Related Experiment Video
Updated: Dec 23, 2025
Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis
Published on: March 9, 2018
Environmental fungal sensitisation associates with poorer clinical outcomes in COPD
Pei Yee Tiew1,2, Fanny Wai San Ko3, Sze Lei Pang4
1Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
Introduction:
Allergic sensitisation to fungi such as Aspergillus are associated to poor clinical outcomes in asthma, bronchiectasis and cystic fibrosis; however, clinical relevance in COPD remains unclear.
Methods:
Patients with stable COPD (n=446) and nondiseased controls (n=51) were prospectively recruited across three countries (Singapore, Malaysia and Hong Kong) and screened against a comprehensive allergen panel including house dust mites, pollens, cockroach and fungi. For the first time, using a metagenomics approach, we assessed outdoor and indoor environmental allergen exposure in COPD. We identified key fungi in outdoor air and developed specific-IgE assays against the top culturable fungi, linking sensitisation responses to COPD outcomes. Indoor air and surface allergens were prospectively evaluated by metagenomics in the homes of 11 COPD patients and linked to clinical outcome.
Results:
High frequencies of sensitisation to a broad range of allergens occur in COPD. Fungal sensitisation associates with frequent exacerbations, and unsupervised clustering reveals a "highly sensitised fungal predominant" subgroup demonstrating significant symptomatology, frequent exacerbations and poor lung function. Outdoor and indoor environments serve as important reservoirs of fungal allergen exposure in COPD and promote a sensitisation response to outdoor air fungi. Indoor (home) environments with high fungal allergens associate with greater COPD symptoms and poorer lung function, illustrating the importance of environmental exposures on clinical outcomes in COPD.
Conclusion:
Fungal sensitisation is prevalent in COPD and associates with frequent exacerbations representing a potential treatable trait. Outdoor and indoor (home) environments represent a key source of fungal allergen exposure, amenable to intervention, in "sensitised" COPD.
Insights
Fungal sensitisation is common in chronic obstructive pulmonary disease (COPD) and linked to worse symptoms and frequent exacerbations. Environmental fungal exposure, both indoors and outdoors, is a key factor in COPD patients.
Area of Science:
- Respiratory Medicine
- Environmental Health
- Allergy and Immunology
Background:
- Allergic sensitization to fungi is linked to poor outcomes in asthma, bronchiectasis, and cystic fibrosis.
- The clinical relevance of fungal sensitization in chronic obstructive pulmonary disease (COPD) has been unclear.
Purpose of the Study:
- To investigate the prevalence and clinical relevance of fungal sensitization in patients with COPD.
- To assess the role of outdoor and indoor environmental fungal exposure in COPD outcomes.
Main Methods:
- A prospective study of 446 stable COPD patients and 51 controls across three Asian countries.
- Screening against a comprehensive allergen panel, including fungi, using metagenomics for environmental exposure assessment.
- Development of specific-IgE assays against key fungi and linking sensitization to clinical outcomes.
Main Results:
- High frequencies of sensitization to various allergens, including fungi, were observed in COPD patients.
- Fungal sensitization was associated with frequent exacerbations and identified a distinct subgroup with severe symptoms and poor lung function.
- Both outdoor and indoor (home) fungal allergen exposure were linked to increased COPD symptoms and poorer lung function.
Conclusions:
- Fungal sensitization is prevalent in COPD and represents a potential treatable trait associated with frequent exacerbations.
- Outdoor and indoor environments are significant sources of fungal allergen exposure in COPD patients.
- Environmental fungal exposure is amenable to intervention and impacts clinical outcomes in sensitized COPD patients.
More Related Videos
03:53Growing a Cystic Fibrosis-Relevant Polymicrobial Biofilm to Probe Community Phenotypes
Published on: April 19, 2024
15:01Confocal Laser Scanning Microscopy-Based Quantitative Analysis of Aspergillus fumigatus Conidia Distribution in Whole-Mount Optically Cleared Mouse Lung
Published on: September 18, 2021
Related Concept Videos
01:20COPD: Pathogenesis and Clinical Features
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
01:20Chronic Obstructive Pulmonary Disease-I: Introduction
01:22Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
01:25Chronic Obstructive Pulmonary Disease-III: Symptoms and Complications.
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:
01:20Chronic Obstructive Pulmonary Disease-II: Pathophysiology
Chronic Inflammation
01:26COPD: Management Using Bronchodilators and Corticosteroids