Fungal sensitivity in bronchial asthma and allergic rhinitis: A search beyond aspergillus fumigatus

Author:

Arti Dhawal Shah, Dhawal Niranjan Shah, Amrita Swati, Swati Milani

Author address:

India

Full conference title:

European Academy of Allergy and Clinical Immunology Congress 2020

Abstract:

Background
Fungi are associated with allergic diseases like allergic rhinitis, bronchial asthma and allergic bronchopulmonary mycoses resulting from exposure to spores. The prevalence of respiratory allergies to fungi is estimated at 20% to 30% among atopic individuals. Thus, we designed this study with the aim to find sensitivity to fungal aeroallergens in bronchial asthma and allergic rhinitis with or without severe disease or exacerbation.

Method
In this institutional ethics committee approved study, consenting patients of bronchial asthma or allergic rhinitis presenting to OPD were included. Skin prick testing was done for aeroallergens and interpreted by pulmonologist (Principal Investigator). The data was collected and analysed for 15 fungal allergens.

Results
90 patients’ data was analysed comprising 54 asthmatics and 36 patients of allergic rhinitis. Most of the patients were between 18 to 30 years of age group. All the patients were non-smokers. Fungal sensitivity was reported 70.37% (36 patients) in asthma and 38.88% (14 patients) in allergic rhinitis. Overall fungal sensitivity is 55.55%. The detailed allergen wise data is presented in table (1).
Most common fungal sensitivity in bronchial asthma was due to Candida Albicans(29.63%) followed by Aspergillus Flavus(27.78%), Aspergillus Tamari(27.78%) & Cladosporium Herbarum(27.78%). While in Allergic Rhinitis most common fungal sensitivity reported was Aspergillus Niger(19.44%) followed by Aspergillus Tamari(16.67%) & Curvularia Lunata(16.67%).
This correlation is explained by farming being the main occupation of patients in this region, where damp and humid storage of food and other items is common.
Similar to our research study, several national & international studies have found that sensitization to the fungi A. alternatata and C. herbarium was a significant risk factor for severe asthma.

Conclusion
This study would help in changing the focus from Aspergillus fumigatus to other Aspergillus species as per local geographic variation. This would also help in educating the patient regarding importance of prevention of exposure to avoid exacerbations and control the disease by treatment and immunotherapy with precautions.

TABLE: 1 Fungal sensitivity pattern in bronchial asthma and allergic rhinitis

Fungus

Bronchial Asthma

N(%)

Allergic Rhinitis N(%)

Total

N (%)

Aspergillus Fumigatus

13 (24.07%)

5 (13.89%)

18 (20.00%)

Aspergillus Niger

13 (24.07%)

7 (19.44%)

20 (22.22%)

Aspergillus Flavus

15 (27.78%)

0

15 (16.66%)

Aspergillus Tamari

15 (27.78%)

6 (16.67%)

21 (23.33%)

Aspergillus Versicolor

13 (24.07%)

0

13 (14.44%)

Alternaria Alternata

11 (20.37%)

4 (11.11%)

15 (16.66%)

Candida Albicans

16 (29.63%)

3 (8.33%)

19 (21.11%)

Cladosporium Herbarum

15 (27.78%)

5 (13.89%)

20 (22.22%)

Fusarium Solani

6 (11.11%)

0

6 (6.66%)

Helminthosporium Sp

14 (25.93%)

4 (11.11%)

18 (20.0%)

Penicillium Sp

13 (24.07%)

5 (13.89%)

18 (20.0%)

Phoma Tropicalis

4 (7.41%)

0

4 (4.44%)

Rhizopus Nigricans

3 (5.56%)

0

3 (3.33%)

Trichoderma

5 (9.26%)

0

5 (5.55%)

Curvularia Lunata

11 (20.37%)

6 (16.67%)

17 (18.88%)

 

Abstract Number: 0390

Conference Year: 2020

Link Conference abstract: 

EAACI 2020

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