Life-threatening asthma is linked to an allergic response to fungi

Published Online: December 22, 2016

Some patients with asthma have severe disease, characterized by continuing symptoms despite treatment with standard medications. Although it is not completely understood why some patients with severe asthma don’t improve with standard medications, it is thought that groups of patients have different reasons for lack of disease control. One possible reason is that some patients with asthma are allergic to fungi or mold in the environment. The purpose of this study was to determine the relationship between fungal allergy (sensitization) and asthma severity and clinical outcomes.

In original research published by The Journal of Allergy and Clinical Immunology: In Practice, Medrek and colleagues collected information on patients with asthma seen in an urban pulmonary subspecialty clinic in the United States. Patients who had undergone blood testing to evaluate whether they had allergy to fungi and other common environmental allergens (including weeds, trees, and mites) were identified. Patients were then categorized into three groups: patients with no allergy, patients with allergy to fungi, and patients with allergy to other substances but not to fungi. Information about each patient’s use of asthma medications, asthma control, and hospitalizations were collected.  Comparison between the three groups was performed.  

Results of the study showed that among 307 patients with asthma who had allergen testing, approximately 17 percent were allergic to fungi and 38 percent were allergic to substances other than fungi. Patients with fungal allergy were more likely to be male and African-American and also tended to be allergic to multiple non-fungal substances. They were more likely than patients without fungal allergy to have life-threatening asthma events, including admission to the intensive care unit and mechanical support of their breathing while in the hospital.

Information gained from this study suggests that patients with asthma and fungal allergy have increased risk of life-threatening asthma compared with patients without fungal allergy. It is important to identify these patients so they can be closely followed and treatment optimized in order to reduce their risk of life-threatening asthma episodes.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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