Severe asthma with fungal sensitization may be an underdiagnosed sub-phenotype of asthma in children, according to data presented at the American Thoracic Society 2012 International Conference in San Francisco.
Researchers prospectively analyzed serum IgE levels and fungal sensitization patterns of 41 children who failed combination asthma therapy. They diagnosed severe asthma with fungal sensitization (SAFS) in 41.5% of patients.
Children with SAFS tended to be older (median aged 11 years vs. 8.5 years; P=.0325), had higher serum IgE levels (2.96 median vs. 1.62 median; P<.001), and performed worse on pulmonary function tests than nonSAFS children. These differences remained significant for IgE levels and pulmonary function tests when SAFS children were compared with nonSAFS children sensitized to nonfungal allergens.
“Our results suggest that SAFS may account for a significant proportion of severe asthma in our pediatric population,” Alfin G. Vicencio, MD, chief of pediatric pulmonology and cystic fibrosis at Cohen Children’s Medical Center in Great Neck, N.Y., said.
More than 65% of children with SAFS showed sensitization to multiple organisms, with the most commonly implicated fungi:
- Aspergillus spp – 81.2%
- Alternaria spp – 68.8%
- Candida spp – 31.2%
- Cladosporium spp – 31.2%
- Setomelanomma spp – 31.2%
- Mucor spp – 25%
- Penicillium spp – 18.8%
“We are actively pursuing new methods to identify fungal organisms in the lower airway, which would enable us to better define treatment protocols,” Vicencio said. “In addition, we are hoping to identify genetic risk factors for disease, which could potentially lead to targeted preventive strategies early in life.”
For more information:
Vicencio AG. #28785: Severe Asthma With Fungal Sensitization in Children: Characterization of a New Pediatric Asthma Sub-Phenotype. Presented at: The American Thoracic Society 2012 International Conference; May 18-23, San Francisco.