Allergic Inflammation in Aspergillus fumigatus-Induced Fungal Asthma

Ghosh, Sumit; Hoselton, Scott A.; Schuh, Jane M.

doi:10.1007/s11882-015-0561-x

Cited by 26 publications

(19 citation statements)

References 142 publications

(150 reference statements)

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“…Although fungal infections have been implicated pathophysiologically in diverse allergic airway diseases [18,20,26,31,32], treatment with antifungals has not been unequivocally beneficial. Treatment with itraconazole reportedly improved asthma symptoms [22] prompting sporadic use of antifungals in others with positive fungal cultures [20][21][22]25], but the lack of efficacy of voriconazole in asthmatics [23] called to question the value of these agents and prompted us to evaluate outcomes of similar asthmatics treated with antifungals in our clinic.…”

Section: Benefits Of Antifungal Therapy In Asthma Patientsmentioning

confidence: 99%

Benefits of antifungal therapy in asthma patients with airway mycosis: A retrospective cohort analysis

Tsai

Maskatia

et al. 2018

Immunity Inflam & Disease

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IntroductionFungal 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.MethodsWe 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.ResultsTreatment 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.ConclusionAntifungals 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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Section: Benefits Of Antifungal Therapy In Asthma Patientsmentioning

confidence: 99%

Benefits of antifungal therapy in asthma patients with airway mycosis: A retrospective cohort analysis

Tsai

Maskatia

et al. 2018

Immunity Inflam & Disease

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“…Asthma is a complex chronic inflammatory disease characterized by airway hyperresponsiveness, reversible airflow obstruction, and airway inflammation ( 73 ). The most common trigger for asthma is the continuous exposure to allergens, of which fungal agents are important factors ( 74 , 75 ), and there is evidence for the presence of fungal sensitization in patients with asthma ( 76 ). Fungal asthma promotes a Th2-type response that mediates the production of cytokines such as IL-4, IL-5, IL-13, and IL-33 ( 77 , 78 ), which leads to the recruitment of complex multi-factorial leukocyte eosinophils ( 79 , 80 ).…”

Section: Respiratory Inflammation and Spn Infectiomentioning

confidence: 99%

Role of Inflammatory Risk Factors in the Pathogenesis of Streptococcus pneumoniae

et al. 2018

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Streptococcus pneumoniae (Spn) is a colonizer of the human nasopharynx (NP), causing a variety of infections in humans including otitis media, pneumonia, sepsis, and meningitis. The NP is an immune permissive site which allows for the persistence of commensal bacteria. Acute or chronic respiratory airway inflammation constitutes a significant risk factor for the manifestation of Spn infections. The inflammatory conditions caused by an upper respiratory viral infection or respiratory conditions such as allergic asthma and chronic obstructive pulmonary disorders (COPDs) are implicated in the dysregulation of airway inflammation and tissue damage, which compromise the respiratory barrier integrity. These immune events promote bacterial outgrowth leading to Spn dissemination and invasion into the bloodstream. Therefore, suppression of inflammation and restoration of respiratory barrier integrity could contain Spn infections manifesting in the backdrop of an inflammatory disease condition. The gained knowledge could be harnessed in the design of novel therapeutic interventions to circumvent Spn bacterial infections.

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“…Asthma is specified by construction changes at airway that possibly will lead the extension of asthma, to pulmonary function. 3 In addition, according to the previous studies there is a positive relationship between the thickness of the lung airway smooth muscle (ASM) layer with airway responsiveness. 4 Its common features including augmentation of mast cells, lymphocytes and eosinophils, and mediators such as interleukin-3 (IL-3), IL-4, IL-5, and IL-13.…”

Section: Introductionmentioning

confidence: 94%

Inhibition of Airway Contraction and Inflammation by Pomalidomide in a Male Wistar Rat Model of Ovalbumin-induced Asthma

Ghaderi

Oryan

Yousofvand

et al. 2019

IJAAI

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Asthma is a chronic inflammatory disease of the airways of the lungs. Pomalidomide (POM) a therapy for multiple myeloma has been stated to have an anti-inflammatory effect. The main goal of the present study was to assess its possible effect on airway contraction and inflammation in a rat model of ovalbumin-induced asthma. Different groups of rats received saline or pomalidomide (0.4, 0.8 mg/kg) or dexamethasone (0.6 mg/kg). The asthma was induced by ovalbumin (OVA). Trachea contraction was assayed by organ bath system. Airway histology was assessed using hematoxylin and eosin method. Serum Tumor necrosis factor alpha (TNF-α) level was analyzed by Enzyme-Linked Immunosorbent Assay and Platelet-derived growth factor (PDGFα) Gene expressions were evaluated by Real-time PCR. Pomalidomide prevented ovalbumin-induced airway contraction and histopathological damage. In addition serum, TNF-α level was significantly (p<0.05) decreased in POM treated animals compared to control (asthmatic animals that received POM vehicle). Results indicate that POM prevented the PDGF expression induced by ovalbumin. In conclusion, we found that pomalidomide ameliorated the symptoms, histopathological changes and inflammatory markers induced by ovalbumin in asthmatic rats and these effects might be related to its anti-inflammatory properties.

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Allergic Inflammation in Aspergillus fumigatus-Induced Fungal Asthma

Cited by 26 publications

References 142 publications

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

Role of Inflammatory Risk Factors in the Pathogenesis of Streptococcus pneumoniae

Inhibition of Airway Contraction and Inflammation by Pomalidomide in a Male Wistar Rat Model of Ovalbumin-induced Asthma

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