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Fungal sensitization in childhood persistent asthma is associated with disease severity

Alfin G Vicencio1, Maria Teresa Santiago, Kalliope Tsirilakis

  • 1Department of Pediatrics, Cohen Children's Medical Center, New Hyde Park, New York.

Pediatric Pulmonology
|February 13, 2013
PubMed
Abstract

Insights

Fungal sensitization is linked to severe asthma in children. Nearly 60% of severe pediatric asthma cases showed fungal sensitization, suggesting potential benefits from anti-fungal treatments.

Area of Science:

  • Pediatric Allergy and Immunology
  • Respiratory Medicine
  • Clinical Microbiology

Background:

  • Emerging evidence links asthma severity to fungal sensitization, particularly in adults.
  • Previous studies indicate potential benefits of anti-fungal therapy for severe asthma patients with fungal sensitization.
  • The prevalence of fungal sensitization in children with severe asthma remains poorly understood.

Purpose of the Study:

  • To determine the prevalence of fungal sensitization in children with moderate to severe persistent asthma.
  • To compare clinical characteristics, including asthma severity, serum immunoglobulin E (IgE) levels, and pulmonary function, between fungal-sensitized and non-sensitized children.
  • To investigate the association between fungal sensitization and asthma severity in pediatric patients.

Main Methods:

  • Enrollment of 64 children with moderate to severe persistent asthma.
  • Assessment of fungal sensitization through specific diagnostic tests.
  • Comparison of clinical parameters: asthma severity, serum IgE, and pulmonary function tests (FEV1, FVC, FEF25-75%).
  • Analysis of bronchial biopsy findings in sensitized children.

Main Results:

  • Fungal sensitization was identified in 39% (25 of 64) of the children.
  • Children with fungal sensitization had a significantly higher likelihood of severe persistent asthma (OR = 6.33, P = 0.0014).
  • Severe persistent asthmatics showed a higher prevalence of fungal sensitization (59%).
  • Fungal-sensitized children exhibited elevated serum IgE levels (P < 0.001) and impaired pulmonary function (P = 0.016 to 0.0004).
  • Bronchial biopsies revealed basement membrane thickening and eosinophil infiltration in sensitized children.

Conclusions:

  • Fungal sensitization is significantly associated with increased asthma severity in children.
  • A substantial proportion of children with severe persistent asthma exhibit fungal sensitization.
  • These findings suggest that children with persistent asthma and fungal sensitization may be candidates for targeted anti-fungal therapies.
Keywords:
allergyeosinophilfungi

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