Children failing asthma therapy may have severe asthma with fungal sensitization

May 22, 2012

New research presented at the ATS 2012 International Conference in San Francisco suggests that a significant proportion of children with asthma failing Step 4 or greater therapy may have severe asthma with fungal sensitization (SAFS).

"SAFS is a newly described sub-phenotype of asthma, and its prevalence and clinical characteristics in are unknown," said Alfin Vicencio, MD, chief of pediatric pulmonology and at the Cohen Children's Medical Center in Great Neck, NY, and David Goldman, associate professor of pediatric infectious diseases at the Children's Hospital at Montefiore, Bronx, NY.

"Accordingly, we prospectively analyzed serum immunoglobulin E (IgE) levels and fungal sensitization patterns in 41 children failing combination . Of these 41 patients, 17 (41.5%) were diagnosed with SAFS."

Compared with those without SAFS, children with SAFS were older, had higher serum IgE levels, and performed worse on . These differences remained significant when children with SAFS were compared to a subset of children without SAFS who were sensitized to non-fungal .

The most commonly implicated organisms were Aspergillus spp (81.2%) and Alternaria spp (68.8%), but numerous other species were represented. More than 65% of children with SAFS exhibited sensitization to more than one . Airway remodeling and persistent eosinophilia may also be associated with SAFS, although the researchers note that additional studies are required to more clearly characterize these features of the disease.

"Our results suggest that SAFS may account for a significant proportion of severe asthma in our pediatric population," said Dr. Vicencio. "At this point, however, there are still many unanswered questions, including the role of anti-fungal therapy."

"We are actively pursuing new methods to identify fungal organisms in the lower airway, which would enable us to better define treatment protocols," Dr. Vicencio concluded. "In addition, we are hoping to identify genetic risk factors for disease, which could potentially lead to targeted preventive strategies early in life."

Explore further: AAAAI: Prevalence of asthma, hay fever lower among Amish

More information: "Severe Asthma With Fungal Sensitization In Children: Characterization Of A New Pediatric Asthma Sub-Phenotype" (Session C27, Tuesday, May 22, 2012: Room 2010-2012, Moscone Center; Abstract 28785)

Related Stories

AAAAI: Prevalence of asthma, hay fever lower among Amish

March 6, 2012
(HealthDay) -- The prevalence of asthma, hay fever, and allergic sensitization is significantly lower among the Amish population than among Swiss children, according to a study presented at the annual meeting of the American ...

Cockroach allergens in homes associated with prevalence of childhood asthma in some neighborhoods

May 17, 2011
In New York City, the prevalence of asthma among children entering school varies by neighborhood anywhere from 3% to 19%, and children growing up within walking distance of each other can have 2-3 fold differences in risk ...

Vitamin D deficiency linked with airway changes in children with severe asthma

September 22, 2011
Children with severe therapy-resistant asthma (STRA) may have poorer lung function and worse symptoms compared to children with moderate asthma, due to lower levels of vitamin D in their blood, according to researchers in ...

Recommended for you

Genetic immune deficiency could hold key to severe childhood infections

July 18, 2017
A gene mutation making young children extremely vulnerable to common viruses may represent a new type of immunodeficiency, according to a University of Queensland researcher.

What are the best ways to diagnose and manage asthma?

July 18, 2017
What are the best ways to diagnose and manage asthma in adults? This can be tricky because asthma can stem from several causes and treatment often depends on what is triggering the asthma.

Study finds molecular explanation for struggles of obese asthmatics

July 17, 2017
A large, bouquet-shaped molecule called surfactant protein A, or SP-A, may explain why obese asthma patients have harder-to-treat symptoms than their lean and overweight counterparts, according to a new study led by scientists ...

Large multi-ethnic study identifies many new genetic markers for lupus

July 17, 2017
Scientists from an international consortium have identified a large number of new genetic markers that predispose individuals to lupus.

Team identifies potential cause for lupus

July 14, 2017
Leading rheumatologist and Feinstein Institute for Medical Research Professor Betty Diamond, MD, may have identified a protein as a cause for the adverse reaction of the immune system in patients suffering from lupus. A better ...

Immunosuppression underlies resistance to anti-angiogenic therapy

July 14, 2017
A Massachusetts General Hospital (MGH) research team has identified a novel mechanism behind resistance to angiogenesis inhibitors - drugs that fight cancer by suppressing the formation of new blood vessels. In their report ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.