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Published on: September 22, 2023
Clinical Distinctness of Allergic Rhinitis in Patients with Allergy to Molds
Krzysztof Kołodziejczyk1, Andrzej Bozek2
1Allergy Outpatient Clinic ZWPS, Lompy 16, 40 038 Katowice, Poland.
Abstract:
Introduction. Molds are a very diverse group of allergens. Exposure and sensitization to fungal allergens can promote the development and worsening of allergic rhinitis (AR). Objective. The natural course of allergic rhinitis was compared between a group of patients with allergy to molds and patients with AR to other allergens as the control groups. Material and Methods. The study group consisted of 229 patients, with a mean age of 27.4 ± 6.5 yrs. The study group was compared to groups of AR patients with allergy to house dust mites or pollens or with multivalent allergy. Allergic sensitization was assessed using the skin prick test (SPT) with a panel of 15 allergens to molds and other common inhalant allergens. Specific IgEs against all tested allergens were measured. Nasal fractional exhaled nitric oxide (FeNO) level was assessed with a chemiluminescence analyzer (NIOX MINO) and compared between groups. Cluster analysis was performed for determine models of AR in whole population. Results. Patients with allergy to mold have had AR with a higher blockage of nose than in the patients with other allergies. Alternaria alternata (59% of examined), Cladosporium herbarum (40%), and Aspergillus fumigatus (36%) were the predominant allergens in the study group. Patients with allergy to mold were more often present in two clusters: there were patients with more frequent accompanying asthma and high level of FeNO. Conclusion. Patients with allergy to molds have a significantly greater predisposition for bronchial asthma and high concentration of FeNO.
Insights
Allergy to molds, common in allergic rhinitis (AR), is linked to more severe nasal blockage and a higher risk of developing asthma. Mold-allergic patients also show elevated levels of fractional exhaled nitric oxide (FeNO).
Area of Science:
- Allergology
- Immunology
- Respiratory Medicine
Background:
- Molds are diverse allergens contributing to allergic rhinitis (AR) development and exacerbation.
- Understanding the specific impact of mold allergy on AR natural course is crucial for targeted management.
Purpose of the Study:
- To compare the clinical course of allergic rhinitis in patients with mold allergy versus those allergic to other allergens.
- To identify distinct AR phenotypes associated with mold sensitization.
Main Methods:
- A cohort of 229 AR patients was studied, comparing mold-allergic individuals with controls (house dust mites, pollens, multivalent allergies).
- Allergic sensitization was confirmed via skin prick tests and specific IgE measurements.
- Nasal fractional exhaled nitric oxide (FeNO) levels were measured, and cluster analysis was employed to identify AR patterns.
Main Results:
- Mold-allergic patients reported significantly higher nasal blockage compared to other AR groups.
- Alternaria alternata, Cladosporium herbarum, and Aspergillus fumigatus were the predominant mold allergens.
- Cluster analysis revealed two distinct AR phenotypes, with mold-allergic patients frequently associated with co-existing asthma and elevated FeNO levels.
Conclusions:
- Patients with mold allergy exhibit a greater predisposition to developing bronchial asthma.
- High concentrations of nasal fractional exhaled nitric oxide (FeNO) are characteristic of mold-allergic AR patients, particularly those with co-existing asthma.
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