期刊
CLINICAL AND EXPERIMENTAL ALLERGY
卷 51, 期 6, 页码 790-800出版社
WILEY
DOI: 10.1111/cea.13799
关键词
airway obstruction; allergens and epitopes; Aspergillus; asthma; IgE; Paediatrics; sensitization
资金
- Henry Smith Charity
- Action Medical Research
The study revealed that a significant proportion of children with asthma are sensitized to thermotolerant fungi, leading to poorer lung function and increased need for systemic corticosteroids. Additionally, filamentous fungi were found in sputum during asthma attacks, suggesting a potential association between fungal presence and acute asthma exacerbations.
Background Sensitization to thermotolerant fungi, including filamentous fungi and Candida albicans, is associated with poor lung function in adults with severe asthma. Data in children are lacking. Environmental exposure to fungi is linked with acute severe asthma attacks, but there are few studies reporting the presence of fungi in the airways during asthma attacks. Methods We investigated the association between fungal sensitization and/or positive fungal sputum culture and markers of asthma severity in children with chronic and acute asthma. Sensitization was determined using serum-specific IgE and skin prick testing against a panel of five fungi. Fungal culture was focused towards detection of filamentous fungi from sputum samples. Results We obtained sensitization data and/or sputum from 175 children: 99 with chronic asthma, 39 with acute asthma and 37 controls. 34.1% of children with chronic asthma were sensitized to thermotolerant fungi compared with no children without asthma (p =< 0.001). These children had worse pre-bronchodilator lung function compared with asthmatics without sensitization including a lower FEV1/FVC ratio (p < .05). The isolation rate of filamentous fungi from sputum was higher in children with acute compared with chronic asthma. Conclusions Fungal sensitization is a feature of children with chronic asthma. Children sensitized to thermotolerant fungi have worse lung function, require more courses of systemic corticosteroids and have greater limitation of activities due to asthma. Asthma attacks in children were associated with the presence of filamentous fungi positive sputum culture. Mechanistic studies are required to establish whether fungi contribute directly to the development of acute asthma.
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