Cited by 252Asthma and respiratory diseasesAntifungal resistance and susceptibilityOccupational exposure and asthma

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IgE Sensitization to Aspergillus fumigatus Is Associated with Reduced Lung Function in Asthma

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Fairs, Abbie, Agbetile, Joshua, Hargadon, Beverley, Bourne, Michelle, Monteiro, William R., Brightling, Christopher E., Bradding, Peter, Green, Ruth H., Mutalithas, Kugathasan, Desai, Dhananjay, Pavord, Ian D., Wardlaw, Andrew J., Pashley, Catherine H.·2010·American Journal of Respiratory and Critical Care Medicine

DOI 10.1164/rccm.201001-0087ocPMC PMC3029929

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Abstract

RATIONALE: The importance of Aspergillus fumigatus sensitization and colonization of the airways in patients with asthma is unclear. OBJECTIVES: To define the relationship between the clinical and laboratory features of A. fumigatus-associated asthma. METHODS: We studied 79 patients with asthma (89% classed as GINA 4 or 5) classified into 3 groups according to A. fumigatus sensitization: (1) IgE-sensitized (immediate cutaneous reactivity > 3 mm and/or IgE > 0.35 kU/L); (2) IgG-only-sensitized (IgG > 40 mg/L); and (3) nonsensitized. These were compared with 14 healthy control subjects. Sputum culture was focused toward detection of A. fumigatus and compared with clinical assessment data. MEASUREMENTS AND MAIN RESULTS: A. fumigatus was cultured from 63% of IgE-sensitized patients with asthma (n = 40), 39% of IgG-only-sensitized patients with asthma (n = 13), 31% of nonsensitized patients with asthma (n = 26) and 7% of healthy control subjects (n = 14). Patients sensitized to A. fumigatus compared with nonsensitized patients with asthma had lower lung function (postbronchodilator FEV₁ % predicted, mean [SEM]: 68 [±5]% versus 88 [±5]%; P < 0.05), more bronchiectasis (68% versus 35%; P < 0.05), and more sputum neutrophils (median [interquartile range]: 80.9 [50.1-94.1]% versus 49.5 [21.2-71.4]%; P < 0.01). In a multilinear regression model, A. fumigatus-IgE sensitization and sputum neutrophil differential cell count were important predictors of lung function (P = 0.016), supported by culture of A. fumigatus (P = 0.046) and eosinophil differential cell count (P = 0.024). CONCLUSIONS: A. fumigatus detection in sputum is associated with A. fumigatus-IgE sensitization, neutrophilic airway inflammation, and reduced lung function. This supports the concept that development of fixed airflow obstruction in asthma is consequent upon the damaging effects of airway colonization with A. fumigatus.

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Authors: Fairs, A., Agbetile, J., Hargadon, B., Bourne, M., Monteiro, W. R., Brightling, C. E., Bradding, P., Green, R. H., Mutalithas, K., Desai, D., Pavord, I. D., Wardlaw, A. J., & Pashley, C. H.
Affiliations: University of Leicester (GB)
ORCID: Hargadon, Beverley
Brightling, Christopher E.
Bradding, Peter
Desai, Dhananjay
Pavord, Ian D.
Wardlaw, Andrew J.
Pashley, Catherine H.
Venue: American Journal of Respiratory and Critical Care Medicine
Publisher: Oxford University Press (OUP)
Published: 2010-12-01
Volume: 182
Issue: 11
Pages: 1362-1368
ISSN: 1073-449X (ISSN-L)
1535-4970
DOI: 10.1164/rccm.201001-0087oc
PMC: PMC3029929
OpenAlex: W2034519404
Cited by: 252
References: 39
Citations by year: 2026: 9 · 2025: 7 · 2024: 14 · 2023: 10 · 2022: 9 · 2021: 17 · 2020: 26 · 2019: 20 · 2018: 18 · 2017: 16 · 2016: 10 · 2015: 15 · 2014: 15 · 2013: 19 · 2012: 28
FWCI: 14.30
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: academic.oup.com/pages/standard-publication-reuse-rights (vor)
Locations: American Journal of Respiratory and Critical Care Medicine (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Leicester Research Archive (University of Leicester) (submittedVersion)
Funders: Wellcome Trust (082265)
Midlands Asthma and Allergy Research Association
European Regional Development Fund
Topics: Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
Keywords: Aspergillus fumigatus, asthma, lung function, bronchiectasis, sputum neutrophils, eosinophils, airway colonization, IgE sensitization, IgG sensitization, FEV1, sputum culture, allergic asthma, non-allergic asthma, airway inflammation, bronchodilator response, eosinophilic asthma
MeSH terms: Adult, Aspergillus fumigatus, Asthma, Bronchiectasis, Female, Forced Expiratory Volume, Humans, Hypersensitivity, Immediate, Immunoglobulin E, Lung, Male, Middle Aged, Neutrophils, Respiratory Function Tests, Severity of Illness Index, Sputum, Cohort Studies

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IgE Sensitization to Aspergillus fumigatus Is Associated with Reduced Lung Function in Asthma

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