Environmental fungal sensitisation associates with poorer clinical outcomes in COPD

IntroductionAllergic sensitisation to fungi such as Aspergillus are associated to poor clinical outcomes in asthma, bronchiectasis and cystic fibrosis; however, clinical relevance in COPD remains unclear.MethodsPatients with stable COPD (n=446) and nondiseased controls (n=51) were prospectively recruited across three countries (Singapore, Malaysia and Hong Kong) and screened against a comprehensive allergen panel including house dust mites, pollens, cockroach and fungi. For the first time, using a metagenomics approach, we assessed outdoor and indoor environmental allergen exposure in COPD. We identified key fungi in outdoor air and developed specific-IgE assays against the top culturable fungi, linking sensitisation responses to COPD outcomes. Indoor air and surface allergens were prospectively evaluated by metagenomics in the homes of 11 COPD patients and linked to clinical outcome.ResultsHigh frequencies of sensitisation to a broad range of allergens occur in COPD. Fungal sensitisation associates with frequent exacerbations, and unsupervised clustering reveals a “highly sensitised fungal predominant” subgroup demonstrating significant symptomatology, frequent exacerbations and poor lung function. Outdoor and indoor environments serve as important reservoirs of fungal allergen exposure in COPD and promote a sensitisation response to outdoor air fungi. Indoor (home) environments with high fungal allergens associate with greater COPD symptoms and poorer lung function, illustrating the importance of environmental exposures on clinical outcomes in COPD.ConclusionFungal sensitisation is prevalent in COPD and associates with frequent exacerbations representing a potential treatable trait. Outdoor and indoor (home) environments represent a key source of fungal allergen exposure, amenable to intervention, in “sensitised” COPD.

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Allergic bronchopulmonary aspergillosis in patients with asthma: Results of a prospective study

Terapevticheskii arkhiv ◽

10.17116/terarkh201789813-16 ◽

2017 ◽

Vol 89 (8) ◽

pp. 13-16 ◽

Cited By ~ 1

Author(s):

Ya I Kozlova ◽

E V Frolova ◽

L V Filippova ◽

A E Uchevatkina ◽

O V Aak ◽

...

Keyword(s):

Severe Asthma ◽

Allergic Bronchopulmonary Aspergillosis ◽

Specific Ige ◽

Skin Tests ◽

Asthmatic Patients ◽

Fungal Allergens ◽

Allergenic Fungi ◽

Fungal Allergen ◽

A Prospective Study ◽

Fungal Sensitization

Aim. To estimate the frequency of fungal sensitization and the incidence of allergic bronchopulmonary aspergillosis (ABPA) in asthmatic patients. Subjects and methods. A total of 140 asthmatic patients were examined. They underwent allergologic (skin tests for fungal allergens, estimation of total and fungal allergen-specific IgE levels) and mycological (microscopy and inoculation of respiratory biosubstrates) examinations. Chest computed tomography, when indicated, was done. A group of patients with ABPA and that of patients with severe asthma and fungal sensitization were identified. Results. The frequency of fungal sensitization in asthmatic patients was 36%; the main allergenic fungi were Aspergillus and Alternaria. The incidence of ABPA was as high as 4% in the patients with asthma and 11% in those with severe asthma and fungal sensitization. Conclusion. The given current diagnostic criteria will assist practitioners to identify ABPA, to prevent its progression, and to initiate specific anti-inflammatory and antifungal therapy in due time.

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Seasonal differences in airway hyperresponsiveness in asthmatic patients: relationship with allergen exposure and sensitization to house dust mites

Clinical & Experimental Allergy ◽

10.1046/j.1365-2222.1997.d01-554.x ◽

1997 ◽

Vol 27 (6) ◽

pp. 627-633 ◽

Cited By ~ 26

Author(s):

S. VAN DER HEIDE ◽

J. G. R. DE MONCHY ◽

K. DE VRIES ◽

A. E. J. DUBOIS ◽

H. F. KAUFFMAN

Keyword(s):

House Dust ◽

Airway Hyperresponsiveness ◽

Allergen Exposure ◽

House Dust Mites ◽

Dust Mites ◽

Seasonal Differences ◽

Asthmatic Patients

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Detection of Serum Allergen-Specific IgE in Atopic Dogs Tested in Northern Italy: Preliminary Study

Animals ◽

10.3390/ani11020358 ◽

2021 ◽

Vol 11 (2) ◽

pp. 358

Author(s):

Morena Di Tommaso ◽

Alessia Luciani ◽

Paolo Emidio Crisi ◽

Marica Beschi ◽

Paolo Rosi ◽

...

Keyword(s):

Monoclonal Antibody ◽

Specific Ige ◽

Elisa Test ◽

Northern Italy ◽

House Dust Mites ◽

Indoor Allergens ◽

Allergic Skin ◽

Antibody Elisa ◽

Ige Mediated ◽

Indoor And Outdoor

Canine atopic dermatitis (CAD) is a pruritic allergic skin disease associated with IgE-mediated hypersensitivity. IgE is detected using Serum Allergen-Specific IgE test (SAT) in order to identify allergens. The present study aims to identify the environmental allergens in atopic dogs living in Northern Italy using SAT. The screening SAT (sSAT), using a monoclonal antibody cocktail-based ELISA to identify indoor and outdoor allergens, was performed. In all positive samples, an anti-IgE monoclonal antibody ELISA test was performed to extend panel of allergens. Out of 117 selected dogs, 69 were included in the study; 71% were positive and 29% were negative to sSAT. Among the 49 positive sSAT, 53% were positive for both indoor and outdoor, 38.8% only for indoor, and 8.2% only for outdoor allergens. This is the first study on the frequency of allergens involved in CAD in Italy using SAT. IgE hypersensitivity in atopic dogs of Northern Italy is usually associated with indoor allergens, primarily house dust mites. Among the outdoor allergens, an important role was played by Rumex acetosa. Polysensitization also commonly occurs. Therefore, since the numerous factors affect the IgE positivity in CAD, specific panels for geographical areas should be considered and re-evaluated at time intervals.

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Neither Dust Mite nor Cat Allergen Exposure Is Associated with Lung Function or Asthma Morbidity in Sensitized Baltimore City Children

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2011.12.733 ◽

2012 ◽

Vol 129 (2) ◽

pp. AB64

Author(s):

S.K. Ahluwalia ◽

P. Breysse ◽

G. Diette ◽

E. Matsui

Keyword(s):

Lung Function ◽

Allergen Exposure ◽

Baltimore City ◽

Asthma Morbidity ◽

Dust Mite ◽

Cat Allergen

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Studies on the role of routes of allergen exposure in high IgE-producing beagle dogs sensitized to house dust mites

Veterinary Dermatology ◽

10.1111/j.1365-3164.2006.00541.x ◽

2006 ◽

Vol 17 (5) ◽

pp. 306-312 ◽

Cited By ~ 37

Author(s):

R. Marsella ◽

C. Nicklin ◽

J. Lopez

Keyword(s):

House Dust ◽

Allergen Exposure ◽

House Dust Mites ◽

Dust Mites ◽

Beagle Dogs

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BASOPHILE ACTIVATION TEST FOR THE DIAGNOSTICS OF FUNGAL SENSITIZATION IN THE PATIENTS WITH CYSTIC FIBROSIS

Medical Immunology (Russia) ◽

10.15789/1563-0625-2019-5-919-928 ◽

2019 ◽

Vol 21 (5) ◽

pp. 919-928

Author(s):

Ya. I. Kozlova ◽

E. V. Frolova ◽

A. E. Uchevatkina ◽

L. V. Filippova ◽

O. V. Aak ◽

...

Keyword(s):

Cystic Fibrosis ◽

Stimulation Index ◽

Allergic Bronchopulmonary Aspergillosis ◽

Basophil Activation Test ◽

Specific Ige ◽

Basophil Activation ◽

Total Ige ◽

Activation Test ◽

Fungal Allergens ◽

Fungal Sensitization

Aspergillus fumigatus colonization in the patients with cystic fibrosis (CF) may cause sensitization against A. fumigatus and/or allergic bronchopulmonary aspergillosis (ABPA), which significantly worsens the course of underlying disease. At the present time, new diagnostic tests are searched for detection of fungal sensitization in these patients. The aim of this work was to evaluate an opportunity of application of basophile activation test with A. fumigatus allergen in vitro using flow cytometry, aiming for identification of fungal sensitization in the CF patients. The study included 190 patients with CF aged 1 to 37 years. All the patients underwent common allergy screening (skin tests with fungal allergens, determination of serum levels of total IgE and specific IgE for the fungal allergens), and mycological examination (microscopy and culture of respiratory substrates). Computed tomography of the chest was performed upon clinical indications. The basophil activation test with the A. fumigatus allergen was performed in 10 CF patients with ABPA, and 10 CF patients without ABPA, in addition to the standard allergological examination. Frequency of sensitization to A. fumigatus in the patients with cystic fibrosis was 27%, the incidence of allergic bronchopulmonary aspergillosis was 5.7%. The number of eosinophils, total IgE and specific IgE levels in CF patients with ABPA were significantly higher than in CF patients without ABPA. In blood of the ABPA patients we have identified 68.5 (52.5-81.5%) of basophilic leukocytes activated by A. fumigatus allergen, with a stimulation index of 17.07 (10.30-27.70). In appropriate comparison group, the stimulation index did not exceed 1.5 (p = 0.000). Direct positive correlation between the levels of specific IgE to A. fumigatus and the number of basophils activated by A. fumigatus allergens was revealed (r = 0.77; р < 0.05). FVC values and the body mass index in CF patients with ABPA were significantly lower when compared with the patients without fungal sensitization. Introduction of the basophil activation test, along with standard techniques, may enable a more differentiated assessment of ABPA development in CF patients. Timely detection of associations between A. fumigatus sensitization and clinical status of CF patients will facilitate early and effective administration of specific therapy.

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Changes in outdoor air pollution due to COVID-19 lockdowns differ by pollutant: evidence from Scotland

Occupational and Environmental Medicine ◽

10.1136/oemed-2020-106659 ◽

2020 ◽

Vol 77 (11) ◽

pp. 798-800 ◽

Cited By ~ 2

Author(s):

Ruaraidh Dobson ◽

Sean Semple

Keyword(s):

Air Pollution ◽

Motor Vehicle ◽

Fine Particulate Matter ◽

Personal Exposure ◽

Indoor Environments ◽

Similar Data ◽

Outdoor Air ◽

Fine Particulate ◽

Hourly Data ◽

The Impact

ObjectivesTo examine the impact of COVID-19 lockdown restrictions in March/April 2020 on concentrations of nitrogen dioxide (NO2) and ambient fine particulate matter (PM2.5) air pollution measured at roadside monitors across Scotland by comparing data with previous years.MethodsPublicly available data of PM2.5 concentrations from reference monitoring systems at sites across Scotland were extracted for the 31-day period immediately following the imposition of lockdown rules on 23 March 2020. Similar data for 2017, 2018 and 2019 were gathered for comparison. Mean period values were calculated from the hourly data and logged values compared using pairwise t-tests. Weather effects were corrected using meteorological normalisation.ResultsNO2 concentrations were significantly lower in the 2020 lockdown period than in the previous 3 years (p<0.001). Mean outdoor PM2.5 concentrations in 2020 were much lower than during the same period in 2019 (p<0.001). However, despite UK motor vehicle journeys reducing by 65%, concentrations in 2020 were within 1 µg/m3 of those measured in 2017 (p=0.66) and 2018 (p<0.001), suggesting that traffic-related emissions may not explain variability of PM2.5 in outdoor air in Scotland.ConclusionsThe impact of reductions in motor vehicle journeys during COVID-19 lockdown restrictions may not have reduced ambient PM2.5 concentrations in some countries. There is also a need for work to better understand how movement restrictions may have impacted personal exposure to air pollutants generated within indoor environments.

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