visnew99@l...> wrote:

> On Wed, 30 Apr 2003 20:35:41

> Beth O'Donnell wrote:

\> Beth and Roxy:

> I'm a bit behind in reading the posts, so I apologize if someone

has already posted the full article. It is rather long.

>

> Al C.

> ------------------------------------------------

> With New Patent, Mayo Clinic Owns a Cure for the Sniffles

>

> Center's Sweeping Rights for Treatment

> That Isn't Yet Proven Angers Others

> By PETER LANDERS

>

> ROCHESTER, Minn. -- Jens Ponikau of the Mayo Clinic says he has

made a breakthrough in treating one of America's most common

diseases. Now Mayo has made a breakthrough of its own: It locked up

the rights to that discovery.

>

> The disease is chronic inflammation of the sinuses, which leaves

some 32 million Americans with a persistent stuffy nose. Dr. Ponikau,

a 37-year-old German citizen, believes the condition is caused by an

immune response to common fungi in the air. In his nine-year quest to

prove his ideas, colleagues have called him crazy. Even his father,

an ear, nose and throat doctor in Hof, Germany, suggested that Dr.

Ponikau drop his research and return to the family clinic.

>

> The Mayo Clinic is adding a modern twist to this age-old tale of a

maverick scientist challenging established medicine. Tuesday, the

nonprofit clinic captured an unusually broad patent that could give

it a chokehold over a new generation of treatments for chronic sinus

inflammation, or sinusitis.

>

> The patent, in effect, blocks others from selling an antifungal

agent to treat the condition without Mayo's approval.<<snip<<

[Guest guest]

amphotericin B,used nasally

Re: Chronic sinusitis+fungus

Does anyone know what the antifungal drug is and how it is

admininstered? I am going on 16 years of the below mentioned sinus

condition (perhaps). And Mayo has never done anything good for us.

[Guest guest]

Rich:

Thanks for your interpretation. I skimmed the article, but didnt' realize the

potential connection to CNS.

Al C.

--

On Sun, 04 May 2003 01:46:11

rvankonynen wrote:

>Al,

>

>

>Thanks for posting this. Commments below.

>

>

------------------------------------------------

>> With New Patent, Mayo Clinic Owns a Cure for the Sniffles

>>

>> Center's Sweeping Rights for Treatment

>> That Isn't Yet Proven Angers Others

>> By PETER LANDERS

>

>> Dr. Ponikau realized that the white blood cells were marching

>through the sinus tissue to get to the open space of the sinus, a

>gathering space for fungi that the patients inhaled. Once there, the

>white blood cells fired off toxins to subdue the fungi -- but the

>toxins also were destroying the outer lining of the sinus tissue,

>clearing the way for a bacterial infection that caused inflammation.

>Dr. Ponikau then looked at the mucus of healthy people. The

>eosinophil cells were absent, meaning the destructive immune-system

>response never got started.

>

>Rich's comment: This is really interesting! Could this be how the

>coagulase-negative staphylocci, which usually aren't very

>pathological, can cause problems?

>

>> Dr. Ponikau has won over one of the field's biggest guns -- Heinz

>Stammberger, a pioneer in sinus surgery at Austria's University of

>Graz. Dr. Stammberger says that when he first read the Mayo paper in

>1999, he assumed the report of fungus everywhere was a mistake. But

>when his lab replicated the results, he changed his mind. " We're

>talking about a significant group of patients, " he now says, adding

>that Dr. Ponikau's research is " the most exciting step in many, many

>years. "

>

>Rich's comment: I think so, too!

>

>>

>> At this point, there's nothing to stop a doctor from prescribing a

>standard antifungal drug such as amphotericin B for sinusitis. But

>few doctors are familiar with the treatment, and a pharmacist would

>have to prepare the drug -- which comes in a variety of forms, from

>ointments to pills -- so that it could be taken nasally. The Mayo

>Clinic says it doesn't plan to police individual doctors who might

>prescribe generic antifungals.

>

>

>Rich's comment: This sounds like something that would be worth

>trying for a lot of PWCs who have sinus issues.

>>

>> Recently, Dr. Ponikau has been working on an even more explosive

>theory -- that chronic asthma is essentially the same disease as

>chronic sinusitis, and can also be cured with an antifungal spray.

>

>Rich's comment: That would really be revolutionary!

>

>>

>> Mayo officials say getting broad patents and licensing them to a

>big pharmaceutical company is the only way to make sure Dr.

>Ponikau's research reaches patients quickly. Dr. Ponikau and Mayo

>executives cite the case of Robin Warren and Barry Marshall, two

>Australians who made one of medicine's biggest discoveries of the

>1980s by proving that the bacterium helicobacter pylori is

>responsible for most stomach ulcers. The two doctors never patented

>their discovery, and it took 10 years for antibiotic treatment to

>sink in among doctors because drug companies -- which already sold

>profitable but less-effective medicines -- didn't pick up on the

>idea.

>

>I think this is a really good point. Unless there is the potential

>for somebody to make money, it just isn't going to happen in our

>economy. Rather than bemoan this situation, we should try to use it

>to advantage. I think there need to be better ways to limit the

>extraction of unreasonable profits from treating sick people, but

>there does need to be an incentive to attract the investment needed

>to get such a treatment out there.

>

>Rich

>

>

>

>

>This list is intended for patients to share personal experiences with each

other, not to give medical advice. If you are interested in any treatment

discussed here, please consult your doctor.

>

>