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Clinical Importance of Alternaria Exposure in Children
Open accessAbstract
The fungus Alternaria is known to be allergenic and is one of the most common fungi worldwide. We investigated the extent to which exposure to Alternaria increases the severity of asthma. We undertook a prospective cohort study in Australia of 399 school children who had positive skin tests to one or more aeroallergens. Airway responsiveness to histamine, wheeze, and bronchodilator use in 1 mo was measured five times between 1997 and 1999. Airway hyperresponsiveness was defined as PD20FEV1 = 3.9 μ mol histamine. Airborne concentrations of Alternaria spores were measured throughout the study, and mean daily concentrations over 1 mo ranged from 2.2 to 307.7 spores/m3 of ambient air. Using generalized estimating equations, we found that airway responsiveness, wheeze, and bronchodilator use increased significantly in association with increased spore concentrations and that the increase in airway responsiveness was greater in children sensitized to Alternarxia than in other children (p = 0.01). The odds ratio for airway hyperresponsiveness in children sensitized to Alternaria was 1.26 (95% CI, 1.14 to 1.39) after an increase in mean exposure of 100 spore/m3/d over 1 mo. These results suggest that Alternaria allergens contribute to severe asthma in regions where exposure to the fungus is high.
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“There is substantial evidence to suggest that indoor allergens generated by house dust mite, mold and cat are triggers for both childhood and adult asthma, especially in those sensitized (100–102).”
From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [102]
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“Moreover, when those sensitized individuals are placed in environments of high fungal exposure, symptoms of airway hyperresponsiveness increase significantly over those seen in nonsensitized individuals in similar situations.(143) Symptoms that are experienced by those patients with fungal allergies are identical, in…”
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“symptoms of airway hyperresponsiveness increase significantly over those of nonsensitized individuals in similar situations.(79) Virtually all studies of the pathophysiology of AFRS have been based on the premise that IgEmediated allergy to one or more fungi underlie the disease, with the predominant finding of eosino…”
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“Patients sensitized to Alternaria alternata were approximately 5 times more likely to have asthma(35) and increased airway responsiveness, wheeze, and bronchodilator use.(36) Emergency visits for asthma exacerbations correlate with high airborne concentrations of mold.”
Background
Metadata
- Authors
- DOWNS, S. H., MITAKAKIS, T. Z., MARKS, G. B., CAR, N. G., BELOUSOVA, E. G., LEÜPPI, J. D., XUAN, W., DOWNIE, S. R., TOBIAS, A., & PEAT, J. K.
- Affiliations
- The University of Sydney (AU)
- Institute of Respiratory Medicine and School of Biological Sciences, University of Sydney, Sydney, Australia; School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, Australia; Clinical Epidemiology Unit, New Children's Hospital, Westmead, NSW, Australia; and Department of Clinical Epidemiology and Public Health, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2001-08-01
- Volume
- 164
- Issue
- 3
- Pages
- 455-459
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- OpenAlex
- W2147199610
- Cited by
- 202
- References
- 41
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 7 · 2023: 7 · 2022: 8 · 2021: 5 · 2020: 8 · 2019: 3 · 2018: 7 · 2017: 5 · 2016: 9 · 2015: 9 · 2014: 3 · 2013: 7 · 2012: 13
- FWCI
- 5.59
- Type
- journal article
- Language
- en
- Open access
- Locations
- American Journal of Respiratory and Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Charles Sturt University Research Output (CRO) (submittedVersion, other-oa)
- Funders
- National Science Foundation
- Novartis Foundation
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- Medical Research Council
- National Health and Medical Research Council
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
- Keywords
- Alternaria, fungal allergens, airway hyperresponsiveness, asthma severity, childhood asthma, allergen sensitization, wheezing, bronchodilator use, aeroallergens, elementary school students
- MeSH terms
- Allergens, Alternaria, Asthma, Child, Environmental Exposure, Female, Forced Expiratory Volume, Humans, Hypersensitivity, Male, Severity of Illness Index, Spores, Cohort Studies
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