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

Autor: Sullivan A; The APC Microbiome Ireland, University College Cork, Cork, Ireland.; The Schools of Medicine and Microbiology, University College Cork, Cork, Ireland., Hunt EB; The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland.; The HRB Funded Clinical Research Facility, University College Cork, Cork, Ireland., Ward C; The Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK., Lapthorne S; The APC Microbiome Ireland, University College Cork, Cork, Ireland., Eustace JA; The HRB Funded Clinical Research Facility, University College Cork, Cork, Ireland., Fanning LJ; The APC Microbiome Ireland, University College Cork, Cork, Ireland., Plant BJ; The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland.; The HRB Funded Clinical Research Facility, University College Cork, Cork, Ireland., O'Byrne PM; The Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada., MacSharry JA; The APC Microbiome Ireland, University College Cork, Cork, Ireland.; The Schools of Medicine and Microbiology, University College Cork, Cork, Ireland., Murphy DM; The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland.; The HRB Funded Clinical Research Facility, University College Cork, Cork, Ireland.
Jazyk: angličtina
Zdroj: Allergy [Allergy] 2020 May; Vol. 75 (5), pp. 1146-1154. Date of Electronic Publication: 2019 Oct 31.
DOI: 10.1111/all.14087
Abstrakt: 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.
(© 2019 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.)
Databáze: MEDLINE
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