Age‐dependency of sensitization to aero‐allergens in asthmatics

Niemeijer, Nr; Demonchy, Jgr

doi:10.1111/j.1398-9995.1992.tb02084.x

Cited by 64 publications

(41 citation statements)

References 16 publications

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“…This is comparable to the rate of 54.3% obtained for the 7- to 12-year-old asthmatics in the present study. In other studies that covered the full age spectrum as the present study, essentially similar results (both in magnitude and age-dependent distribution) were reported [7, 24]. …”

Section: Discussionsupporting

confidence: 75%

IgE-Mediated Sensitization to Mould Allergens among Patients with Allergic Respiratory Diseases in a Desert Environment

Ezeamuzie¹,

Al-Ali²,

Khan³

et al. 2000

Int Arch Allergy Immunol

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Background: The importance of fungal allergens in the development of allergic diseases in a desert environment is uncertain. This study evaluated the prevalence of IgE sensitization to moulds among patients with allergic respiratory diseases in Kuwait – a desert country. Methods: A total of 810 patients (male:female ratio 1.4) with a mean age of 32.3 years (range 2–76 years) with extrinsic asthma or allergic rhinitis were studied. Sera from the patients were tested by the CAP-RAST method for specific IgE to 6 fungi (Penicillium, Cladosporium, Aspergillus, Candida, Alternaria and Helminthosporium). For comparison house dust mite and Bermuda grass were also assessed. Results: The overall positivity to at least one mould was 20.9%. Among 120 matched control subjects, the value was 5.8%. The value was much higher among patients with asthma alone (45.8%) or both asthma and rhinitis (28.3%) than those with rhinitis alone (11.8%; p < 0.001). Asthmatic children had the highest sensitization rate (66.0% in the 7- to 12-year age group), which declined sharply with age. Among asthmatics, Candida and Aspergillus had the highest sensitization rates (23.1 and 21.3%, respectively), followed by Helminthosporium (18.8%), Cladosporium (15.9%), Alternaria (14.6%) and Penicillium (13.9%). The values for mite and Bermuda grass were 41.2 and 54.6%, respectively. Among asthmatic children, severe asthma was significantly more frequent among mould-positive (51.6%) than mould-negative patients (17.5%; p < 0.0001). Conclusions: Even in this desert environment, sensitization to moulds is quite common among patients with allergic respiratory diseases, with a striking preponderance among children with asthma. Mould allergy could also be an important factor determining asthma severity in this environment.

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Section: Discussionsupporting

confidence: 75%

IgE-Mediated Sensitization to Mould Allergens among Patients with Allergic Respiratory Diseases in a Desert Environment

Ezeamuzie¹,

Al-Ali²,

Khan³

et al. 2000

Int Arch Allergy Immunol

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“…The prevalence of sensitization to fungi is unclear, although estimates suggest that 3% to 10% of the general population, 12% to 42% of atopic patients, and up to 66% of patients with severe asthma may be sensitized to fungi [9,10,32]; yet, not all sensitized individuals will develop allergic symptoms [5]. Prevalence varies with age [33,34] and can differ between countries [35]. Surveys based on skin prick testing (SPT), which is relatively insensitive for some fungal allergens, may underestimate the prevalence of IgE sensitization.…”

Section: Allergic Immune Responses To Fungimentioning

confidence: 99%

Allergic Fungal Airway Disease

Rick¹,

Woolnough²,

Pashley³

et al. 2016

J Investig Allergol Clin Immunol

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Fungi are ubiquitous and form their own kingdom. Up to 80 genera of fungi have been linked to type I allergic disease, and yet, commercial reagents to test for sensitization are available for relatively few species. In terms of asthma, it is important to distinguish between species unable to grow at body temperature and those that can (thermotolerant) and thereby have the potential to colonize the respiratory tract. The former, which include the commonly studied Alternaria and Cladosporium genera, can act as aeroallergens whose clinical effects are predictably related to exposure levels. In contrast, thermotolerant species, which include fungi from the Candida, Aspergillus, and Penicillium genera, can cause a persistent allergenic stimulus independent of their airborne concentrations. Moreover, their ability to germinate in the airways provides a more diverse allergenic stimulus, and may result in noninvasive infection, which enhances inflammation. The close association between IgE sensitization to thermotolerant filamentous fungi and fixed airflow obstruction, bronchiectasis, and lung fibrosis suggests a much more tissue-damaging process than that seen with aeroallergens. This review provides an overview of fungal allergens and the patterns of clinical disease associated with exposure. It clarifies the various terminologies associated with fungal allergy in asthma and makes the case for a new term (allergic fungal airway disease) to include all people with asthma at risk of developing lung damage as a result of their fungal allergy. Lastly, it discusses the management of fungirelated asthma. Key words: Thermotolerant fungi. Allergic fungal airway disease (AFAD). ABPA. SAFS. Asthma. Allergic fungal rhinosinusitis (AFRS). Immune responses. Diagnosis. Treatment. ResumenLos hongos son obicuos y forman su propio reino. Hasta 80 géneros de hongos han sido asociados con la enfermedad alérgica tipo I; sin embargo, los reactivos comerciales para testar las sensibilizaciones a los mismos, se encuentran disponibles para un número relativamente pequeño de especies. En cuanto al asma, es importante distinguir entre especies incapaces de crecer en temperatura ambiente y aquellas que son termotolerantes y que, por lo tanto, tienen una capacidad potencial para colonizar el tracto respiratorio. Los primeros, que incluyen los géneros comúnmente estudiados Alternaria y Cladosporium, pueden actuar como aeroalérgenos y sus efectos clínicos están relacionados con los niveles de exposición. En contraste, las especies termotolerantes, que incluyen hongos del género Candida, Aspergillus y Penicillium, pueden causar un estímulo alergénico persistente independiente de su concentración en el aire. Además, su capacidad para germinar en las vías aéreas da lugar a estímulos alergénicos más diversos y puede dar como resultado infecciones no invasivas que facilitan la inflamación. La estrecha asociación entre sensibilización dependiente de IgE a hongos filamentosos termotolerantes y la obstrucción del flujo aéreo, bronquiectasias y fib...

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“…Nimeijer et al have demonstrated that the sensitivity of the allergy skin test decreases with age to all allergens except for grass pollen. 26 Consequently, this could lead to a possible desensitisation of a widespread allergens such as pollens in the elderly population. In our study, dysphagia was the most common symptom presentation among elderly EoE patients.…”

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confidence: 99%