Allergic Fungal Rhinosinusitis Diagnosis, Management, Associated Conditions, Pathophysiology, and Future Directions: Summary of a Multidisciplinary Workshop

Lauren T. Roland; Cecelia Damask; Amber U. Luong; Antoine Azar; Charles S. Ebert; Thomas Edwards; Katherine N. Cahill; Do Yeon Cho; David Corry; Tara L. Croston; Alexandra F. Freeman; Amin Javer; Paneez Khoury; Jean Kim; Michael Koval; Edward D. McCoul; James W. Mims; Anju Peters; Jay F. Piccirillo; Richard P. Ramonell; Amali Samarasinghe; Robert P. Schleimer; Prestina Smith-Davidson; Andrej Spec; Michael E. Wechsler; Sarah K. Wise; Joshua M. Levy

doi:10.1002/alr.23582

Allergic Fungal Rhinosinusitis Diagnosis, Management, Associated Conditions, Pathophysiology, and Future Directions: Summary of a Multidisciplinary Workshop

Lauren T. Roland^*, Cecelia Damask, Amber U. Luong, Antoine Azar, Charles S. Ebert, Thomas Edwards, Katherine N. Cahill, Do Yeon Cho, David Corry, Tara L. Croston, Alexandra F. Freeman, Amin Javer, Paneez Khoury, Jean Kim, Michael Koval, Edward D. McCoul, James W. Mims, Anju Peters, Jay F. Piccirillo, Richard P. RamonellAmali Samarasinghe, Robert P. Schleimer, Prestina Smith-Davidson, Andrej Spec, Michael E. Wechsler, Sarah K. Wise, Joshua M. Levy

^*Corresponding author for this work

Medicine, Allergy Division

Research output: Contribution to journal › Review article › peer-review

Abstract

Allergic fungal rhinosinusitis (AFRS) is a unique endotype of chronic rhinosinusitis with nasal polyps (CRSwNP). Despite high recurrence rates and often more severe presenting signs compared with other subtypes of CRSwNP, research dedicated to AFRS has been lacking. Diagnostic criteria are outdated, the mechanistic relationship of AFRS to other associated diseases is unclear, and the pathophysiology of disease and risk factors for recurrence have not been well studied. In December 2023, a multidisciplinary group of rhinologists, otolaryngologists, pulmonologists, allergists, immunologists, scientists, and infectious disease experts met at the National Institute of Health to discuss unmet needs for future AFRS research and care, including patient management, diagnostic criteria, severity, pathophysiology, and related conditions. A summary of these clinical and associated research discussions is included below.

Original language	English (US)
Pages (from-to)	626-641
Number of pages	16
Journal	International Forum of Allergy and Rhinology
Volume	15
Issue number	6
DOIs	https://doi.org/10.1002/alr.23582
State	Accepted/In press - 2025

Funding

: This work was jointly supported by funds from the American Rhinologic Society (ARS), American Academy of Otolaryngic Allergy (AAOA) and NIDCD Division of Intramural Research to J.M.L. (DC000098\u201002). Funding We would like to acknowledge the participation of the following at the NIH Allergic Fungal Rhinosinusitis Workshop: Novartis, Sanofi, GSK, Regeneron, AstraZeneca, and Amgen. This work was jointly supported by funds from the American Rhinologic Society (ARS), American Academy of Otolaryngic Allergy (AAOA) and NIDCD Division of Intramural Research to J.M.L. (DC000098\u201002).

Keywords

allergic fungal sinusitis
allergic sinusitis
chronic rhinosinusitis
fungal sinusitis
invasive fungal sinusitis
nasal polyps

ASJC Scopus subject areas

Immunology and Allergy
Otorhinolaryngology

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10.1002/alr.23582

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Roland, L. T., Damask, C., Luong, A. U., Azar, A., Ebert, C. S., Edwards, T., Cahill, K. N., Cho, D. Y., Corry, D., Croston, T. L., Freeman, A. F., Javer, A., Khoury, P., Kim, J., Koval, M., McCoul, E. D., Mims, J. W., Peters, A., Piccirillo, J. F., ... Levy, J. M. (Accepted/In press). Allergic Fungal Rhinosinusitis Diagnosis, Management, Associated Conditions, Pathophysiology, and Future Directions: Summary of a Multidisciplinary Workshop. International Forum of Allergy and Rhinology, 15(6), 626-641. https://doi.org/10.1002/alr.23582

@article{1c157ce9fc214b18ad50fe5fe2606f5f,

title = "Allergic Fungal Rhinosinusitis Diagnosis, Management, Associated Conditions, Pathophysiology, and Future Directions: Summary of a Multidisciplinary Workshop",

abstract = "Allergic fungal rhinosinusitis (AFRS) is a unique endotype of chronic rhinosinusitis with nasal polyps (CRSwNP). Despite high recurrence rates and often more severe presenting signs compared with other subtypes of CRSwNP, research dedicated to AFRS has been lacking. Diagnostic criteria are outdated, the mechanistic relationship of AFRS to other associated diseases is unclear, and the pathophysiology of disease and risk factors for recurrence have not been well studied. In December 2023, a multidisciplinary group of rhinologists, otolaryngologists, pulmonologists, allergists, immunologists, scientists, and infectious disease experts met at the National Institute of Health to discuss unmet needs for future AFRS research and care, including patient management, diagnostic criteria, severity, pathophysiology, and related conditions. A summary of these clinical and associated research discussions is included below.",

keywords = "allergic fungal sinusitis, allergic sinusitis, chronic rhinosinusitis, fungal sinusitis, invasive fungal sinusitis, nasal polyps",

author = "Roland, {Lauren T.} and Cecelia Damask and Luong, {Amber U.} and Antoine Azar and Ebert, {Charles S.} and Thomas Edwards and Cahill, {Katherine N.} and Cho, {Do Yeon} and David Corry and Croston, {Tara L.} and Freeman, {Alexandra F.} and Amin Javer and Paneez Khoury and Jean Kim and Michael Koval and McCoul, {Edward D.} and Mims, {James W.} and Anju Peters and Piccirillo, {Jay F.} and Ramonell, {Richard P.} and Amali Samarasinghe and Schleimer, {Robert P.} and Prestina Smith-Davidson and Andrej Spec and Wechsler, {Michael E.} and Wise, {Sarah K.} and Levy, {Joshua M.}",

note = "Publisher Copyright: {\textcopyright} 2025 ARS-AAOA, LLC.",

year = "2025",

doi = "10.1002/alr.23582",

language = "English (US)",

volume = "15",

pages = "626--641",

journal = "International Forum of Allergy and Rhinology",

issn = "2042-6976",

publisher = "John Wiley and Sons Inc.",

number = "6",

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Roland, LT, Damask, C, Luong, AU, Azar, A, Ebert, CS, Edwards, T, Cahill, KN, Cho, DY, Corry, D, Croston, TL, Freeman, AF, Javer, A, Khoury, P, Kim, J, Koval, M, McCoul, ED, Mims, JW, Peters, A, Piccirillo, JF, Ramonell, RP, Samarasinghe, A, Schleimer, RP, Smith-Davidson, P, Spec, A, Wechsler, ME, Wise, SK & Levy, JM 2025, 'Allergic Fungal Rhinosinusitis Diagnosis, Management, Associated Conditions, Pathophysiology, and Future Directions: Summary of a Multidisciplinary Workshop', International Forum of Allergy and Rhinology, vol. 15, no. 6, pp. 626-641. https://doi.org/10.1002/alr.23582

Allergic Fungal Rhinosinusitis Diagnosis, Management, Associated Conditions, Pathophysiology, and Future Directions: Summary of a Multidisciplinary Workshop. / Roland, Lauren T.; Damask, Cecelia; Luong, Amber U. et al.
In: International Forum of Allergy and Rhinology, Vol. 15, No. 6, 2025, p. 626-641.

Research output: Contribution to journal › Review article › peer-review

TY - JOUR

T1 - Allergic Fungal Rhinosinusitis Diagnosis, Management, Associated Conditions, Pathophysiology, and Future Directions

T2 - Summary of a Multidisciplinary Workshop

AU - Roland, Lauren T.

AU - Damask, Cecelia

AU - Luong, Amber U.

AU - Azar, Antoine

AU - Ebert, Charles S.

AU - Edwards, Thomas

AU - Cahill, Katherine N.

AU - Cho, Do Yeon

AU - Corry, David

AU - Croston, Tara L.

AU - Freeman, Alexandra F.

AU - Javer, Amin

AU - Khoury, Paneez

AU - Kim, Jean

AU - Koval, Michael

AU - McCoul, Edward D.

AU - Mims, James W.

AU - Peters, Anju

AU - Piccirillo, Jay F.

AU - Ramonell, Richard P.

AU - Samarasinghe, Amali

AU - Schleimer, Robert P.

AU - Smith-Davidson, Prestina

AU - Spec, Andrej

AU - Wechsler, Michael E.

AU - Wise, Sarah K.

AU - Levy, Joshua M.

PY - 2025

Y1 - 2025

N2 - Allergic fungal rhinosinusitis (AFRS) is a unique endotype of chronic rhinosinusitis with nasal polyps (CRSwNP). Despite high recurrence rates and often more severe presenting signs compared with other subtypes of CRSwNP, research dedicated to AFRS has been lacking. Diagnostic criteria are outdated, the mechanistic relationship of AFRS to other associated diseases is unclear, and the pathophysiology of disease and risk factors for recurrence have not been well studied. In December 2023, a multidisciplinary group of rhinologists, otolaryngologists, pulmonologists, allergists, immunologists, scientists, and infectious disease experts met at the National Institute of Health to discuss unmet needs for future AFRS research and care, including patient management, diagnostic criteria, severity, pathophysiology, and related conditions. A summary of these clinical and associated research discussions is included below.

AB - Allergic fungal rhinosinusitis (AFRS) is a unique endotype of chronic rhinosinusitis with nasal polyps (CRSwNP). Despite high recurrence rates and often more severe presenting signs compared with other subtypes of CRSwNP, research dedicated to AFRS has been lacking. Diagnostic criteria are outdated, the mechanistic relationship of AFRS to other associated diseases is unclear, and the pathophysiology of disease and risk factors for recurrence have not been well studied. In December 2023, a multidisciplinary group of rhinologists, otolaryngologists, pulmonologists, allergists, immunologists, scientists, and infectious disease experts met at the National Institute of Health to discuss unmet needs for future AFRS research and care, including patient management, diagnostic criteria, severity, pathophysiology, and related conditions. A summary of these clinical and associated research discussions is included below.

KW - allergic fungal sinusitis

KW - allergic sinusitis

KW - chronic rhinosinusitis

KW - fungal sinusitis

KW - invasive fungal sinusitis

KW - nasal polyps

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UR - http://www.scopus.com/inward/citedby.url?scp=105003888257&partnerID=8YFLogxK

U2 - 10.1002/alr.23582

DO - 10.1002/alr.23582

M3 - Review article

C2 - 40310935

AN - SCOPUS:105003888257

SN - 2042-6976

VL - 15

SP - 626

EP - 641

JO - International Forum of Allergy and Rhinology

JF - International Forum of Allergy and Rhinology

IS - 6

ER -

Allergic Fungal Rhinosinusitis Diagnosis, Management, Associated Conditions, Pathophysiology, and Future Directions: Summary of a Multidisciplinary Workshop

Abstract

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Keywords

ASJC Scopus subject areas

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