FUNGAL SPUTUM CULTURE IN PATIENTS WITH SEVERE ASTHMA IS ASSOCIATED WITH A REDUCED POST BRONCHODILATOR FEV1

J Agbetile, A Fairs, M Bourne, B Hargadon, K Mutalithas, W Monteiro, R Edwards, J Morley, D Desai, C E Brightling, P H Bradding, R H Green, I D Pavord, A J Wardlaw, C H Pashley.

Author address: 

Department of Infection, Immunity and Inflammation, Leicester. University & Institute for Lung Health, Glenfield Hospital, Leicester, UK

Abstract: 

Introduction and objectives IgE sensitisation to fungal allergens is common in severe asthma, but the clinical relevance of this, and the relationship to airway colonisation with fungi, is not known. Many of the fungi that can grow at body temperature are filamentous moulds from the genera Aspergillus and Pencillium. We report here the relationship between lung function and fungal sputum culture in patients with severe asthma. Methods We recruited 126 patients attending a tertiary referral centre with a diagnosis of asthma and 18 healthy volunteers. 93% of patients were on GINA treatment step 4 or higher. At a single stable visit subjects underwent: spirometry with reversibility to 200 mg salbutamol; sputum fungal culture and a sputum cell differential count; skin prick testing to both common aeroallergens and an extended fungal panel (+ve $3 mm); specific IgE to Aspergillus fumigatus by CAP (positive >0.35 kU/l). Fungi were identified by morphology and species identity confirmed by sequencing regions of the nuclear ribosomal operon. Results Patients had a mean age of 56 years (21e84 years); 48% were males with median ICS dose of 800 mg Fluticasone equivalent. 60% were atopic to common aeroallergens, 45% were IgE sensitised to one fungal allergen and 27% to $2 fungal allergens. 64% of patients cultured a mould in their sputum, 7% more than one species. This compared with three healthy subjects (17%) culturing any mould (p
2010

abstract No: 

S136

Full conference title: 

British Thorasic Society Winter Meeting 2010
    • BTSWM 2010