Features of fungal sensitization in patients with asthma and cystic fibrosis: the results of a prospective study

Abstract

Background. To estimate the frequency of fungal sensitization and allergic bronchopulmonary aspergillosis in patients with asthma or cystic fibrosis. Methods. The study included 205 patients with asthma and 190 patients with cystic fibrosis. For detection of fungal sensitization specific IgE antibodies in the blood serum with «AllergoELISA-specific IgE» test system and biotinylated fungal allergens were determined. Mycological examination included microscopy and cultural study of respiratory biomaterials. According to the indications, a CAT scan of the chest was performed. Results. The incidence of fungal sensitization in patients with asthma was 35,6%, CI [29,1%; 42,6%], in patients with cystic fibrosis - 56,8% [49,5%; 64%]. In patients with severe asthma the main fungal allergens were Alternaria spp. (70%) and Aspergillus spp. (60%); in patients with cystic fibrosis: Candida spp. - 73%, Alternaria spp. - 34%, Aspergillus spp. - 27%. The incidence of allergic bronchopulmonary aspergillosis (ABPA) in patients with asthma was 5,3%, in patients with cystic fibrosis - 5,7%. Conclusion Early detection of ABPA in patients with asthma and cystic fibrosis is very important as it changes the therapeutic measures of patients’ management and prevents progression of bronchiectasis and respiratory failure. Determination of specific Aspergillus spp. IgE antibodies in vitro is a necessary stage of diagnosis of ABPA in patients at risk.