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IgE Sensitization to Aspergillus fumigatus Is Associated with Reduced Lung Function in Asthma
Open accessAbstract
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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“IgE sensitization to fungal species is associated with increased asthma severity, neutrophilic inflammation, and reduced lung function consistent with ACOS (105).”
From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [105]
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Metadata
- 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
- 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
- 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
- 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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