Sputum Inflammatory Mediators Are Increased in Aspergillus fumigatus Culture-Positive Asthmatics

다국어 초록 (Multilingual Abstract)

Aspergillus fumigatus sensitization and culture in asthma are associated with disease severity and lung function impairment, but their relationship with airway inflammation is poorly understood. We investigated the profile of 24 sputum inflammatory mediators in A. fumigatus culture-positive or-negative moderate-to-severe asthmatics. Fifty-two subjects were recruited from a single center. A. fumigatus was cultured from 19 asthmatics.
Asthma control, symptom score, lung function, and sputum cell count were not significantly different between the asthmatics with and without a positive A. fumigatus culture. All of the sputum mediators were numerically increased in subjects with a positive versus negative sputum A. fumigatus culture. Sputum TNF-R2 was significantly elevated (P=0.03) and the mediator that best distinguished A. fumigatus culture-positive from culturenegative subjects (receiver-operator characteristic area under the curve 0.66 [95% CI: 0.51 to 0.82, P=0.045]). A. fumigates-positive culture in moderate- to-severe asthma is associated with increased inflammatory sputum mediators.

참고문헌 (Reference)

1 Wu W, "Unsupervised phenotyping of Severe Asthma Research Program participants using expanded lung data" 133 : 1280-1288, 2014

2 Brightling C, "Targeting TNF-α: a novel therapeutic approach for asthma" 121 : 5-10, 2008

3 Desai D, "Sputum mediator profiling and relationship to airway wall geometry imaging in severe asthma" 14 : 17-, 2013

4 Pashley CH, "Routine processing procedures for isolating filamentous fungi from respiratory sputum samples may underestimate fungal prevalence" 50 : 433-438, 2012

5 Denning DW, "Randomized controlled trial of oral antifungal treatment for severe asthma with fungal sensitization: the Fungal Asthma Sensitization Trial (FAST) study" 179 : 11-18, 2009

6 Bafadhel M, "Profiling of sputum inflammatory mediators in asthma and chronic obstructive pulmonary disease" 83 : 36-44, 2012

7 Wardlaw AJ, "Lassoing a chimera: the semantics of allergic fungal airway disease" 45 : 1746-1749, 2015

8 Agbetile J, "Isolation of filamentous fungi from sputum in asthma is associated with reduced post-bronchodilator FEV1" 42 : 782-791, 2012

9 Public Health England, "Investigation of bronchoalveolar lavage, sputum and associated specimens: Bacteriology, B 57, Issue no: 3.1" Public Health England

10 Chung KF, "International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma" 43 : 343-373, 2014

11 Fairs A, "IgE sensitization to Aspergillus fumigatus is associated with reduced lung function in asthma" 182 : 1362-1368, 2010

12 Global Initiative for Asthma, "Global Initiative for Asthma guidelines" Global Initiative for Asthma

13 Knutsen AP, "Fungi and allergic lower respiratory tract diseases" 129 : 280-291, 2012

14 Agbetile J, "Effectiveness of voriconazole in the treatment of Aspergillus fumigatus-associated asthma (EVITA3 study)" 134 : 33-39, 2014

15 Lin WR, "Does spore count matter in fungal allergy?: the role of allergenic fungal species" 8 : 404-411, 2016

16 Haldar P, "Cluster analysis and clinical asthma phenotypes" 178 : 218-224, 2008

17 Ghebre MA, "Biological clustering supports both “Dutch” and “British” hypotheses of asthma and chronic obstructive pulmonary disease" 135 : 63-72, 2015

18 Bafadhel M, "Aspergillus fumigatus during stable state and exacerbations of COPD" 43 : 64-71, 2014

19 Shah A, "Allergic bronchopulmonary aspergillosis: a perplexing clinical entity" 8 : 282-297, 2016

20 Bafadhel M, "Acute exacerbations of chronic obstructive pulmonary disease:identification of biologic clusters and their biomarkers" 184 : 662-671, 2011

21 Piper E, "A phase II placebo-controlled study of tralokinumab in moderate-tosevere asthma" 41 : 330-338, 2013