Sensitization to Airborne Fungal Allergens Associates with Asthma and Allergic Rhinitis Presentation and Severity in the Singaporean/Malaysian Population

Abstract

Fungal spores and conidia are the major components of total airspora in the tropical Asia environment, and their sensitization patterns are often associated with allergic diseases such as asthma, allergic rhinitis (AR), and atopic dermatitis. Hence, we recruited a cross-sectional cohort of 9223 Singapore/Malaysia Chinese adults and assessed their sensitization against Curvularia lunata allergen using the skin prick test approach. A subset of this cohort (n = 254) was also screened for specific Immunoglobulin E (sIgE) titers against a panel of 11 fungal allergens. We found significant association of Curvularia lunata sensitization with the risk of asthma (OR = 1.66, 95% CI: 1.17–2.33; p = 0.00391) and AR (OR = 1.69, 95% CI: 1.18–2.41; p = 0.00396). Among asthmatic patients (n = 1680), Curvularia lunata sensitization also increased frequencies of wheezing symptoms (OR = 1.81, 95% CI: 1.05–2.96; p = 0.0239), general practitioner/specialist visits (OR = 2.37, 95% CI: 1.13–4.61; p = 0.0157), and other asthma-related exacerbation events (OR = 2.14, 95% CI: 1.04–4.10; p = 0.0289). In our serum cohort, sensitization to Aspergillus spp. was the most common fungal sensitization, with 23.6% (n = 60) had a class 3 and above sensitization (positive sensitization; sIgE titers of > 3.5 kU/L) against this allergen. Increasing sIgE titer against Aspergillus spp. was also correlated with increased AR risk and AR-related symptoms. In conclusion, our findings emphasize an important role of fungal sensitization in the manifestations of asthma and AR in the Southeast Asian Chinese population.

Risk factors of asthma in the Asian population: a systematic review and meta-analysis

“…Indoor dampness and the presence of mold in the household were shown to associate with increased asthma risk in a previously conducted meta-analysis study [ 267 ]. This indicates allergenic sensitizations towards fungal spores and conidia might associate with asthma development, which is in concordance with previous epidemiological and immunological evidence [ 268 – 270 ]. Similarly, the usage of carpet in the household environment might also increase an individual’s sensitization to house dust mite allergens, which was consistently shown to increase the risk of developing asthma in the tropical region of Asia [ 32 , 271 – 273 ].…”

Environmental Factors Shaping the Diversity and Spatial-Temporal Distribution of Indoor and Outdoor Culturable Airborne Fungal Communities in Tianjin University Campus, Tianjin, China

“…Aspergillus species are common mycotoxin producing organisms, and they have been recently reported as the most common fungi increasing specific Immunoglobulin E (sIgE) titer. Besides, Aspergillus fungi have been correlated with increased allergic rhinitis risk and allergic rhinitis-related symptoms ( Sio et al, 2021 ). Although the concentration of fungal species in Tianjin University air environments was far below the recommended limits ( GB/T 18883, 2002 ), the presence of the above-mentioned fungi with potential hazardous effect on human health deserves attention from a pathological point of view and should be monitored in future studies.…”

The influence of <i>Aspergillus fumigatus</i> micromycetes on immune response regulation in patients with asthma

“…Опубликованы результаты исследований, согласно которым микогенная сенсибилизация ассоциирована с тяжелым течением БА, развитием бронхоэктазов и фиброза [15,26]. В работе Woolnough K.F.…”