Aspergillus-sensitized asthma in children.

IF 4.3 2区医学 Q2 ALLERGY

Pediatric Allergy and Immunology Pub Date : 2024-08-01 DOI:10.1111/pai.14212

Enes Celik, Dilara Kocacik Uygun, Mehmet Akif Kaya, Merve Sibel Gungoren, Ayse Keven, Aysen Bingol

{"title":"Aspergillus-sensitized asthma in children.","authors":"Enes Celik, Dilara Kocacik Uygun, Mehmet Akif Kaya, Merve Sibel Gungoren, Ayse Keven, Aysen Bingol","doi":"10.1111/pai.14212","DOIUrl":null,"url":null,"abstract":"Background: Asthma is the most common chronic respiratory disease in childhood. Aspergillus fumigatus sensitivity may be involved in the pathogenesis of asthma by leading to different clinical presentations.Objective: To investigate the demographic, clinical, laboratory, and radiological characteristics of A. fumigatus sensitivity in childhood asthma and identify associated risk factors and diagnostic parameters.Methods: A total of 259 children with asthma were included in the study, 7 (2.7%) with allergic bronchopulmonary aspergillosis (ABPA), 84 (32.4%) with A. fumigatus-sensitized asthma (Af-SA), and 168 (64.9%) with A. fumigatus-unsensitized asthma (Af-UA).Results: Aspergillus sensitivity was associated with early asthma onset and longer asthma duration. Total IgE level and asthma severity are highest in ABPA and higher in Af-SA. Absolute eosinophil count was higher, and FEV1 was lower in Af-SA and ABPA. Aspergillus fumigatus was associated with greater odds of being male (odds ratio [OR], 2.45), having atopic dermatitis (OR, 3.159), Alternaria sensitivity (OR, 10.37), and longer asthma duration (OR, 1.266). The best cut-off values for detecting A. fumigatus positivity were 363.5 IU/mL for total IgE and 455 cells/μL for absolute eosinophil count. In Af-SA compared to Af-UA, centrilobular nodules and peribronchial thickening were more common, and the bronchoarterial ratio was higher.Conclusions: Aspergillus sensitivity is a strong allergic stimulus in asthma, leading to laboratory, structural, clinical, and functional consequences. Af-SA is a distinct asthma endotype independent of ABPA that is characterized by increased risk of severe clinical presentations and impaired lung function.","PeriodicalId":19929,"journal":{"name":"Pediatric Allergy and Immunology","volume":"35 8","pages":"e14212"},"PeriodicalIF":4.3000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Allergy and Immunology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/pai.14212","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ALLERGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Asthma is the most common chronic respiratory disease in childhood. Aspergillus fumigatus sensitivity may be involved in the pathogenesis of asthma by leading to different clinical presentations.

Objective: To investigate the demographic, clinical, laboratory, and radiological characteristics of A. fumigatus sensitivity in childhood asthma and identify associated risk factors and diagnostic parameters.

Methods: A total of 259 children with asthma were included in the study, 7 (2.7%) with allergic bronchopulmonary aspergillosis (ABPA), 84 (32.4%) with A. fumigatus-sensitized asthma (Af-SA), and 168 (64.9%) with A. fumigatus-unsensitized asthma (Af-UA).

Results: Aspergillus sensitivity was associated with early asthma onset and longer asthma duration. Total IgE level and asthma severity are highest in ABPA and higher in Af-SA. Absolute eosinophil count was higher, and FEV1 was lower in Af-SA and ABPA. Aspergillus fumigatus was associated with greater odds of being male (odds ratio [OR], 2.45), having atopic dermatitis (OR, 3.159), Alternaria sensitivity (OR, 10.37), and longer asthma duration (OR, 1.266). The best cut-off values for detecting A. fumigatus positivity were 363.5 IU/mL for total IgE and 455 cells/μL for absolute eosinophil count. In Af-SA compared to Af-UA, centrilobular nodules and peribronchial thickening were more common, and the bronchoarterial ratio was higher.

Conclusions: Aspergillus sensitivity is a strong allergic stimulus in asthma, leading to laboratory, structural, clinical, and functional consequences. Af-SA is a distinct asthma endotype independent of ABPA that is characterized by increased risk of severe clinical presentations and impaired lung function.

查看原文本刊更多论文

儿童曲霉过敏性哮喘。

背景：哮喘是儿童时期最常见的慢性呼吸道疾病：哮喘是儿童时期最常见的慢性呼吸道疾病。曲霉菌敏感可能与哮喘的发病机制有关，导致不同的临床表现：研究儿童哮喘中烟曲霉菌敏感性的人口统计学、临床、实验室和放射学特征，并确定相关风险因素和诊断参数：研究共纳入 259 名哮喘患儿，其中 7 人（2.7%）患有过敏性支气管肺曲霉菌病（ABPA），84 人（32.4%）患有烟曲霉菌敏感性哮喘（Af-SA），168 人（64.9%）患有烟曲霉菌不敏感性哮喘（Af-UA）：结果：曲霉菌敏感与哮喘发病早、持续时间长有关。总 IgE 水平和哮喘严重程度在 ABPA 中最高，在 Af-SA 中较高。Af-SA和ABPA患者的嗜酸性粒细胞绝对数更高，FEV1更低。烟曲霉菌与男性（几率比 [OR]，2.45）、特应性皮炎（OR，3.159）、Alternaria 敏感性（OR，10.37）和哮喘持续时间较长（OR，1.266）的几率较大相关。检测烟曲霉菌阳性的最佳临界值是总 IgE 为 363.5 IU/mL，嗜酸性粒细胞绝对计数为 455 cells/μL。与Af-UA相比，在Af-SA中，小叶中心结节和支气管周围增厚更常见，支气管动脉比率更高：结论：曲霉菌敏感性是哮喘的一种强烈过敏性刺激，会导致实验室、结构、临床和功能方面的后果。Af-SA是一种独立于ABPA的独特哮喘终末型，其特点是出现严重临床表现和肺功能受损的风险增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Pediatric Allergy and Immunology 医学-过敏

CiteScore

9.10

自引率

9.10%

发文量

200

审稿时长

4-8 weeks

期刊介绍： Pediatric Allergy and Immunology is the world''s leading journal in pediatric allergy, publishing original contributions and comprehensive reviews related to the understanding and treatment of immune deficiency and allergic inflammatory and infectious diseases in children. Other areas of interest include: development of specific and accessory immunity; the immunological interaction during pregnancy and lactation between mother and child. As Pediatric Allergy and Immunology promotes communication between scientists engaged in basic research and clinicians working with children, we publish both clinical and experimental work.