Roles of Fungal Sensitization in Severe Asthmatic Patients

Katsunori Masaki, Koichi Fukunaga, Takashi Kamatani, Kengo Ohtsuka, Takae Tanosaki, Masako Matsusaka, Hiroki Kabata, Soichiro Ueda, Yusuke Suzuki, Koichiro Asano, Tomoko Betsuyaku, Takao Mochimaru

Abstract: 

Rationale

Fungal exposure is an important trigger of asthma exacerbation. However, little is known about the effects of fungal sensitization on the characteristics of severe asthma.

 

Methods

We collected data from 146 severe asthmatic patients and analyzed the data including sensitization to fungi (Aspergillus, Alternaria, Cladosporium, Penicillium, and Trichophyton) and non-fungal antigens (house dust mite, dog, cat, cockroach, moth, and chironomidae) as well as Asthma Control Test (ACT) score, pulmonary function, and fractional exhaled nitric oxide (FeNO) value. The diagnosis of sensitization was made by detecting an increase in serum IgE specific to these allergens. We defined atopic asthma patients sensitized by one or more allergens.

 

Results

86 patients (59%) were sensitized to one or more antigens. 35 patients (24%) were sensitized to fungal allergen, among which Aspergillus (22 patients, 15%) and Trichophyton (19 patients, 13%) were most common. In the 86 atopic patients, 5 were only sensitized to fungus (Group F), 51 were only sensitized to non-fungal allergen (Group N), and 30 were sensitized to both fungal and non-fungal antigens (Group F+N). ACT score of Group F+N was significantly lower than that of Group F. FeNO level was much higher in Group F+N compared with Group N. About a half of Group F+N were depending upon oral steroid therapy.

 

Conclusions

Fungal sensitization, in addition to non-fungal sensitization, is associated with the poorer asthma control in severe asthmatic patients.

abstract No: 

267
    • AAAAI 2015 (71st)