Allergic Fungal Airway Disease

Rick, Eva-Maria; Woolnough, Kerry; Pashley, Catherine H.; Wardlaw, Andrew J.

doi:10.18176/jiaci.0122

Cited by 87 publications

(96 citation statements)

References 79 publications

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“…Spores and fragments from Aspergillus and Penicillium species are small enough to reach the lower airways (2‐10 μm); because they are thermotolerant, they are also able to germinate and colonize the region . These species are the ones most commonly associated with fungal polysensitization in humans …”

Section: Discussionmentioning

confidence: 99%

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Fungi in respiratory samples of horses with inflammatory airway disease

Dauvillier¹,

Woort²,

Erck-Westergren³

2018

Veterinary Internal Medicne

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Background Fungi contribute to the inflammatory response of lungs in horses with recurrent airway obstruction and in some forms of asthma in humans. The role of fungi in inflammatory airway disease (IAD) has not been assessed. Objectives Evaluate the prevalence of fungi in the respiratory samples of horses diagnosed with IAD, describe clinical signs associated with the presence of fungi in respiratory samples, and assess the risk factors associated with IAD and with the presence of fungi in the airways. Animals Seven‐hundred thirty‐one active horses referred to a specialized ambulatory practice for signs of respiratory disease or poor performance. Methods A prospective observational study was performed, collecting clinical data, environmental conditions, and results of a tracheal wash (TW; cytology, fungal culture, and bacterial culture), and bronchoalveolar lavage (cytology). Results A positive fungal culture was obtained in 55% (402/731) of horses. Horses with fungal elements observed on the TW cytology had 2 times greater chance of having IAD than horses without fungi (odds ratio [OR] = 2.1; 95% CI 1.08‐3.33; P = .0003). Risks of being diagnosed with IAD and likelihood of fungi in TW were higher when horses were bedded on straw (OR = 2.0; 95% CI 1.2‐3.2 and OR = 1.9; 95% CI 1.3‐2.6, respectively) or fed dry hay (OR = 2.7; 95% CI 1.7‐4.4 and OR = 2.6; 95% CI 1.6‐3.4, respectively). Conclusions and Clinical Importance Horses inhaling aerosolized fungal particles are at a significantly higher risk of developing IAD. The type of bedding and forage represent significant risk factors for IAD and fungal contamination of equine airways.

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Section: Discussionmentioning

confidence: 99%

“…When infective, they can further damage their host by producing toxins. Aspergillus species are the most prominent cause of fungal lung infections in humans …”

Section: Introductionmentioning

confidence: 99%

Fungi in respiratory samples of horses with inflammatory airway disease

Dauvillier¹,

Woort²,

Erck-Westergren³

2018

Veterinary Internal Medicne

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“…Many fungal species, in particular Aspergillus species, have been implicated in the development of allergic diseases such as allergic rhinitis and asthma, because fungal spores are often potent allergens (Rick, Woolnough, Pashley, & Wardlaw, ; I. Zhang, Pletcher, Goldberg, Barker, & Cope, ). Antibiotic use, which promotes the outgrowth of symbiotic fungi, is also associated with an increased risk for asthma and allergies (Huffnagle, ).…”

Section: Why Does the Mycobiome Matter?mentioning

confidence: 99%

The mammalian mycobiome: A complex system in a dynamic relationship with the host

Lai

Tan

Pavelka

2018

WIREs Mechanisms of Disease

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Mammalian barrier surfaces are densely populated by symbiont fungi in much the same way the former are colonized by symbiont bacteria. The fungal microbiota, otherwise known as the mycobiota, is increasingly recognized as a critical player in the maintenance of health and homeostasis of the host. Here we discuss the impact of the mycobiota on host physiology and disease, the factors influencing mycobiota composition, and the current technologies used for identifying symbiont fungal species. Understanding the tripartite interactions among the host, mycobiota, and other members of the microbiota, will help to guide the development of novel prevention and therapeutic strategies for a variety of human diseases. This article is categorized under: Physiology > Mammalian Physiology in Health and Disease Laboratory Methods and Technologies > Genetic/Genomic Methods Models of Systems Properties and Processes > Organismal Models

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“…3,4 The respiratory tract is constantly exposed to hyphal fragments, fungal spores and yeasts. [5][6][7] Thermotolerant fungi, including Candida, Aspergillus and Penicillium, are sources of allergens, commensals and opportunistic pathogens can colonize airways with potential clinical ramifications. 5 Aspergillus fumigatus, a ubiquitous fungus can elicit a destructive response in a susceptible host.…”

Section: Introductionmentioning

confidence: 99%

The presence of Aspergillus fumigatus in asthmatic airways is not clearly related to clinical disease severity

Sullivan

Hunt

Ward

et al. 2019

Allergy

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Background: It is suggested that airway fungi, in particular Aspergillus may impinge on clinical phenotype in asthma. Indeed, the term severe asthma with fungal sensitization (SAFS) has been coined. We aimed to ascertain whether the presence of fungi, in particular Aspergillus fumigatus, in the airway correlated with asthma severity and control. Furthermore, we aimed to determine whether traditional markers of Aspergillus sensitization related to the presence of Aspergillus within the airway. Methods: Sixty-nine patients characterized by asthma severity (GINA) and level of control (ACQ-7) underwent bronchoscopy and bronchoalveolar lavage (BAL). Serum was assessed for A fumigatus-specific IgE and total IgE. Galactomannan and relevant cytokine levels were assessed in serum, plasma and BAL. BAL was analyzed for the presence of A fumigatus. Results: In BAL, fungi were visible by microscopy in 70% and present by qPCR in 86% of patients, while A fumigatus was detectable by qPCR in 46%. Plasma and BAL IL-4, IL-6, IL-10, IL-13 and TNF-α correlated with BAL fungal presence, while plasma IL-17 correlated with BAL fungal presence. Aspergillus positive BAL correlated with increased plasma and BAL IL-6 and BAL IL-13. There was no relationship between fungal airway presence and steroid dose, asthma severity or control. The presence of Aspergillus within the airway did not relate to serum IgE positivity for Aspergillus.Conclusions: Fungi were present in a large proportion of our asthmatic patients' airways, but their presence was not predicted by traditional markers of sensitization, nor did it appear to be related to measures of disease severity or control. K E Y W O R D S allergy, Aspergillus fumigatus, asthma, bronchoscopy, fungi | 1147 SULLIVAN et AL.Note: Breakdown of patient demographics based on patient groupings of mild, moderate and severe asthmatics as defined by GINA groupings of GINA 1 + 2 = mild, GINA 3 = moderate and GINA 4 + 5 = severe with our results for each level of asthma severity shown. Abbreviations: ACQ-7, Asthma Control Questionnaire; BMI, Body Mass Index; FeNO, Fractional exhaled Nitric Oxide; FEV-1, Forced Expiratory Volume in the first second. S U PP O RTI N G I N FO R M ATI O NAdditional supporting information may be found online in the Supporting Information section.How to cite this article: Sullivan A, Hunt EB, Ward C, et al.The presence of Aspergillus fumigatus in asthmatic airways is not clearly related to clinical disease severity. Allergy.

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Allergic Fungal Airway Disease

Cited by 87 publications

References 79 publications

Fungi in respiratory samples of horses with inflammatory airway disease

Fungi in respiratory samples of horses with inflammatory airway disease

The mammalian mycobiome: A complex system in a dynamic relationship with the host

The presence of Aspergillus fumigatus in asthmatic airways is not clearly related to clinical disease severity

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