Author contributions: Alfin G. Vicencio: Conception and design of project, patient recruitment, data acquisition and analysis, drafting of manuscript. Anne Stone: Patient recruitment and data acquisition (directed project at satellite site), manuscript revisions and approval. Stefan Worgall: Patient recruitment, data acquisition, and data analysis/interpretation. Maria Teresa Santiago: Patient recruitment, data acquisition, manuscript revisions, and approval. Kalliope Tsirilakis: Patient recruitment, data acquisition, manuscript revisions, and approval. Elizabeth A. Foley: Data acquisition and analysis, manuscript revisions, and approval. Douglas Bush: Data acquisition and analysis, manuscript revisions, and approval. David L. Goldman: Conception and design of project, supervision and performance of data analysis, and editing/approval of final manuscript.
Fungal sensitization in childhood persistent asthma is associated with disease severity
Article first published online: 8 FEB 2013
© 2013 Wiley Periodicals, Inc.
Volume 49, Issue 1, pages 8–14, January 2014
How to Cite
Vicencio, A. G., Santiago, M. T., Tsirilakis, K., Stone, A., Worgall, S., Foley, E. A., Bush, D. and Goldman, D. L. (2014), Fungal sensitization in childhood persistent asthma is associated with disease severity. Pediatr. Pulmonol., 49: 8–14. doi: 10.1002/ppul.22779
Conflict of interest: None.
- Issue published online: 16 DEC 2013
- Article first published online: 8 FEB 2013
- Manuscript Accepted: 3 NOV 2012
- Manuscript Received: 28 AUG 2012
- none reported
Recent observations, especially in adults, suggest that asthma severity may be associated with fungal sensitization. Other studies suggest that some patients with severe asthma and fungal sensitization may benefit from anti-fungal therapy. Currently, the prevalence of fungal sensitization among children with severe asthma is not well characterized.
We determined prevalence of fungal sensitization among children with moderate to severe persistent asthma and compared clinical characteristics between sensitized and non-sensitized children, including asthma severity, serum immunoglobulin E, and pulmonary function.
Of the 64 children enrolled, 25 (39%) had evidence of sensitization to one or more fungi. Nineteen of 25 (76%) children with fungal sensitization were categorized as severe persistent compared to 13 of 39 (33%) children without evidence of fungal sensitization (odds ratio = 6.33, 95% confidence interval 2.04–19.68, P = 0.0014). Of 32 severe persistent asthmatics, 19 (59%) demonstrated evidence of fungal sensitization. Serum immunoglobulin E was significantly higher (P < 0.001), and pulmonary function (including FEV1, FEV1/FVC, and FEF25–75%) significantly lower in the fungal-sensitized patients (P = 0.016, 0.0004, and 0.002, respectively). Bronchial biopsy of sensitized children revealed basement membrane thickening and eosinophil infiltration.
Fungal sensitization in children with persistent asthma is associated with disease severity. Almost 60% of our severe persistent asthma patients had evidence of fungal sensitization and, based on our previous studies, may be potential candidates for anti-fungal therapy. Pediatr Pulmonol. 2014; 49:8–14. © 2013 Wiley Periodicals, Inc.