الفهرس 
Bronchial Asthma
Fungal allergensOnly 14 pages are availabe for public view
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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
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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.