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Fungal allergen sensitization: Prevalence, risk factors, and geographic variation in the United States

Kenny Kwong1, Matthew Robinson2, Adam Sullivan2

  • 1Department of Pediatrics, Division of Allergy-Immunology, Los Angeles County and University of Southern California Medical Center, Los Angeles, Calif.

The Journal of Allergy and Clinical Immunology
|September 23, 2023
PubMed
Abstract

Insights

This study found that 22% of patients had fungal sensitization, with common allergens including Candida albicans and Alternaria alternata. Risk factors like male sex, teen age, asthma, and atopic dermatitis were identified.

Area of Science:

  • Allergy and Immunology
  • Environmental Health
  • Epidemiology

Background:

  • Fungal species are linked to allergic disease pathogenesis.
  • Previous studies have focused on limited fungal species for IgE-mediated sensitization.
  • This research addresses the gap by examining a broader range of fungi.

Purpose of the Study:

  • To determine the prevalence of fungal allergen sensitization in the United States.
  • To identify risk factors associated with fungal sensitization.
  • To analyze geographic variations in fungal sensitization patterns.

Main Methods:

  • Analysis of 7,912,504 serum-specific IgE (sIgE) test results from 1,651,203 patients (aged 0-85) across the US (2014-2019).
  • Evaluation of 17 fungal species for sensitization.
  • Statistical analysis of prevalence, patterns, and correlations with demographics, diagnoses, and geography.

Main Results:

  • Twenty-two percent of patients showed sensitization to at least one fungal allergen; 13.7% to more than two.
  • Highest sensitization rates were observed for Candida albicans (18.6%), Alternaria alternata (16.6%), Stemphylium herbarum (14.9%), and Aspergillus fumigatus (14.2%).
  • Independent risk factors included male sex, teenage years, atopic dermatitis, asthma, and urban/grassland ecoregions.

Conclusions:

  • Fungal sensitization is prevalent, affecting over one-fifth of the studied population.
  • Key risk factors for sensitization include demographic and clinical characteristics.
  • Geographic location, particularly urban and grassland areas, influences fungal sensitization risk.
Keywords:
Allergenallergic sensitizationallergyasthmaatopic dermatitisfungigeographicmoldserum IgE

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