[Increased sensitivity to Candida in patients with bronchial asthma]

Area of Science:

• Medical Mycology
• Pediatric Pulmonology
• Immunology

Background:

• Bronchial asthma in children is a significant respiratory condition.
• The role of fungal infections, specifically Candida, in pediatric asthma is not fully understood.
• Environmental factors, such as proximity to microbiological factories, may influence allergic sensitization.

Purpose of the Study:

• To investigate the prevalence and type of Candida hypersensitivity in children with bronchial asthma.
• To explore the association between allergic candidiasis and asthma severity/characteristics.
• To evaluate the clinical response to antimycotic treatment in asthmatic children with allergic candidiasis.

Main Methods:

• Mycological, immunological, and allergological examinations were performed on 86 children (aged 3-14) with bronchial asthma.
• Allergy testing included prick tests, basophil degranulation tests (direct Shelley's test), and leukocyte migration inhibition tests with Candida antigen.
• Patients were categorized based on proximity to a microbiological factory and verified candidiasis.

Main Results:

• Hypersensitivity to Candida was detected in 83.3% of children with asthma, particularly those near a microbiological factory.
• In children with confirmed candidiasis, 83.3% showed Candida hypersensitivity, predominantly of the immediate type (47%).
• Allergic candidiasis was diagnosed in 20% of the control group. Asthmatic children with allergic candidiasis often had refractory obstructive bronchitis responsive to antimycotic drugs.

Conclusions:

• A high prevalence of Candida hypersensitivity exists in children with bronchial asthma.
• Both immediate and delayed type hypersensitivity to Candida can be associated with pediatric asthma.
• Allergic candidiasis may contribute to persistent obstructive bronchitis in asthmatic children, suggesting a role for antifungal therapy.