Masaki K, et al. – The clinical characteristics of severe asthma with fungal sensitization had been examined. In this study, early onset of disease and high serum levels of interleukin–33 characterized severe asthma with fungal sensitization. An association was found between multiple fungal sensitizations and poor asthma control.

Methods

• 124 patients with severe asthma were part of this study.
• Clinical aspects, such as various serum cytokines, fractional exhaled nitric oxide, pulmonary function, and serum immunoglobulin E (IgE) were appraised.
• By determining serum levels of IgE specific to fungal allergens (Aspergillus, Alternaria, Candida, Cladosporium, Penicillium, and Trichophyton species and Schizophyllum commune), fungal sensitization was assessed. 

Results

• The clinicians reported that thirty-six patients (29%) showed sensitization to at least 1 fungal allergen.
• Candida (16%), Aspergillus (11%), and Trichophyton (11%) were the most common species.
• As compared to those without fungal sensitization (45% vs 25%; P = .02), the rate of early-onset asthma (<16 years of age) was higher in patients with fungal sensitization.
• They observed higher interleukin-33 levels in patients with fungal sensitization than in those without fungal sensitization.
• Of patients with atopic asthma, as compared to patients with a single fungal sensitization or those without fungal sensitization Asthma Control Test scores were worse in patients with multiple fungal sensitizations.