Epidemic asthma and the role of the fungal mold Alternaria alternata

Pulimood, Thomas; Corden, Julie M.; Bryden, Clare; Sharples, Linda D.; Nasser, Shuaib

doi:10.1016/j.jaci.2007.04.045

Cited by 244 publications

(191 citation statements)

References 32 publications

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“…It is likely that there is no role for cold or thunderbolts as only patients with allergic sensitisation to pollen and not patients suffering from intrinsic asthma have been involved. In the case of fungal spores, such as Alternaria, the prerequisites for asthma epidemics associated with thunderstorms have been described as follows [20,25]: 1) a sensitised, atopic, asthmatic individual; 2) a sudden, large allergen exposure; 3) a large-scale thunderstorm with cold outflow occurring at a time and location during an allergen season in which large numbers of asthmatics are outdoors; and 4) sudden release of large amounts of respirable allergenic fragments, particularly fungal spores such as Alternaria.…”

Section: Possible Mechanisms For Thunderstorm-related Asthmamentioning

confidence: 99%

“…MARKS et al [19] demonstrated that the arrival of a thunderstorm outflow was accompanied by a large increase in the concentration of ruptured pollen grains in ambient air. PULIMOOD et al [20] reported that in the thunderstorm in which they studied asthma, epidemics were associated with increased levels of Alternaria, Cladosporium and Didymella spp. but this has not been reproduced in any experiment.…”

Section: Coherencementioning

confidence: 99%

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A trans-disciplinary overview of case reports of thunderstorm-related asthma outbreaks and relapse

D’Amato¹,

Cecchi²,

Annesi‐Maesano³

2012

European Respiratory Review

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Section: Possible Mechanisms For Thunderstorm-related Asthmamentioning

confidence: 99%

Section: Coherencementioning

confidence: 99%

A trans-disciplinary overview of case reports of thunderstorm-related asthma outbreaks and relapse

D’Amato¹,

Cecchi²,

Annesi‐Maesano³

2012

European Respiratory Review

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“…Epidemiological, environmental, and clinical research was focused on relevant species like Alternaria, Aspergillum and Penicillium (13,14). Several epidemiological and diagnostic studies reported variable prevalence of allergic reactivity to fungi by means of skin testing or IgE detection (8,15,16).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Fungal Allergens in Respiratory Allergic Patients in Ahvaz City, Southwest Iran

Shakurnia

Assarehzadegan

Amini³

et al. 2013

Jundishapur J Microbiol

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Background: Fungi are ubiquitous in our environment and they are one of the important causes of allergic diseases. Identification of the most common aeroallergens to which patients are sensitized in a specific area is important in the diagnosis and treatment of allergic rhinitis. Objectives: The purpose of this study was to determine the prevalence of skin reactivity to common fungal allergens and total IgE in patients with allergic rhinitis in Ahvaz city. Patients and Methods:In this cross sectional study, 295 volunteers with the signs and symptoms of allergic diseases who referred to the Khuzestan Jahad Daneshgahi Medical Center in Ahvaz during 2010 were investigated. All patients were subjected to skin prick test (SPT) with common allergenic extracts. Data were analyzed by SPSS-18 software using Chi square test. Results: Seventy subjects, comprising 23.7% of the study group had positive skin test to at least one of the fungal allergens. The prevalence rate of sensitivity to fungal allergens was as follow: Cephalosporin 11.5%; mold mix 9.8%; Penicillium mix 9.5%; Alternaria mix 8.1%; and Aspergillus 5.1%. Mean total IgE in patients with SPT was significantly higher than in patients without any positive skin prick test (251 vs. 125 IU/mL, P = 0.001). There was no statistical difference in the prevalence of sensitization to these allergens between two sexes; whereas, 15-35 age groups had significantly higher rates of allergy to fungal allergens (P = 0.047). Conclusions: Fungal sensitization is a relatively common finding among patients with allergic rhinitis. Elimination or reduction of mold exposure in allergic patients is of special consideration and measures to reduce environmental factors which facilitate mold growth and proliferation are very important.

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“…Only a minority of asthma deaths are in patients considered to have mild or moderately severe disease, though sudden fatal attacks can still occurpossibly triggered by aero-allergens. 52,53 Inadequate treatment, inadequate objective monitoring of asthma and follow-up review, widespread underuse of written management plans, a heavy PRIMARY CARE RESPIRATORY JOURNAL www.thepcrj.org Box 5. Key components of an asthma educational programme.…”

Section: Asthma Deathsmentioning

confidence: 99%

Summary of the 2008 BTS/SIGN British Guideline on the Management of Asthma

Levy

Thomas

Small

et al. 2009

Primary Care Respiratory Journal

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SummaryThe 2008 BTS/SIGN British Guideline on the management of asthma provides comprehensive updated evidence-based guidance on asthma management for healthcare professionals. This primary care-focussed summary has been produced to aid dissemination and implementation of the key guideline messages into primary care. The section on diagnosis emphasises the new integrated symptombased approach with clinicians using their deductive skills to determine the probability that the patient has asthma. The various tools used for monitoring asthma are discussed. There are sections on both non-pharmacological and pharmacological management of chronic asthma in adults and children. Treatment options for children are subdivided into the under-5s and children aged 5-12 years. Poor asthma control is manifested by exacerbations and acute asthma. Personalised asthma action plans for guided self management should be provided and used when levels of asthma control change. There are sections on difficult asthma and the treatment of exacerbations and acute severe asthma. Various outcome measures for auditing the quality of asthma care are discussed.

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Epidemic asthma and the role of the fungal mold Alternaria alternata

Cited by 244 publications

References 32 publications

A trans-disciplinary overview of case reports of thunderstorm-related asthma outbreaks and relapse

A trans-disciplinary overview of case reports of thunderstorm-related asthma outbreaks and relapse

Prevalence of Fungal Allergens in Respiratory Allergic Patients in Ahvaz City, Southwest Iran

Summary of the 2008 BTS/SIGN British Guideline on the Management of Asthma

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