Isolation of filamentous fungi from sputum in asthma is associated with reduced post-bronchodilator FEV1.
Isolation of filamentous fungi from sputum in asthma is associated with reduced post-bronchodilator FEV1.
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DOI：
10.1111/j.1365-2222.2012.03987.x
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发表时间：
2012-05
期刊：
影响因子：
--
通讯作者：
Pashley CH
中科院分区：
文献类型：
--
作者：
Agbetile J;Fairs A;Desai D;Hargadon B;Bourne M;Mutalithas K;Edwards R;Morley JP;Monteiro WR;Kulkarni NS;Green RH;Pavord ID;Bradding P;Brightling CE;Wardlaw AJ;Pashley CH
真菌致敏在严重哮喘中很常见，但其临床相关性以及与真菌气道定植的关系尚不清楚。在哮喘中可能定植在气道中的真菌的范围是未知的。目的全面分析哮喘患者痰液中丝状真菌的分布情况，并探讨其与临床免疫学特征的关系。我们招募了126名被诊断为哮喘的受试者，其中94%患有中度至重度疾病，18名健康志愿者。在单次稳定访视时，受试者接受肺功能测定;痰真菌培养和痰细胞分类计数;常见空气过敏原和扩展真菌组的皮肤点刺试验;烟曲霉特异性IgE。通过形态学鉴定真菌，并通过测序确认物种身份。4例患者有过敏性支气管肺曲霉病。48%的哮喘受试者对一种真菌过敏原过敏，22%对≥ 2种真菌过敏原过敏。27个不同的分类群的丝状真菌分离出54%的菌丝，超过一个物种被检测到17%。这与培养任何真菌的3个（17%）健康对照相比（P < 0.01）。曲霉属最常单独培养，其次是青霉属。哮喘患者支气管扩张剂治疗后FEV 1（%预测值）真菌培养阳性者为71（± 25），真菌培养阴性者为83（± 25），差异有显著性（P < 0.01）。除A.可以从中度至重度哮喘患者的痰中培养出烟曲霉菌;阳性培养与使用支气管扩张剂后FEV 1受损有关，这可能是哮喘中固定气流阻塞发生的部分原因。对这些真菌的致敏也很常见。
Fungal sensitization is common in severe asthma, but the clinical relevance of this and the relationship with airway colonization by fungi remain unclear. The range of fungi that may colonize the airways in asthma is unknown. To provide a comprehensive analysis on the range of filamentous fungi isolated in sputum from people with asthma and report the relationship with their clinico-immunological features of their disease. We recruited 126 subjects with a diagnosis of asthma, 94% with moderate-severe disease, and 18 healthy volunteers. At a single stable visit, subjects underwent spirometry; sputum fungal culture and a sputum cell differential count; skin prick testing to both common aeroallergens and an extended fungal panel; specific IgE to Aspergillus fumigatus. Fungi were identified by morphology and species identity was confirmed by sequencing. Four patients had allergic bronchopulmonary aspergillosis. Forty-eight percent of asthma subjects were IgE-sensitized to one fungal allergen and 22% to ≥ 2. Twenty-seven different taxa of filamentous fungi were isolated from 54% of their sputa, more than one species being detected in 17%. This compared with 3 (17%) healthy controls culturing any fungus (P < 0.01). Aspergillus species were most frequently cultured in isolation followed by Penicillium species. Post-bronchodilator FEV1 (% predicted) in the subjects with asthma was 71(± 25) in those with a positive fungal culture vs. 83 (± 25) in those culture-negative, (P < 0.01). Numerous thermotolerant fungi other than A. fumigatus can be cultured from sputum of people with moderate-to-severe asthma; a positive culture is associated with an impaired post-bronchodilator FEV1, which might be partly responsible for the development of fixed airflow obstruction in asthma. Sensitization to these fungi is also common.
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影响因子：
14.2
作者：
Green, BJ;Sercombe, JK;Tovey, ER
通讯作者：
Tovey, ER
影响因子：
168.9
作者：
Brightling, CE;Monteiro, W;Pavord, ID
通讯作者：
Pavord, ID
DOI：
10.1164/rccm.200805-737oc
发表时间：
2009-01-01
影响因子：
24.7
作者：
Denning, David W.;O'Driscoll, B. Ronan;Niven, Robert M.
通讯作者：
Niven, Robert M.
DOI：
10.1164/rccm.201001-0087oc
发表时间：
2010-12-01
影响因子：
24.7
作者：
Fairs, Abbie;Agbetile, Joshua;Pashley, Catherine H.
通讯作者：
Pashley, Catherine H.
影响因子：
10
作者：
MALO, JL;HAWKINS, R;PEPYS, J
通讯作者：
PEPYS, J