Pulmonary Emphysema is Associated with Fungal Sensitization in Asthma

Overview

Journal J Thorac Dis

Publisher AME Publishing Company

Specialty Pulmonary Medicine

Date 2020 Nov 19

PMID 33209420

Authors

Yuta Kono

Masako To

Ryuta Tsuzuki

Satoshi Yamawaki

Seiko Soeda

Yasuo To

Affiliations

Soon will be listed here.

Abstract

Background: Fungal sensitization is a risk factor for severe asthma. Colonization in the lower respiratory tract is one of the forms of fungal exposure, and it is related to fungal sensitization. Pulmonary emphysema was recently reported to be an underlying disease of fungal colonization. The aim of study was to evaluate the prevalence of pulmonary emphysema in asthmatic patients with and without fungal sensitization.

Methods: We enrolled 108 patients with allergic asthma and divided them into the patients sensitized to Aspergillus and/or Candida (n=56) and those not sensitized to both Aspergillus and Candida (n=52). The presence of pulmonary emphysema on chest CT was evaluated retrospectively.

Results: The frequency of pulmonary emphysema was significantly higher in the patients sensitized to Aspergillus and/or Candida compared to the patients not sensitized to both fungi (P=0.0040). The frequency of pulmonary emphysema was also significantly higher in the patients sensitized to either Aspergillus or Candida compared to the patient not sensitized to the fungi (P=0.0398 and P=0.0198, respectively). A multivariate logistic regression analysis demonstrated that the presence of pulmonary emphysema was independently associated with the sensitization to Aspergillus and/or Candida (OR 7.84, 95% CI: 1.20-51.10).

Conclusions: Pulmonary emphysema is associated with sensitization to Aspergillus and/or Candida.

References

Maiz L, Nieto R, Canton R, Gomez G de la Pedrosa E, Martinez-Garcia M . Fungi in Bronchiectasis: A Concise Review. Int J Mol Sci. 2018; 19(1). PMC: 5796091. DOI: 10.3390/ijms19010142. View

Farrant J, Brice H, Fowler S, Niven R . Fungal sensitisation in severe asthma is associated with the identification of Aspergillus fumigatus in sputum. J Asthma. 2016; 53(7):732-5. DOI: 10.3109/02770903.2016.1154073. View

Takahashi S, Ishii M, Namkoong H, Hegab A, Asami T, Yagi K . Pneumococcal Infection Aggravates Elastase-Induced Emphysema via Matrix Metalloproteinase 12 Overexpression. J Infect Dis. 2015; 213(6):1018-30. DOI: 10.1093/infdis/jiv527. View

Monod M, Capoccia S, Lechenne B, Zaugg C, Holdom M, Jousson O . Secreted proteases from pathogenic fungi. Int J Med Microbiol. 2002; 292(5-6):405-19. DOI: 10.1078/1438-4221-00223. View

Fairs A, Agbetile J, Hargadon B, Bourne M, Monteiro W, Brightling C . IgE sensitization to Aspergillus fumigatus is associated with reduced lung function in asthma. Am J Respir Crit Care Med. 2010; 182(11):1362-8. PMC: 3029929. DOI: 10.1164/rccm.201001-0087OC. View

Pendleton K, Huffnagle G, Dickson R . The significance of Candida in the human respiratory tract: our evolving understanding. Pathog Dis. 2017; 75(3). PMC: 6433300. DOI: 10.1093/femspd/ftx029. View

Black P, Udy A, Brodie S . Sensitivity to fungal allergens is a risk factor for life-threatening asthma. Allergy. 2000; 55(5):501-4. DOI: 10.1034/j.1398-9995.2000.00293.x. View

Wang D, Wang Y, Liu Y . Experimental pulmonary infection and colonization of Haemophilus influenzae in emphysematous hamsters. Pulm Pharmacol Ther. 2010; 23(4):292-9. DOI: 10.1016/j.pupt.2010.02.006. View

Masaki K, Fukunaga K, Matsusaka M, Kabata H, Tanosaki T, Mochimaru T . Characteristics of severe asthma with fungal sensitization. Ann Allergy Asthma Immunol. 2017; 119(3):253-257. DOI: 10.1016/j.anai.2017.07.008. View

10.

Gago S, Denning D, Bowyer P . Pathophysiological aspects of Aspergillus colonization in disease. Med Mycol. 2018; 57(Supplement_2):S219-S227. DOI: 10.1093/mmy/myy076. View

11.

Chowdhary A, Agarwal K, Kathuria S, Gaur S, Randhawa H, Meis J . Allergic bronchopulmonary mycosis due to fungi other than Aspergillus: a global overview. Crit Rev Microbiol. 2013; 40(1):30-48. DOI: 10.3109/1040841X.2012.754401. View

12.

Maiz L, Cuevas M, Quirce S, Canon J, Pacheco A, Sousa A . Serologic IgE immune responses against Aspergillus fumigatus and Candida albicans in patients with cystic fibrosis. Chest. 2002; 121(3):782-8. DOI: 10.1378/chest.121.3.782. View

13.

Zureik M, Neukirch C, Leynaert B, Liard R, Bousquet J, Neukirch F . Sensitisation to airborne moulds and severity of asthma: cross sectional study from European Community respiratory health survey. BMJ. 2002; 325(7361):411-4. PMC: 119432. DOI: 10.1136/bmj.325.7361.411. View

14.

Trudzinski F, Seiler F, Wilkens H, Metz C, Kamp A, Bals R . Microbiological airway colonization in COPD patients with severe emphysema undergoing endoscopic lung volume reduction. Int J Chron Obstruct Pulmon Dis. 2018; 13:29-35. PMC: 5741074. DOI: 10.2147/COPD.S150705. View

15.

Chiang T, Tsao S, Yeh C, Yang S . Matrix metalloproteinases in pneumonia. Clin Chim Acta. 2014; 433:272-7. DOI: 10.1016/j.cca.2014.03.031. View

16.

Stevens D, Schwartz H, Lee J, Moskovitz B, Jerome D, Catanzaro A . A randomized trial of itraconazole in allergic bronchopulmonary aspergillosis. N Engl J Med. 2000; 342(11):756-62. DOI: 10.1056/NEJM200003163421102. View

17.

Kennedy J, Heymann P, Platts-Mills T . The role of allergy in severe asthma. Clin Exp Allergy. 2012; 42(5):659-69. PMC: 3335737. DOI: 10.1111/j.1365-2222.2011.03944.x. View

18.

Wark P, Hensley M, Saltos N, Boyle M, Toneguzzi R, Epid G . Anti-inflammatory effect of itraconazole in stable allergic bronchopulmonary aspergillosis: a randomized controlled trial. J Allergy Clin Immunol. 2003; 111(5):952-7. DOI: 10.1067/mai.2003.1388. View

19.

Baxter C, Moore C, Jones A, Webb A, Denning D . IgE-mediated immune responses and airway detection of Aspergillus and Candida in adult cystic fibrosis. Chest. 2012; 143(5):1351-1357. DOI: 10.1378/chest.12-1363. View

20.

Denning D, Riniotis K, Dobrashian R, Sambatakou H . Chronic cavitary and fibrosing pulmonary and pleural aspergillosis: case series, proposed nomenclature change, and review. Clin Infect Dis. 2003; 37 Suppl 3:S265-80. DOI: 10.1086/376526. View