Objective: To investigate the effect of fungal sensitization in severe asthmatic patients.
Methods: We collected data from 146 patients with severe asthma for analysis of the following variables: asthma control test (ACT) score, pulmonary function, fractional exhaled nitric oxide (FeNO), and sensitization to fungi (Aspergillus, Alternaria, Cladosporium, Penicillium, Trichophyton, and Schizophyllum commune) and non-fungal antigen sources (house dust mites, dogs, cats, cockroaches, moths, and chironomids). Fungal sensitization was diagnosed when an increase in the serum IgE levels specific to these allergens was detected.
Results: Eighty-seven patients (60%) were sensitized to one or more antigens; 37 (25%) were sensitized to fungal allergens, the most common of which were Aspergillus (22 patients, 15%) and Trichophyton(19 patients, 13%). Of the 87 patients, six were only sensitized to fungus (Group F), 50 only to non-fungal allergens (Group N), and 31 to both fungal and non-fungal antigens (Group F + N). The sex distribution, pulmonary function, and dose of inhaled corticosteroid were not significantly different between the three groups; however, the ACT score was significantly lower for Group F + N than for the other groups. The FeNO and the ratio of subjects dependent on oral steroid therapy were higher in Group F + N than in Group N.
Conclusion: Fungal sensitization, in addition to non-fungal sensitization, is associated with poor control of asthma in patients with severe asthma.