Pei Yee Tiew, Janice M Leung, Micheál Mac Aogáin, Parteek Johal, Tavleen Kaur Jaggi, Agnes Che Yan Yuen, Fransiskus Xaverius Ivan, Julia Yang, Tina Afshar, Augustine Tee, Mariko Siyue Koh, Yee Hui Lim, Anthony Wong, Lakshmi Chandrasekaran, Justine G Dacanay, Daniela I Drautz-Moses, Thun How Ong, John A Abisheganaden, Fook Tim Chew, Stephan C Schuster, Christopher Carlsten, Sanjay H Chotirmall
{"title":"在住宅中接触曲霉菌与慢性阻塞性肺病的病情加重有关。","authors":"Pei Yee Tiew, Janice M Leung, Micheál Mac Aogáin, Parteek Johal, Tavleen Kaur Jaggi, Agnes Che Yan Yuen, Fransiskus Xaverius Ivan, Julia Yang, Tina Afshar, Augustine Tee, Mariko Siyue Koh, Yee Hui Lim, Anthony Wong, Lakshmi Chandrasekaran, Justine G Dacanay, Daniela I Drautz-Moses, Thun How Ong, John A Abisheganaden, Fook Tim Chew, Stephan C Schuster, Christopher Carlsten, Sanjay H Chotirmall","doi":"10.1183/13993003.00907-2024","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Sensitisation to <i>Aspergillus fumigatus</i> is linked to worse outcomes in patients with COPD; however, its prevalence and clinical implications in domestic (residential) settings remains unknown.</p><p><strong>Methods: </strong>Individuals with COPD (n=43) recruited in Singapore had their residences prospectively sampled and assessed by shotgun metagenomic sequencing including indoor air, outdoor air and touch surfaces (a total of 126 specimens). The abundance of environmental <i>A. fumigatus</i> and the occurrence of <i>A. fumigatus</i> (Asp f) allergens in the environment were determined and immunological responses to <i>A. fumigatus</i> allergens determined in association with clinical outcomes including exacerbation frequency. Findings were validated in 12 individuals (31 specimens) with COPD in Vancouver, Canada, a climatically different region.</p><p><strong>Results: </strong>157 metagenomes from 43 homes were assessed. 11 and nine separate <i>Aspergillus</i> spp<i>.</i> were identified in Singapore and Vancouver, respectively. Despite climatic, temperature and humidity variation, <i>A. fumigatus</i> was detectable in the environment from both locations. The relative abundance of environmental <i>A. fumigatus</i> was significantly associated with exacerbation frequency in both Singapore (r=0.27, p=0.003) and Vancouver (r=0.49, p=0.01) and individuals with higher Asp f 3 sensitisation responses lived in homes with a greater abundance of environmental Asp f 3 allergens (p=0.037). Patients exposed and sensitised to Asp f 3 allergens demonstrated a higher rate of COPD exacerbations at 1-year follow-up (p=0.021).</p><p><strong>Conclusion: </strong>Environmental <i>A. fumigatus</i> exposure in the home environment including air and surfaces with resulting sensitisation carries pathogenic potential in individuals with COPD. Targeting domestic <i>A. fumigatus</i> abundance may reduce COPD exacerbations.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":16.6000,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11602665/pdf/","citationCount":"0","resultStr":"{\"title\":\"Residential exposure to <i>Aspergillus</i> spp<i>.</i> is associated with exacerbations in COPD.\",\"authors\":\"Pei Yee Tiew, Janice M Leung, Micheál Mac Aogáin, Parteek Johal, Tavleen Kaur Jaggi, Agnes Che Yan Yuen, Fransiskus Xaverius Ivan, Julia Yang, Tina Afshar, Augustine Tee, Mariko Siyue Koh, Yee Hui Lim, Anthony Wong, Lakshmi Chandrasekaran, Justine G Dacanay, Daniela I Drautz-Moses, Thun How Ong, John A Abisheganaden, Fook Tim Chew, Stephan C Schuster, Christopher Carlsten, Sanjay H Chotirmall\",\"doi\":\"10.1183/13993003.00907-2024\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Sensitisation to <i>Aspergillus fumigatus</i> is linked to worse outcomes in patients with COPD; however, its prevalence and clinical implications in domestic (residential) settings remains unknown.</p><p><strong>Methods: </strong>Individuals with COPD (n=43) recruited in Singapore had their residences prospectively sampled and assessed by shotgun metagenomic sequencing including indoor air, outdoor air and touch surfaces (a total of 126 specimens). The abundance of environmental <i>A. fumigatus</i> and the occurrence of <i>A. fumigatus</i> (Asp f) allergens in the environment were determined and immunological responses to <i>A. fumigatus</i> allergens determined in association with clinical outcomes including exacerbation frequency. Findings were validated in 12 individuals (31 specimens) with COPD in Vancouver, Canada, a climatically different region.</p><p><strong>Results: </strong>157 metagenomes from 43 homes were assessed. 11 and nine separate <i>Aspergillus</i> spp<i>.</i> were identified in Singapore and Vancouver, respectively. Despite climatic, temperature and humidity variation, <i>A. fumigatus</i> was detectable in the environment from both locations. The relative abundance of environmental <i>A. fumigatus</i> was significantly associated with exacerbation frequency in both Singapore (r=0.27, p=0.003) and Vancouver (r=0.49, p=0.01) and individuals with higher Asp f 3 sensitisation responses lived in homes with a greater abundance of environmental Asp f 3 allergens (p=0.037). Patients exposed and sensitised to Asp f 3 allergens demonstrated a higher rate of COPD exacerbations at 1-year follow-up (p=0.021).</p><p><strong>Conclusion: </strong>Environmental <i>A. fumigatus</i> exposure in the home environment including air and surfaces with resulting sensitisation carries pathogenic potential in individuals with COPD. 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引用次数: 0
摘要
背景:对烟曲霉菌的过敏与慢性阻塞性肺病(COPD)患者的预后恶化有关,但其在家庭(住宅)环境中的流行程度和临床影响仍不清楚:在新加坡招募的慢性阻塞性肺病患者(43 人)对其住所进行了前瞻性采样,并通过霰弹枪元基因组测序法对室内空气、室外空气和接触表面(共 126 份标本)进行了评估。测定了环境中烟曲霉菌的丰度和烟曲霉菌(Asp f)过敏原的发生率,并测定了烟曲霉菌过敏原与临床结果(包括恶化频率)相关的免疫反应。研究结果在气候不同的加拿大温哥华地区的 12 名慢性阻塞性肺病患者(31 份标本)中得到了验证:结果:对来自 43 个家庭的 157 个元基因组进行了评估。结果:对来自 43 个家庭的 157 个元基因组进行了评估,在新加坡和温哥华分别发现了 11 个和 9 个不同的曲霉菌属。尽管气候、温度和湿度存在差异,但两地的环境中都能检测到曲霉菌。在新加坡(r=0.27,p=0.003)和温哥华(r=0.49,p=0.01),环境中烟曲霉的相对含量与病情恶化频率有显著相关性,Asp f 3致敏反应较高的人居住在环境中Asp f 3过敏原含量较高的家庭中(p=0.037)。暴露于Asp f 3过敏原并对其过敏的患者在1年随访时慢性阻塞性肺病加重率较高(p=0.021):结论:家庭环境中的烟曲霉菌暴露,包括空气和物体表面,会导致慢性阻塞性肺病患者致敏,并具有致病潜力。针对家用烟曲霉的丰度可减少慢性阻塞性肺病的恶化。
Residential exposure to Aspergillus spp. is associated with exacerbations in COPD.
Background: Sensitisation to Aspergillus fumigatus is linked to worse outcomes in patients with COPD; however, its prevalence and clinical implications in domestic (residential) settings remains unknown.
Methods: Individuals with COPD (n=43) recruited in Singapore had their residences prospectively sampled and assessed by shotgun metagenomic sequencing including indoor air, outdoor air and touch surfaces (a total of 126 specimens). The abundance of environmental A. fumigatus and the occurrence of A. fumigatus (Asp f) allergens in the environment were determined and immunological responses to A. fumigatus allergens determined in association with clinical outcomes including exacerbation frequency. Findings were validated in 12 individuals (31 specimens) with COPD in Vancouver, Canada, a climatically different region.
Results: 157 metagenomes from 43 homes were assessed. 11 and nine separate Aspergillus spp. were identified in Singapore and Vancouver, respectively. Despite climatic, temperature and humidity variation, A. fumigatus was detectable in the environment from both locations. The relative abundance of environmental A. fumigatus was significantly associated with exacerbation frequency in both Singapore (r=0.27, p=0.003) and Vancouver (r=0.49, p=0.01) and individuals with higher Asp f 3 sensitisation responses lived in homes with a greater abundance of environmental Asp f 3 allergens (p=0.037). Patients exposed and sensitised to Asp f 3 allergens demonstrated a higher rate of COPD exacerbations at 1-year follow-up (p=0.021).
Conclusion: Environmental A. fumigatus exposure in the home environment including air and surfaces with resulting sensitisation carries pathogenic potential in individuals with COPD. Targeting domestic A. fumigatus abundance may reduce COPD exacerbations.
期刊介绍:
The European Respiratory Journal (ERJ) is the flagship journal of the European Respiratory Society. It has a current impact factor of 24.9. The journal covers various aspects of adult and paediatric respiratory medicine, including cell biology, epidemiology, immunology, oncology, pathophysiology, imaging, occupational medicine, intensive care, sleep medicine, and thoracic surgery. In addition to original research material, the ERJ publishes editorial commentaries, reviews, short research letters, and correspondence to the editor. The articles are published continuously and collected into 12 monthly issues in two volumes per year.