Characteristics of severe asthma with fungal sensitization

Publication date: Available online 8 August 2017
Source:Annals of Allergy, Asthma & Immunology
Author(s): Katsunori Masaki, Koichi Fukunaga, Masako Matsusaka, Hiroki Kabata, Takae Tanosaki, Takao Mochimaru, Takashi Kamatani, Kengo Ohtsuka, Rie Baba, Soichiro Ueda, Yusuke Suzuki, Fumio Sakamaki, Yoshitaka Oyamada, Takashi Inoue, Tsuyoshi Oguma, Koichi Sayama, Hidefumi Koh, Morio Nakamura, Akira Umeda, Katsuhiko Kamei, Kenji Izuhara, Koichiro Asano, Tomoko Betsuyaku
BackgroundSome patients with severe asthma also have fungal sensitization and are considered to have severe asthma with fungal sensitization. However, there is limited information on the clinical features of SAFS.ObjectiveTo investigate the clinical characteristics of severe asthma with fungal sensitization.MethodsThe present study enrolled 124 patients with severe asthma. We evaluated clinical aspects, such as various serum cytokines, fractional exhaled nitric oxide, pulmonary function, and serum immunoglobulin E (IgE). Fungal sensitization was assessed by determining serum levels of IgE specific to fungal allergens (Aspergillus, Alternaria, Candida, Cladosporium, Penicillium, and Trichophyton species and Schizophyllum commune). The protocol was registered at a clinical trial registry (http://ift.tt/1QNm0c9; UMIN 000002980).ResultsThirty-six patients (29%) showed sensitization to at least 1 fungal allergen. The most common species were Candida (16%), Aspergillus (11%), and Trichophyton (11%). The rate of early-onset asthma (<16 years of age) was higher in patients with fungal sensitization than in those without fungal sensitization (45% vs 25%; P = .02). Interleukin-33 levels were higher in patients with fungal sensitization than in those without fungal sensitization. Of patients with atopic asthma, Asthma Control Test scores were worse in patients with multiple fungal sensitizations than in patients with a single fungal sensitization or those without fungal sensitization.ConclusionSevere asthma with fungal sensitization is characterized by early onset of disease and high serum levels of interleukin-33. Multiple fungal sensitizations are associated with poor asthma control.Trial RegistrationUMIN Clinical Trials Registry (UMIN-CTR; http://ift.tt/1QNm0c9): UMIN 000002980.



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