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Association of molds and metrological parameters to frequency of severe asthma exacerbation
Mona Al-Ahmad1,2, Edin Jusufovic3, Nermina Arifhodzic2
11Microbiology Department, Faculty of Medicine, Kuwait University, P.O. Box 24923, 13110 Safat, Kuwait.
Background:
Sensitization to airborne molds may be a risk factor for severe asthma and direct cause of asthma exacerbation (AE).
Methods:
A prospective, 1-year (April 2016-March 2017) study, done in Kuwait Allergy Centre, investigated the link between AEs with exposure to outdoor molds and the role of meteorological parameters in mold sensitized patients and compared with non-allergic asthma patients who had asthma deterioration. The total of 676 adult asthmatics with moderate-severe AEs were included and divided into atopic (85.65%) and non-atopic group. Atopy was defined by positive skin prick test (SPT) to at least one inhalant allergen. Data regarding atopy and asthma severity were collected from patient's records. Patients with symptoms and signs of acute respiratory infection and patient sensitized to indoor allergens only were excluded. Daily count of local pollens (Salsola kali, Bermuda grass) and molds (Aspergillus, Alternaria and Cladosporium) were obtained from the Aerobiology department. Daily metrological parameters (atmospheric pressure-AP, temperature-T and relative humidity-RH) were provided by Kuwait Environment Public Authority. Count of spores/m3 and weather variable are shown on weekly basis. The year circle was divided into 4 Seasons (1, 2, 3, 4) accordingly to typical desert climate.
Results:
Sensitization to molds was relatively high but significantly less (25.0%) if compared to the pollens sensitization. The highest number of AEs was in season 4 for both molds and pollens sensitized patients. Seasonal patterns for both allergens were significant and positively correlated with RH and AP. In season 1 only, mold sensitized patients showed higher rate of AEs. Non-atopic patients have been less sensitive to increased RH than atopic. Negative correlation with T was similar in both atopic and non-atopic patients.
Conclusion:
Despite of high rate of sensitization to molds, their significant role in triggering AE was not found in desert environment. Typical desert climate and high allergencity of local weeds outweigh the influence of the molds.
Insights
Mold sensitization is common, but this study found no significant link to asthma exacerbations in a desert environment. Local weed pollens, not molds, were more influential in triggering asthma symptoms.
Area of Science:
- Environmental Allergology
- Pulmonary Medicine
- Aerobiology
Background:
- Airborne mold sensitization is a potential risk factor for severe asthma and can trigger asthma exacerbations (AE).
- Understanding the role of environmental allergens and meteorological factors in asthma is crucial for patient management.
Purpose of the Study:
- To investigate the association between outdoor mold exposure and asthma exacerbations in mold-sensitized patients within a desert climate.
- To compare the impact of mold exposure on allergic versus non-allergic asthma patients.
- To assess the influence of meteorological parameters on asthma exacerbations related to mold sensitization.
Main Methods:
- A prospective, 1-year study in Kuwait involving 676 adult asthmatics with moderate-severe AEs.
- Patients were categorized into atopic and non-atopic groups based on skin prick tests.
- Daily counts of local pollens and molds, along with meteorological data (atmospheric pressure, temperature, relative humidity), were collected and analyzed weekly across four seasons.
Main Results:
- Mold sensitization was observed in 25.0% of patients, less than pollen sensitization.
- The highest number of AEs occurred in season 4 for both mold and pollen-sensitized patients, with seasonal patterns correlating positively with relative humidity and atmospheric pressure.
- While mold-sensitized patients had more AEs in season 1, non-atopic patients showed less sensitivity to increased relative humidity compared to atopic patients.
Conclusions:
- Despite high mold sensitization rates, molds did not play a significant role in triggering asthma exacerbations in this desert environment.
- The study suggests that the unique desert climate and the high allergenicity of local weeds may overshadow the impact of molds on asthma exacerbations.
- Further research may be needed to fully elucidate the complex interplay between environmental allergens, climate, and asthma in arid regions.
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