الفهرس | Only 14 pages are availabe for public view |
Abstract Bronchial asthma is an inflammatory disease of the airways which may be worsened due to numerous extrinsic factors. The most common trigger is continuous exposure to allergens of which fungal agents are important factors. There is overwhelming evidence for the presence of fungal sensitization in patients with asthma. The diagnosis of fungal sensitization can be made either with skin testing with antigens derived from fungi or measuring specific IgE levels. There is also a strong association between fungal sensitization and severity of asthma. (Agarwal and Gupta, 2011) Fungi can have adverse effects on human health, causing infection, IgE-mediated allergy, non-IgE-mediated hypersensitivity, and toxicity/irritation. The incidence of fungal diseases has risen rapidly over the last two decades, and fungal allergy is one of the common health problems/medical conditions worldwide. It is estimated that there are approximately 1.5 million species of fungi, and numerous fungal species have been described as causes of allergic diseases in the literature. (Fukutomi and Taniguchi, 2015) The aim of the study is to study Candida Albican sensitization and Aspergillus fumigatus among Egyptian patients with allergic Asthma. The design of the study is a cross-sectional study including 100 adult consecutive asthmatic patients attending the Allergy and Clinical Immunology outpatient clinic, Ain Shams University Hospitals between the years 2015 and 2016. Diagnosis of asthma was done according to GINA 2015 guidelines and only patients with partly controlled or controlled asthma where enrolled. (Reddel et al, 2015) Demographic and clinical data were collected after an informed consent. A skin prick test including common airborne allergens and fungal allergens was performed. Bronchial provocation test to Candida albicans and Aspergillus fumigatus was done only to patients with positive skin prick test. The results were correlated and statistically analyzed. We found that Candida albicans and Aspergillus fumigatus were positive in 32% of the patients by SPT. Aspergillus hypersensitivity was positive in 12% and Candida albicans sensitization was positive in 28% of the patients. The positive predictive value of Aspergillus fumigatus SPT was 83.3% and the positive predictive value of Candida albicans SPT was 78.6%. This was confirmed by doing BPT to all skin test positive patients to confirm bronchial hypersensitivity to these fungi. The most common allergen Summary 136 was HDM followed by Grass pollens then Candida albicans and Dog hair. The least common was goat hair. There was No statistically significant difference between the non-sensitized patients to Candida and/or Aspergillus and those to sensitized to Candida and/or Aspergillus groups as regard age, gender, duration of asthma, associated allergic conditions, positive family history of allergic conditions, total IgE, FEV1, FVC and FEV1/FVC. There was A statistically significant difference among the two groups as regards number of sensitizers. |