IgE-Mediated Sensitization to Mould Allergens among Patients with Allergic Respiratory Diseases in a Desert Environment

Abstract

Background: The importance of fungal allergens in the development of allergic diseases in a desert environment is uncertain. This study evaluated the prevalence of IgE sensitization to moulds among patients with allergic respiratory diseases in Kuwait – a desert country. Methods: A total of 810 patients (male:female ratio 1.4) with a mean age of 32.3 years (range 2–76 years) with extrinsic asthma or allergic rhinitis were studied. Sera from the patients were tested by the CAP-RAST method for specific IgE to 6 fungi (Penicillium, Cladosporium, Aspergillus, Candida, Alternaria and Helminthosporium). For comparison house dust mite and Bermuda grass were also assessed. Results: The overall positivity to at least one mould was 20.9%. Among 120 matched control subjects, the value was 5.8%. The value was much higher among patients with asthma alone (45.8%) or both asthma and rhinitis (28.3%) than those with rhinitis alone (11.8%; p < 0.001). Asthmatic children had the highest sensitization rate (66.0% in the 7- to 12-year age group), which declined sharply with age. Among asthmatics, Candida and Aspergillus had the highest sensitization rates (23.1 and 21.3%, respectively), followed by Helminthosporium (18.8%), Cladosporium (15.9%), Alternaria (14.6%) and Penicillium (13.9%). The values for mite and Bermuda grass were 41.2 and 54.6%, respectively. Among asthmatic children, severe asthma was significantly more frequent among mould-positive (51.6%) than mould-negative patients (17.5%; p < 0.0001). Conclusions: Even in this desert environment, sensitization to moulds is quite common among patients with allergic respiratory diseases, with a striking preponderance among children with asthma. Mould allergy could also be an important factor determining asthma severity in this environment.

Analysis of the Serum Levels of Fungi-Specific Immunoglobulin E in Patients with Allergic Diseases

“…Similar results were reported by Ezeamuzie et al [16], although their study was conducted in a desert area, whereas our study was conducted in a subtropical region characterized by high temperature and humidity. …”

“…Exposure to allergenic fungi may lead to IgE-mediated allergic respiratory disease [16] and AD [9], yet few studies have examined fungal sensitization in Asian populations. Our study showed comparable findings with regard to age dependency of mold sensitization to those reported in the literature [16,17,18]. The sensitization pattern revealed that fungal allergy was extremely common among children with RAD, especially in those <10 years of age.…”

“…The sensitization pattern revealed that fungal allergy was extremely common among children with RAD, especially in those <10 years of age. One possible reason is that younger children may be less efficient in clearing airway fungal spores, which results in higher and longer antigenic stimulation [16]. The higher specific IgE titers to fungi in adults compared to children may reflect a difference in cumulative exposure or poor elimination.…”

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

“…These fungal allergens were the most common airborne fungi in many areas with similar climate within our region (20,21).…”

Variation in Airborne Fungal Spore Concentrations in Four Different Microclimate Regions in Romania

“…Only in the concentrations of Epicoccum were no significant differences between the sampling sites. Airborne spore concentrations greatly differ, a fact due to the variety of the vegetation existing in each region (Ballero et al, 1992;Eseamuzie et al, 2000). Awad (2005) reported that type of vegetation in the sampling area can affect the concentration and type of fungal taxa in the atmosphere.…”