Mold sensitization in cystic fibrosis patients

YI Kozlova1, YV Borzova1, OV Aak1, AV Orlov2, TS Stepanenko2, NN Klimko1

Author address: 

1Kashkin Research Institute of Medical Mycology, North-Western State Medical University named after I.I. Mechnikov, Saint - Petersburg, Russia 2City Multidisciplinary Hospital №2, Saint - Petersburg, Russia

Abstract: 

Purpose: To study the prevalence of mold sensitization and its spectrum in patients with cystic fibrosis in various regions of the Russian Federation. Methods: 131 patients with cystic fibrosis predominantly (77%) with severe disease: men – 64 (children – 43, adults – 21), women – 67 (children – 47, adults – 20) were included in the retrospective study. Patients were divided into 5 groups by city of residence: Saint-Petersburg – 45 persons, Moscow – 12, Voronezh – 24, Yekaterinburg – 24, Samara – 29. In the sera of all patients determination of total IgE (tIgE) and specific IgE(sIgE) to the panel 6 biotinylated fungal allergens (Alkor Bio, St.Petersburg) was performed. The panel included the allergens of Aspergillus fumigatus, Alternaria alternata, Cladosporium herbarum, Penicillium notatum, Rhizopus nigricans, Candida albicans. Results: The majority of patients with cystic fibrosis – from 82% (St. Petersburg) to 91% (Moscow) was sensitized to at least one of the fungi at low median values of tIgE (10,5-20,0 IU / ml). High values were determined by the high frequency of sensitization to the fast growing Candida (65% patients in Voronezh, up to 86% in Samara). The frequency of sensitization to Aspergillus was in the range 11-27% (Samara-Moscow), to Alternaria – in the range 8-27% (Samara-Moscow), to Rhizopus – in the range 9-32% (Voronezh -Samara). The frequency of sensitization to less pathogenic Cladosporium, Penicillium everywhere was 1.5-2 times lower. Significant differences in samples according to the level of sensitization (median criterion for independent samples) were revealed for the genera Aspergillus (p = 0.012), Alternaria (p = 0.039) and Rhizopus (p = 0.001). Conclusion: Cystic fibrosis is a disease characterized by the highest known level of mold (including genus Aspergillus)sensitization at low levels of total IgE. The cause of regional differences should be clarified in further studies.
2018

Full conference title: 

The 8th Advances Against Aspergillus, Lisbon Conference Center, Lisbon, Portugal
    • AAA 8th (2018)