Analysis of Clinical and Immunological Characteristics of Fungal Allergic Asthma

Analysis of Clinical and Immunological Characteristics of Fungal Allergic Asthma

Allergy and Airway SESSION TITLE: Asthma and Allergy SESSION TYPE: Original Investigation Slide PRESENTED ON: Sunday, April 17, 2016 at 02:15 PM - 03:...

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Allergy and Airway SESSION TITLE: Asthma and Allergy SESSION TYPE: Original Investigation Slide PRESENTED ON: Sunday, April 17, 2016 at 02:15 PM - 03:45 PM

Analysis of Clinical and Immunological Characteristics of Fungal Allergic Asthma Shiquan Wu* Nili Wei Wenting Luo Huimin Huang Xi Chen Baoqing Sun; and Qingling Zhang State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China PURPOSE: The aim of this study is to investigate the clinical and immunological characteristics of the fungus- allergic asthma. We make a evaluation for each patient and seek to further treatment METHODS: A total of 68 inpatients with asthma were selected from 2014 to 2015 and were divided into 2 groups [fungus-allergic asthma group (n¼41) and non-fungus-allergic asthma group (n¼27)] based on the results of enzyme-linked immunosorbent assay (ELISA). We retrospectively analyze the clinical data, including general information, laboratory tests and fungus-specific (Cladosporium, Aspergillus, Alternaria) IgE (sIgE). RESULTS: In the FA group, most of the cases are eosinophilic asthma (48.8%) while in the NFA group, the major phenotype are neutrophilic, eosinophilic and mixed granulocytic asthma (25.9%, 29.6% and 29.6% respectively). There is no evident difference in FeNO between two groups (3425.5 vs. 46.430.3, P¼0.116). The FVC pred% of the FA group is lower compared to the NFA group (81.524.7 vs. 89.6914.53, P<0.05). The FEV1pred% and FEV1/FVC in FA group are not significantly lower than that in NFA group (59.724.9 vs. 68.5323.32, P¼0.65; 57.115.2 vs. 58.4618.05, P¼0.656). The patients with fungus allergic tend to need more daily ICS than those in the NFA group (516238 vs. 320250, P<0.01). The level of total IgE in the FA group is higher than the other group (16321423 vs.249125, P<0.01). Almost all 41patients with fungus-allergic are aspergillusrelated-specific-IgE positive, while 46.3% are Cladosporium-related-specific-IgE positive and 48.8% are alternaria-related-specificIgE positive.

CLINICAL IMPLICATIONS: We aim to provide a good theoretical basis for the clinical judgment of the control of patients with fungus allergic asthma and make clinicians pay more attention to the fungal sensitization in patients with asthma. DISCLOSURE: The following authors have nothing to disclose: Shiquan Wu, Nili Wei, Wenting Luo, Huimin Huang, Xi Chen, Baoqing Sun, Qingling Zhang No Product/Research Disclosure Information DOI:

http://dx.doi.org/10.1016/j.chest.2016.02.005

Copyright ª 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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ALLERGY AND AIRWAY

CONCLUSIONS: Aspergillus may be the most common fungus causing sensitization in asthmatic patients. The clinical characteristics of fungus-allergic group are different from that of the other group. The patients with eosinophilic asthma are more likely to be caused sensitization. The fungus allergic patients require higher ICS dose to control their symptoms and inflammation.