Prevalence of fungal sensitization and its association with clinical parameters of asthma—A longitudinal study in a tertiary care center in Tamil Nadu

Q3 Medicine

Allergo Journal International Pub Date : 2024-08-08 DOI:10.1007/s40629-024-00302-y

Zubair Khan, Jebin Roger, Pushparaj Nilkanth Patil, Devasahayam J. Christopher

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Abstract

Background

Studies have shown that asthmatics with sensitization to fungi have worse outcomes, but published data from tropical countries like India are lacking.

Objective

We studied the prevalence of sensitization to clinically relevant fungi in asthmatics and investigated the impact of these fungi on asthma.

Methods

This prospective observational study was conducted in a tertiary care hospital in India. The skin prick test was used to check the sensitization status to fungal and non-fungal allergens. The association between fungal sensitization and various asthma outcomes, i.e. lung function, treatment phase, level of control, exacerbations in the previous year, was evaluated.

Results

Out of 720 patients, 472 (65.6%) were sensitized to one or more fungal allergens; Aspergillus fumigatus was the predominant fungus in these patients. Patients with fungal sensitization (FS) had a lower lung function than those with no fungal sensitization (NFS; mean [SD] FEV₁ [% predicted, post-BD] 73.6% [19.6] vs. 83.2% [15.0]; p < 0.001), were more likely to be on step 4 or 5 of Global Initiative for Asthma (GINA) treatment (78.1% vs. 63.7; p < 0.001), and were more likely to be on high-dose inhaled corticosteroids (28.2% of FS patients vs. 18.1% of NFS; p < 0.001). Furthermore, 11% of FS had uncontrolled asthma versus 4% of the NFS patients (p = 0.003). Persistent significant bronchodilator reversibility of FEV₁ was seen in 37.9% of FS patients vs. 13.4% of NFS patients (p < 0.001).

Conclusion

Fungal sensitization was associated with poorer asthma outcomes. In patients with FS, the physician needs to anticipate and sensitize the patient about the risk of a severe course of asthma.

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泰米尔纳德邦一家三级医疗中心的真菌过敏流行率及其与哮喘临床参数的关系--纵向研究

研究表明，对真菌过敏的哮喘患者的预后更差，但缺乏来自印度等热带国家的公开数据。目的研究哮喘患者对临床相关真菌的致敏率，探讨这些真菌对哮喘的影响。方法本前瞻性观察研究在印度一家三级医院进行。采用皮肤点刺试验检查对真菌和非真菌过敏原的致敏状态。评估了真菌致敏与各种哮喘结局（即肺功能、治疗阶段、控制水平、前一年的恶化情况）之间的关系。结果720例患者中，472例（65.6%）对一种或多种真菌过敏原敏感；烟曲霉是这些患者的主要真菌。真菌致敏（FS）患者的肺功能低于没有真菌致敏的患者(NFS；平均[SD] FEV1[%预测，bd后]73.6% [19.6]vs. 83.2% [15.0]；p < 0.001)，更有可能接受全球哮喘倡议（GINA）治疗的第4步或第5步(78.1% vs. 63.7；p < 0.001)，并且更有可能使用高剂量吸入皮质类固醇(FS患者的28.2% vs NFS患者的18.1%；p & lt; 0.001)。此外，11%的FS患者有未控制的哮喘，而NFS患者为4% （p = 0.003）。FS患者FEV1持续显著的支气管扩张剂可逆性为37.9%，NFS患者为13.4% （p < 0.001）。结论真菌致敏与哮喘预后较差有关。对于FS患者，医生需要预测并使患者对严重哮喘病程的风险敏感。

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来源期刊

Allergo Journal International Medicine-Immunology and Allergy

CiteScore

4.60

自引率

0.00%

发文量

期刊介绍： Allergo Journal International is the official Journal of the German Society for Applied Allergology (AeDA) and the Austrian Society for Allergology and Immunology (ÖGAI). The journal is a forum for the communication and exchange of ideas concerning the various aspects of allergy (including related fields such as clinical immunology and environmental medicine) and promotes German allergy research in an international context. The aim of Allergo Journal International is to provide state of the art information for all medical and scientific disciplines that deal with allergic, immunological and environmental diseases. Allergo Journal International publishes original articles, reviews, short communications, case reports, and letters to the editor. The articles cover topics such as allergic, immunological and environmental diseases, the latest developments in diagnosis and therapy as well as current research work concerning antigens and allergens and aspects related to occupational and environmental medicine. In addition, it publishes clinical guidelines and position papers approved by expert panels of the German, Austrian and Swiss Allergy Societies. All submissions are reviewed in single-blind fashion by at least two reviewers. Originally, the journal started as a German journal called Allergo Journal back in 1992. Throughout the years, English articles amounted to a considerable portion in Allergo Journal. This was one of the reasons to extract the scientific content and publish it in a separate journal. Hence, Allergo Journal International was born and now is the international continuation of the original German journal. Nowadays, all original content is published in Allergo Journal International first. Later, selected manuscripts will be translated and published in German and included in Allergo Journal.