Benefits of antifungal therapy in asthma patients with airway mycosis: A retrospective cohort analysis.
Benefits of antifungal therapy in asthma patients with airway mycosis: A retrospective cohort analysis.
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DOI：
10.1002/iid3.215
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发表时间：
2018-06
期刊：
影响因子：
--
通讯作者：
Corry DB
中科院分区：
文献类型：
--
作者：
Li E;Tsai CL;Maskatia ZK;Kakkar E;Porter P;Rossen RD;Perusich S;Knight JM;Kheradmand F;Corry DB
Fungal airway infection (airway mycosis) is increasingly recognized as a cause of asthma and related disorders. However, prior controlled studies of patients treated with antifungal antibiotics have produced conflicting results. Our objective is to measure the effect of antifungal therapy in moderate to severe adult asthmatics with positive fungal sputum cultures in a single center referral‐based academic practice. We retrospectively evaluated 41 patients with asthma and culture‐proven airway mycosis treated with either terbinafine, fluconazole, itraconazole, voriconazole, or posaconazole for 4 to >12 weeks together with standard bronchodilator and anti‐inflammatory agents. Asthma control (1 = very poorly controlled; 2 = not well controlled; and 3 = well controlled), peak expiratory flow rates (PEFR), serum total IgE, and absolute blood eosinophil counts before and after antifungal therapy were assessed. In comparison, we also studied nine patients with airway mycosis and moderate to severe asthma who received standard therapy but no antifungals. Treatment with azole‐based and allylamine antifungals was associated with improved asthma control (mean change in asthma control 1.72–2.25; p = 0.004), increased PEFR (69.4% predicted to 79.3% predicted, p = 0.0011) and markedly reduced serum IgE levels (1,075 kU/L to 463 kU/L, p = 0.0005) and blood eosinophil counts (Mean absolute count 530–275, p = 0.0095). Reduction in symptoms, medication use, and relapse rates decreased as duration of therapy increased. Asthmatics on standard therapy who did not receive antifungals showed no improvement in asthma symptoms or PEFR. Antifungals were usually well tolerated, but discontinuation (12.2%) and relapse (50%) rates were relatively high. Antifungals help control symptoms in a subset of asthmatics with culture‐proven airway mycosis. Additional randomized clinical trials are warranted to extend and validate these findings.
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DOI：
10.1126/science.1240342
发表时间：
2013-08-16
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Millien VO;Lu W;Shaw J;Yuan X;Mak G;Roberts L;Song LZ;Knight JM;Creighton CJ;Luong A;Kheradmand F;Corry DB
通讯作者：
Corry DB
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.
影响因子：
1.9
作者：
Chishimba, Livingstone;Niven, Robert M.;Denning, David W.
通讯作者：
Denning, David W.
影响因子：
4.4
作者：
Lamhamedi-Cherradi, Salah-Eddine;Martin, Rachel Elizabeth;Moyle, Matthew
通讯作者：
Moyle, Matthew
主要的屋尘螨过敏原通过选择性裂解 CD23（抗蛋白酶的先天保护）来破坏免疫球蛋白 E 网络。
DOI：
10.1084/jem.182.5.1537
发表时间：
1995-11-01
期刊：
The Journal of experimental medicine
影响因子：
--
作者：
Hewitt CR;Brown AP;Hart BJ;Pritchard DI
通讯作者：
Pritchard DI