Residential exposure to Aspergillus spp. is associated with exacerbations in COPD.

Autor:	Tiew PY; Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore.; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.; Joint-first authors., Leung JM; Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada.; Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, Canada.; Joint-first authors., Mac Aogáin M; Department of Biochemistry, St. James's Hospital, Dublin, Ireland.; School of Medicine, Trinity College Dublin, Dublin, Ireland., Johal P; Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, Canada., Jaggi TK; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore., Yuen ACY; Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, Canada., Ivan FX; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore., Yang J; Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada., Afshar T; Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, Canada., Tee A; Department of Respiratory and Critical Care Medicine, Changi General Hospital, Singapore., Koh MS; Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore., Lim YH; Singapore Centre for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University Singapore., Wong A; Singapore Centre for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University Singapore., Chandrasekaran L; Singapore Centre for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University Singapore., Dacanay JG; Singapore Centre for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University Singapore., Drautz-Moses DI; Singapore Centre for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University Singapore., Ong TH; Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore., Abisheganaden JA; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.; Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore., Chew FT; Department of Biological Sciences, National University of Singapore, Singapore., Schuster SC; Singapore Centre for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University Singapore., Carlsten C; Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada.; Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, Canada.; Joint-senior authors., Chotirmall SH; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore schotirmall@ntu.edu.sg.; Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore.; Joint-senior authors.
Jazyk:	angličtina
Zdroj:	The European respiratory journal [Eur Respir J] 2024 Nov 21. Date of Electronic Publication: 2024 Nov 21.
DOI:	10.1183/13993003.00907-2024
Abstrakt:	Background: Sensitisation to Aspergillus fumigatus is linked to worse outcomes in patients with chronic obstructive pulmonary disease (COPD), however, its prevalence and clinical implications in domestic (residential) settings remains unknown. Methods: Individuals with COPD (n=43) recruited in Singapore had their residences prospectively sampled and assessed by shotgun metagenomic sequencing including indoor air, outdoor air, and touch surfaces (total: 126 specimens). The abundance of environmental A. fumigatus and the occurrence of A. fumigatus (Asp f) allergens in the environment were determined and immunological responses to A. fumigatus allergens determined in association with clinical outcomes including exacerbation frequency. Findings were validated in 12 individuals (31 specimens) with COPD in Vancouver, Canada, a climatically different region. Results: 157 metagenomes from 43 homes were assessed. Eleven and nine separate Aspergillus spp. were identified in Singapore and Vancouver respectively. Despite climatic, temperature, and humidity variation, A. fumigatus was detectable in the environment from both locations. The relative abundance of environmental A. fumigatus was significantly associated with exacerbation frequency in both Singapore (r=0.27, p=0.003) and Vancouver (r=0.49, p=0.01) and individuals with higher Asp f 3 sensitisation responses lived in homes with a greater abundance of environmental Asp f 3 allergens (p=0.037). Patients exposed and sensitised to Asp f 3 allergens demonstrated a higher rate of COPD exacerbations at 1-year follow-up (p=0.021). Conclusion: Environmental A. fumigatus exposure in the home environment including air and surfaces with resulting sensitisation carries pathogenic potential in individuals with COPD. Targeting domestic A. fumigatus abundance may reduce COPD exacerbations. (Copyright ©The authors 2024.)
Databáze:	MEDLINE
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