A comparison of the prevalence of sensitization to antigens among asthmatics in Cleveland and London

Schwartz, Howard J.; Citron, K. M.; Chester, Edward H.; Kaimal, J.; Barlow, Peter B.; Baum, Gerald L.; Schuyler, Mark

doi:10.1016/0091-6749(78)90065-9

Cited by 94 publications

(34 citation statements)

References 11 publications

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“…Patients with sensitisation to Aspergillus antigens had significantly more severe airflow obstruction and more prescriptions for oral corticosteroids. Similar findings were reported in another study from Cleveland (OH, USA) and London (UK) [225]. These observations suggest that it is crucial to screen asthmatic patients for sensitisation to Aspergillus antigens and to monitor these patients more closely and exclude the presence of ABPA.…”

Section: Allergic Bronchopulmonary Aspergillosissupporting

confidence: 75%

Pulmonary aspergillosis: a clinical review

Kousha¹,

Tadi²,

Soubani³

2011

Eur Respir Rev

579

596

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Aspergillus is a mould which may lead to a variety of infectious, allergic diseases depending on the host's immune status or pulmonary structure. Invasive pulmonary aspergillosis occurs primarily in patients with severe immunodeficiency. The significance of this infection has dramatically increased with growing numbers of patients with impaired immune state associated with the management of malignancy, organ transplantation, autoimmune and inflammatory conditions; critically ill patients and those with chronic obstructive pulmonary disease appear to be at an increased risk. The introduction of new noninvasive tests, combined with more effective and better-tolerated antifungal agents, has resulted in lower mortality rates associated with this infection. Chronic necrotising aspergillosis is a locally invasive disease described in patients with chronic lung disease or mild immunodeficiency. Aspergilloma is usually found in patients with previously formed cavities in the lung, whereas allergic bronchopulmonary aspergillosis, a hypersensitivity reaction to Aspergillus antigens, is generally seen in patients with atopy, asthma or cystic fibrosis. This review provides an update on the evolving epidemiology and risk factors of the major manifestations of Aspergillus lung disease and the clinical manifestations that should prompt the clinician to consider these conditions. Current approaches for the diagnosis and management of these syndromes are discussed.

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Section: Allergic Bronchopulmonary Aspergillosissupporting

confidence: 75%

Pulmonary aspergillosis: a clinical review

Kousha¹,

Tadi²,

Soubani³

2011

Eur Respir Rev

579

596

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“…85 When considering persistent asthma in west European countries, it is identified in 20%-25% of patients. 66,86,87 In other studies involving CF, 31-59% of patients were sensitised to A. fumigates. 67,88 When considering CF and ABPA, although sensitisation to A. fumigatus is crucial to ABPA diagnosis, it is important to differentiate lung colonisation by Aspergillus (40%), 69 allergic sensitisation (20-60%), 66,85 and clinically proven ABPA, a sizeable minority ranging from 1 to 11%.…”

Section: Allergic Sensitisation and Clinical Relevancementioning

confidence: 93%

Cystic fibrosis, atopy, asthma and ABPA

Antunes

Fernandes

Borrego

et al. 2010

Allergologia et Immunopathologia

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The role of atopy on cystic fibrosis (CF) progression remains unclear but evidence suggests that it may influence the appearance of co-morbid conditions such as CF asthma or allergic bronchopulmonary aspergillosis (ABPA). Recognising asthma in patients with CF is not always easy but the identification of atopic markers favours the diagnosis. Physicians should be aware of this fact in order to achieve a better control of respiratory symptoms in patients with CF. Bronchial mucosa inflammation and abnormal mucus predispose to mould colonisation. These patients are at higher risk of allergic sensitisation, especially when atopic susceptibility is present. In the particular case of A. fumigatus, allergic sensitisation precedes ABPA development, which occurs in up to 10% of CF patients. Progression of lung function deterioration is most strikingly pronounced in patients with ABPA. Therefore, sensitisation with A. fumigatus should be regularly tested in patients with CF, especially those at higher risk. Recombinant allergens constitute an important advance in differentiating Aspergillus sensitisation from ABPA itself.

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“…Some of the studies took only A. fumigatus antigen for skin testing, while others included other fungal allergens too. [4,5,7,[13][14][15][16][17][18] Similarly, type I, type III and type IV skin test reactivity was considered in some studies and only type I in others. [3,4,7,13,17] There was also a difference in the type of skin test used in various studies like some studies used prick test while others used intradermal test.…”

Section: Discussionmentioning

confidence: 99%

“…[4,5,7,[13][14][15][16][17][18] Similarly, type I, type III and type IV skin test reactivity was considered in some studies and only type I in others. [3,4,7,13,17] There was also a difference in the type of skin test used in various studies like some studies used prick test while others used intradermal test. [4][5][6][7][13][14][15] All these factors may contribute to diversity of the results.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Allergic Broncho Pulmonary Aspergillosis in patients with Asthma attending allergy clinic in a North West Indian Tertiary Care Institute

Mathur

2016

Int J of Biomed & Adv Res

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Context: Allergic Broncho Pulmonary Aspergillosis (ABPA) is an allergic disorder. Aspergillus fumigatus is the most common pathogen responsible for occurrence of ABPA. There can be serious consequences of ABPA including worsening of symptoms of asthma and more sinister complications like extensive fibrosis and bronchiectasis. Aims: To find out the prevalence of ABPA among asthma patients and association of former with factors like age, sex, occupation, family history of bronchial asthma, socioeconomic status and other relevant factors. Settings and Design: This study was a descriptive type of observational study conducted at our tertiary care institute. Methods and Material: Three hundred severe asthmatic patients underwent skin prick test (SPT) for five Aspergillus species. Four tests were applied to all SPT positive patients -Total serum IgE, spirometry, chest x-ray and High-resolution Computed Tomography (HRCT) scan of thorax. The diagnosis of ABPA was made when the patient fulfilled at least three out of four criteria. Results: Out of 300 severe asthmatic patients 27 (9%) patients were found SPT positive. Out of these 27 SPT positive patients, four patients refused for further investigations, and 23 were investigated further. Out of 23 SPT positive patients, eight patients (2.7%) were diagnosed as ABPA. It was also found that two out of eight patients with ABPA were misdiagnosed and treated earlier as pulmonary tuberculosis. Conclusions: All patients with bronchial asthma should be screened for ABPA by skin test for Aspergillus. There is need to implement screening programme and meticulous approach by physicians to diagnose and treat such patients. Key Messages: A diagnosis of allergic bronchopulmonary aspergillosis should be considered in patients coming with asthma. Skin prick test can be used to screen such patients. A further workup of the skin test positive patients leads to a high diagnostic yield.

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A comparison of the prevalence of sensitization to antigens among asthmatics in Cleveland and London

Cited by 94 publications

References 11 publications

Pulmonary aspergillosis: a clinical review

Pulmonary aspergillosis: a clinical review

Cystic fibrosis, atopy, asthma and ABPA

Prevalence of Allergic Broncho Pulmonary Aspergillosis in patients with Asthma attending allergy clinic in a North West Indian Tertiary Care Institute

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