The spectrum of allergic fungal diseases of the upper and lower airways

Rodrigues, J.; Caruthers, Carrie; Azmeh, Roua; Dykewicz, Mark S.; Slavin, Raymond G.; Knutsen, Alan P.

doi:10.1586/1744666x.2016.1142874

Cited by 32 publications

(38 citation statements)

References 202 publications

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“…Depending on still incompletely understood factors, fungi can exist symbiotically, invade sinonasal tissues, serve as antigens against which the host immune system can mount a hypersensitivity or inflammatory response, or induce sinus mucosal disease through other mechanisms (eg, proteolytic effects that disrupt mucosal epithelial integrity). 8…”

Section: Afrs In the Broader Context Of Fungal Sinus Diseasementioning

confidence: 99%

“…1,73 Adjuvant medical therapy is integral for successful treatment of AFRS, and a variety of agents have been studied, such as oral and topical steroids, oral and topical antifungals, leukotriene antagonists, omalizumab, and immunotherapy. 1,8 Systemic steroids reduce the inflammatory response, which in turn causes polyp regression and decreased sinomucosal edema. When given preoperatively, steroids decrease symptoms arising from mechanical obstruction and improve intraoperative visualization of sinonasal anatomy during functional endoscopic sinus surgery.…”

Section: Treatmentmentioning

confidence: 99%

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Allergic fungal rhinosinusitis

Dykewicz¹,

Rodrigues

Slavin³

2018

Journal of Allergy and Clinical Immunology

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Section: Afrs In the Broader Context Of Fungal Sinus Diseasementioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Allergic fungal rhinosinusitis

Dykewicz¹,

Rodrigues

Slavin³

2018

Journal of Allergy and Clinical Immunology

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“…Asthma patients with severe disease who are sensitized to one or more fungi, but do not meet the diagnostic criteria for allergic bronchopulmonary aspergillosis (ABPA) are classified as having severe asthma with fungal sensitization (SAFS) (Denning, ), recently broadened to ‘fungal asthma’ (Moss, ). SAFS is a relatively new classification of allergic asthmatic subjects, but is increasingly recognized (Castanhinha et al., ; Denning, ; Farrant et al., ; Rodrigues et al., ).…”

Section: Introductionmentioning

confidence: 99%

Genetic susceptibility to severe asthma with fungal sensitization

Overton

Simpson

Bowyer

et al. 2017

Int J Immunogenetics

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Severe asthma is problematic and its pathogenesis poorly understood. Fungal sensitization is common, and many patients with severe asthma with fungal sensitization (SAFS), used to denote this subgroup of asthma, respond to antifungal therapy. We have investigated 325 haplotype-tagging SNPs in 22 candidate genes previously associated with aspergillosis in patients with SAFS, with comparisons in atopic asthmatics and healthy control patients, of whom 47 SAFS, 279 healthy and 152 atopic asthmatic subjects were genotyped successfully. Significant associations with SAFS compared with atopic asthma included Toll-like receptor 3 (TLR3) (p = .009), TLR9 (p = .025), C-type lectin domain family seven member A (dectin-1) (p = .043), interleukin-10 (IL-10) (p = .0010), mannose-binding lectin (MBL2) (p = .007), CC-chemokine ligand 2 (CCL2) (2 SNPs, p = .025 and .041), CCL17 (p = .002), plasminogen (p = .049) and adenosine A2a receptor (p = .024). These associations differ from those found in ABPA in asthma, indicative of contrasting disease processes. Additional and broader genetic association studies in SAFS, combined with experimental work, are likely to contribute to our understanding of different phenotypes of problematic asthma.

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“…As far back as 1698 Floyer described a patient with an asthmatic attack after exposure to fermenting wine [1]. Since then, asthma has been associated with fungal sensitivity, especially to Alternaria alternata and Cladosporium herbarum , [2], [3] and allergic bronchopulmonary mycosis (ABPM) has been described in association to multiple fungi species, most commonly Aspergillus fumigatus [1], [3].…”

Section: Introductionmentioning

confidence: 99%

A Case of Chronic Cough in a Winemaker

Viteri

Foray

Song

et al. 2017

Respiratory Medicine Case Reports

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BackgroundFungi have been known to cause a variety of respiratory conditions, ranging from mold- associated asthma to allergic bronchopulmonary mycosis and invasive disease. More recently some fungal species have been implicated in a non-asthmatic chronic cough syndrome.Case presentationA 59-year-old male presented to the pulmonary clinic with chronic nonproductive cough. Workup included pulmonary function tests with methacholine challenge, sputum cultures, CT scans of the chest and therapeutic trial with proton pump inhibitors. Sputum cultures repeatedly showed Saccharomyces cerevisiae and patient had elevated specific IgA and IgG. Bronchoscopy was unremarkable, except for tracheal mucosa biopsies revealing acute and chronic inflammation. A one-month course of steroids provided temporary relief of chronic cough, but symptoms returned once steroids were discontinued. He also experienced temporary relief away from home. Upon further evaluation, the patient described his hobby of wine making which was believed to be the source of Saccharomyces cerevisiae. Once he stopped wine making at home and cleared his cellar, his symptoms stopped and have not returned since.ConclusionWe describe a rare presentation of non-asthmatic chronic cough associated with exposure to Saccharomyces cerevisiae. This is the first report of fungi associated chronic cough without asthmatic features outside of Japan and the first one associated with Saccharomyces cerevisiae. This report provides further evidence linking fungi with chronic cough syndrome without the features of asthma or allergic bronchopulmonary mycosis.

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The spectrum of allergic fungal diseases of the upper and lower airways

Cited by 32 publications

References 202 publications

Allergic fungal rhinosinusitis

Allergic fungal rhinosinusitis

Genetic susceptibility to severe asthma with fungal sensitization

A Case of Chronic Cough in a Winemaker

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