Utility of immunology, microbiology, and helminth investigations in clinical assessment of severe asthma

Singer, A; Ali, FR; Quantrill, Simon; North, Nathan; Stevens, Mike; Lambourne, Jonathan; Grigoriadou, Sofia; Pfeffer, Paul

doi:10.1080/02770903.2020.1868496

Cited by 2 publications

(2 citation statements)

References 41 publications

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“…A systematic severe asthma assessment program performed in a reference center in United Kingdom demonstrated that 7% of patients with confirmed severe asthma had a positive Strongyloides serology. In this study, no impact on asthma control was seen following ivermectin treatment; however, treatment of Strongyloides was intended primarily to prevent severe complications that could result from the use of corticosteroids and biological agents for asthma treatment [23 ▪ ].…”

Section: Strongyloides and Lung Involvementmentioning

confidence: 99%

Strongyloidiasis-related lung involvement: too much of a bad thing

Barkati

Greenaway

Libman

2023

Current Opinion in Infectious Diseases

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Purpose of reviewStrongyloidiasis is a soil-transmitted helminthiasis, a neglected tropical disease that affects 300–900 million individuals globally. Strongyloides stercoralis is associated with cutaneous, respiratory, and gastrointestinal clinical manifestations. Chronicity is due to an autoinfective cycle, and host immunosuppression can lead to severe and fatal disease. Lung involvement is significant in severe strongyloidiasis, and Strongyloides has a complex association with a number of lung diseases, which will be discussed in this review.Recent findingsThe treatment of chronic lung diseases such as asthma and chronic obstructive pulmonary disease with corticosteroids is an important risk factor for Strongyloides hyperinfection syndrome (SHS)/disseminated strongyloidiasis. The use of corticosteroids in the treatment of coronavirus disease 2019 (COVID-19) and potentially COVID-19-induced eosinopenia are risk factors for severe strongyloidiasis. Recent findings have demonstrated a significant immunomodulatory role of Strongyloides in both latent and active pulmonary tuberculosis associated to an impaired immune response and poor outcomes in active pulmonary tuberculosis.SummaryStrongyloides lung involvement is a common finding in severe infection. Prompt recognition of Strongyloides infection as well as prevention of severe disease by screening or presumptive treatment are important goals in order to improve Strongyloides outcomes in at-risk population.

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Section: Strongyloides and Lung Involvementmentioning

confidence: 99%

Strongyloidiasis-related lung involvement: too much of a bad thing

Barkati

Greenaway

Libman

2023

Current Opinion in Infectious Diseases

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“…Allergic fungal sensitization may be a sign of attenuated immunosuppression, possibly contributing to later onset of chronic rejection. Detection of fungus-specific IgG antibodies on the other hand, may reflect past fungal presence in the airways ( 10 ), and could thus potentially be used as a measure for fungal exposure, independent of airway sampling, identifying patients at a higher risk of (invasive) fungal infections and CLAD.…”

Section: Introductionmentioning

confidence: 99%

Aspergillus-Specific IgG Antibodies are Associated With Fungal-Related Complications and Chronic Lung Allograft Dysfunction After Lung Transplantation

Beeckmans¹,

Roy²,

Kaes³

et al. 2023

Transpl Int

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Fungal exposure and sensitization negatively affect outcomes in various respiratory diseases, however, the effect of fungal sensitization in lung transplant (LTx) recipients is still unknown. We performed a retrospective cohort study of prospectively collected data on circulating fungal specific IgG/IgE antibodies, and their correlation with fungal isolation, chronic lung allograft dysfunction (CLAD) and overall survival after LTx. 311 patients transplanted between 2014 and 2019 were included. Patients with elevated Aspergillus fumigatus or Aspergillus flavus IgG (10%) had more mold and Aspergillus species isolation (p = 0.0068 and p = 0.0047). Aspergillus fumigatus IgG was specifically associated with Aspergillus fumigatus isolation in the previous or consecutive year (AUC 0.60, p = 0.004 and AUC 0.63, p = 0.022, respectively). Elevated Aspergillus fumigatus or Aspergillus flavus IgG was associated with CLAD (p = 0.0355), but not with death. Aspergillus fumigatus, Aspergillus flavus or Aspergillus niger IgE was elevated in 19.3% of patients, but not associated with fungal isolation, CLAD or death. Mold isolation and Aspergillus species isolation from respiratory cultures were associated with CLAD occurrence (p = 0.0011 and p = 0.0005, respectively), and Aspergillus species isolation was also associated with impaired survival (p = 0.0424). Fungus-specific IgG could be useful in long-term follow-up post-LTx, as a non-invasive marker for fungal exposure, and thus a diagnostic tool for identifying patients at risk for fungal-related complications and CLAD.

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Utility of immunology, microbiology, and helminth investigations in clinical assessment of severe asthma

Cited by 2 publications

References 41 publications

Strongyloidiasis-related lung involvement: too much of a bad thing

Strongyloidiasis-related lung involvement: too much of a bad thing

Aspergillus-Specific IgG Antibodies are Associated With Fungal-Related Complications and Chronic Lung Allograft Dysfunction After Lung Transplantation

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