Fungal allergy in asthma-state of the art ...
Document type :
Article dans une revue scientifique: Article original
DOI :
PMID :
Title :
Fungal allergy in asthma-state of the art and research needs.
Author(s) :
Denning, David [Auteur correspondant]
Pashley, Catherine [Auteur]
Hartl, Domink [Auteur]
Wardlaw, Andrew [Auteur]
Godet, Cendrine [Auteur]
del Giacco, Stefano [Auteur]
Delhaes, Laurence [Auteur]
Service de Parasitologie-Mycologie [CHRU LIlle]
Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 [CIIL]
Sergejeva, Svetlana [Auteur]
Pashley, Catherine [Auteur]
Hartl, Domink [Auteur]
Wardlaw, Andrew [Auteur]
Godet, Cendrine [Auteur]
del Giacco, Stefano [Auteur]
Delhaes, Laurence [Auteur]
Service de Parasitologie-Mycologie [CHRU LIlle]
Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 [CIIL]
Sergejeva, Svetlana [Auteur]
Journal title :
Clinical and Translational Allergy
Pages :
14
Publisher :
Wiley
Publication date :
2014-04-15
ISSN :
2045-7022
HAL domain(s) :
Sciences du Vivant [q-bio]/Immunologie
English abstract : [en]
: Sensitization to fungi and long term or uncontrolled fungal infection are associated with poor control of asthma, the likelihood of more severe disease and complications such as bronchiectasis and chronic pulmonary ...
Show more >: Sensitization to fungi and long term or uncontrolled fungal infection are associated with poor control of asthma, the likelihood of more severe disease and complications such as bronchiectasis and chronic pulmonary aspergillosis. Modelling suggests that >6.5 million people have severe asthma with fungal sensitizations (SAFS), up to 50% of adult asthmatics attending secondary care have fungal sensitization, and an estimated 4.8 million adults have allergic bronchopulmonary aspergillosis (ABPA). There is much uncertainty about which fungi and fungal allergens are relevant to asthma, the natural history of sensitisation to fungi, if there is an exposure response relationship for fungal allergy, and the pathogenesis and frequency of exacerbations and complications. Genetic associations have been described but only weakly linked to phenotypes. The evidence base for most management strategies in ABPA, SAFS and related conditions is weak. Yet straightforward clinical practice guidelines for management are required. The role of environmental monitoring and optimal means of controlling disease to prevent disability and complications are not yet clear. In this paper we set out the key evidence supporting the role of fungal exposure, sensitisation and infection in asthmatics, what is understood about pathogenesis and natural history and identify the numerous areas for research studies.Show less >
Show more >: Sensitization to fungi and long term or uncontrolled fungal infection are associated with poor control of asthma, the likelihood of more severe disease and complications such as bronchiectasis and chronic pulmonary aspergillosis. Modelling suggests that >6.5 million people have severe asthma with fungal sensitizations (SAFS), up to 50% of adult asthmatics attending secondary care have fungal sensitization, and an estimated 4.8 million adults have allergic bronchopulmonary aspergillosis (ABPA). There is much uncertainty about which fungi and fungal allergens are relevant to asthma, the natural history of sensitisation to fungi, if there is an exposure response relationship for fungal allergy, and the pathogenesis and frequency of exacerbations and complications. Genetic associations have been described but only weakly linked to phenotypes. The evidence base for most management strategies in ABPA, SAFS and related conditions is weak. Yet straightforward clinical practice guidelines for management are required. The role of environmental monitoring and optimal means of controlling disease to prevent disability and complications are not yet clear. In this paper we set out the key evidence supporting the role of fungal exposure, sensitisation and infection in asthmatics, what is understood about pathogenesis and natural history and identify the numerous areas for research studies.Show less >
Language :
Anglais
Peer reviewed article :
Oui
Audience :
Internationale
Popular science :
Non
Source :
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