Study On The Correlation Between Fungal Allergen And Clinical Feature Of Asthma

Part 1 Analysis of clinical features of allergic respiratory disease and the distribution of inhalation allergens Background:Respiratory allergic disease is currently significantly increased worldwide incidence,including allergic rhinitis and asthma,has become a wide range of health problems.Previous studies on inhaled allergens are directed against mites,pollen and so on,the distribution of allergens in the north and south are different,in the southern the house dust mites and cockroaches positive rate is higher,while in the northern climate is dry and cold,not suitable for mites and cockroaches growth.Inhalation of fungal spores in the air is an important cause of respiratory allergic diseases.In recent years,air fungal spores have also been the concern of clinicians,is considered an important allergen,can induce increased respiratory allergic diseases.Guangzhou is a subtropical monsoon climate,summer rainy and humid,high temperature throughout the year,it's conducive to the growth and reproduction of fungi and spores,so they are wide variety.Therefore,to understand the clinical characteristics of respiratory allergic disease in the region and its relationship with the incidence of fungi can provide the basis of clinical diagnosis and treatment of fungal allergenic allergic diseases.Objective:Clinical data of patients with asthma and allergic rhinitis in the region were collected and analyzed for clinical characteristics and their relevance to fungal allergens.Methods:122 allergic rhinitis and/or asthma patients were divided 3 groups: the rhinitis group,the asthma combined with rhinitis group,the asthma group.All the patients had taken the serum inhalation allergens Ig E test including total Ig E,mite combination(house dust mite,dust mite),tree pollen combination(cypress pollen,elm pollen,sycamore pollen,willow pollen,poplar pollen)and mold combination(Aspergillus fumigatus,Cladosporium,and/or the skin prick test(Including pollen,amaranth,mite,silk,cockroach,house dust,cat hair,dog hair,moth,litter,beast feather,bee,German cockroach and mold group(Aspergillus fumigatus,Mycelia).The clinical data and the distribution of inhalant allergens were analyzed in 3groups according to the test.Result :The serum total Ig E level of asthma and rhinitis group is significantly higher than that of rhinitis group and asthma group(P < 0.01 all).The count of eosinophils of asthma and rhinitis group is significantly higher than that of the asthma group(P=0.012).The ratio of mite allergen positive in asthma group is significantly lower than that of remain 2 groups(P < 0.01 all).The ratio of tree pollen allergen positive in asthma group is significantly lower than that of the rhinitis group and the asthma combined with rhinitis group(P=0.011;P=0.001).There were 11 cases(78.5%)of serum s Ig E positive in 14 patients with positive combination of mold,including 6 cases(42.9%)of aspergillus fumigatus,4 cases(28.6%)of candida albicans sicillin,2 cases of penicillium(14.3%),1 case of alternaria alternata(7.1%),1 case of Mucor(7.1%)2 cases of aspergillus fumigatus and penicillium s Ig E,1 case both candida albicans,Mucor and Penicillium s Ig E positiveConclusion:1?Fungal is an important allergen of respiratory allergic disease.2?Patients with allergic rhinitis and asthma have strong systemic allergy and high rate of fungi allergy.Part 2 Analysis of clinic features of asthma patients with fungal sensitizationBackground:Bronchial asthma(referred to as asthma)is a common chronic respiratory disease of the respiratory tract,the pathology of asthma is a chronic airway inflammation caused by a variety of cells,allergenic stimulation can induce chronic airway inflammation and airway hyper-responsiveness to the patients with specific physical condition,and then recurrent cough and / or wheezing.Our previous studies have shown that fungi are common inhalation allergens,and the positive rate of fungal allergen in asthmatic patients with allergic rhinitis is high.Recent studies suggest that fungal allergens are closely related to the severity of asthma.In the environment there are a variety of fungi and spores,atopic individual exposure which can induce allergic diseases.In China we rarely concern the fungal allergic asthma compared to the Western developed countries,but fungi is a common allergen of asthma which can induce allergic asthma,and is closely related to severe asthma.Our previous studies also show that fungi are common allergens that induce asthma and the positive rate of fungal allergens in asthmatic patients with allergic rhinitis is high,but the fungal sensitization and the clinical features of asthma are still not completely clear.Therefore,deeply studying the clinical characteristics of fungal allergic asthma patients and the allergenic fungi species in this area can contribute to the diagnosis and treatment of fungal-related asthma,reduce the medical,economic,family burden.Objective:To analyze the clinic features of asthma patients with fungal sensitization in this area.Methods:Collected 112 cases of asthma patients,the average age of 48 years(3-82 years),of which 12 children,including 49 males and 63 females.All the patients had taken the serum fungal special Ig E testincluding total Ig E,mite combination(house dust mite,dust mite),tree pollen combination(cypress pollen,elm pollen,sycamore pollen,willow pollen,poplar pollen)and mold combination(Aspergillus fumigatus,Cladosporium and/or the skin prick test(Including pollen,amaranth,mite,silk,cockroach,house dust,cat hair,dog hair,moth,litter,beast feather,bee,German cockroach and mold group(Aspergillus fumigatus,Mycelia).The clinical data was analyzed in all the patients which were divided into two groups according to the test result: fungal sensitization group(26 patients),without fungal sensitization group(86 patients).Result :The average age of fungal sensitization group is obviously lower than that of fungal non-allergic group(P=0.04).The ratio of severe asthma patients in the fungal sensitization group was higher than that of the fungal non-allergic group(P=0.032).The ratio of accompanied multifarious allergens patients in the sensitization group were higher than that of the fungal non-allergic group(P <0.001).There were no difference between the ratio of gender,amalgamate allergic rhinitis and/or allergic dermatitis,the serum total Ig E level,count of eosinophil and FEV1% in the two groups(P>0.05).Conclusion:1?Fungal sensitized asthma patients have low average age and more common in children and high rate of severe asthma.These patients always are sensitive to a variety of allergens.2?Aspergillus fumigatus and candida albicans are common fungal allergens of asthma in this area.