Aspergillus fumigatus Sensitization Is Associated With High-Risk Bronchiectasis
Pei Yee Tiew1, Jayanth Kumar Narayana2, Tavleen Kaur Jaggi2
1Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore.
Chest
|December 12, 2025
Summary
Fungal sensitization, especially to Aspergillus fumigatus, is linked to worse bronchiectasis outcomes, particularly in low-risk patients and those of Asian descent. This finding highlights a potentially treatable factor in managing bronchiectasis severity.
Area of Science:
- Pulmonary Medicine
- Allergy and Immunology
- Respiratory Diseases
Background:
- Fungal sensitization is an emerging factor in chronic respiratory conditions.
- Its specific role and clinical impact in bronchiectasis are not well understood.
- This study offers a detailed evaluation of fungal sensitization in bronchiectasis.
Purpose of the Study:
- To determine the prevalence of fungal sensitization in bronchiectasis patients.
- To investigate the clinical implications of fungal sensitization.
- To assess the relationship between fungal sensitization and disease severity, exacerbations, and comorbidities.
Main Methods:
- An international, multi-center study involving 277 bronchiectasis patients.
- Utilized an expanded panel of 35 fungal allergens (11 crude, 24 recombinant).
- Assessed sensitization against clinical characteristics, exacerbation frequency, and geographic origin.
Main Results:
- Sensitization to recombinant Aspergillus fumigatus (rAsp f) allergens 12, 15, and 17 correlated with bronchiectasis severity.
- This association was most pronounced in low-risk patients, showing increased disease severity and bronchiectasis-COPD overlap.
- Asian patients sensitized to these rAsp f allergens exhibited poorer lung function and more severe disease.
Conclusions:
- Aspergillus fumigatus sensitization, particularly to specific recombinant allergens, is clinically significant in bronchiectasis.
- This sensitization is a potentially treatable trait, especially relevant for patients with fewer baseline exacerbations and of Asian descent.
- Further research into targeted antifungal therapies may benefit this patient subgroup.
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