The presence of Aspergillus fumigatus in asthmatic airways is not clearly related to clinical disease severity

Show simple item record Sullivan, Ashley Hunt, Eoin B. Ward, Chris Lapthorne, Susan Eustace, Joseph A. Fanning, Liam J. Plant, Barry J. O'Byrne, Paul M. MacSharry, John A. Murphy, Desmond M. 2020-01-06T15:34:21Z 2020-01-06T15:34:21Z 2019-10-12
dc.identifier.citation Sullivan, A., Hunt, E. B., Ward, C., Lapthorne, S., Eustace, J. A., Fanning, L. J., Plant, B. J., O'Byrne, P. M., MacSharry, J. A. and Murphy, D. M. 'The presence of Aspergillus fumigatus in asthmatic airways is not clearly related to clinical disease severity', Allergy, doi: 10.1111/all.14087 en
dc.identifier.startpage 1 en
dc.identifier.endpage 9 en
dc.identifier.issn 0105-4538
dc.identifier.doi 10.1111/all.14087 en
dc.description.abstract Background: It is suggested that airway fungi, in particular Aspergillus may impinge on clinical phenotype in asthma. Indeed, the term severe asthma with fungal sensitization (SAFS) has been coined. We aimed to ascertain whether the presence of fungi, in particular Aspergillus fumigatus, in the airway correlated with asthma severity and control. Furthermore, we aimed to determine whether traditional markers of Aspergillus sensitization related to the presence of Aspergillus within the airway. Methods: Sixty‐nine patients characterized by asthma severity (GINA) and level of control (ACQ‐7) underwent bronchoscopy and bronchoalveolar lavage (BAL). Serum was assessed for A fumigatus‐specific IgE and total IgE. Galactomannan and relevant cytokine levels were assessed in serum, plasma and BAL. BAL was analyzed for the presence of A fumigatus. Results: In BAL, fungi were visible by microscopy in 70% and present by qPCR in 86% of patients, while A fumigatus was detectable by qPCR in 46%. Plasma and BAL IL‐4, IL‐6, IL‐10, IL‐13 and TNF‐α correlated with BAL fungal presence, while plasma IL‐17 correlated with BAL fungal presence. Aspergillus positive BAL correlated with increased plasma and BAL IL‐6 and BAL IL‐13. There was no relationship between fungal airway presence and steroid dose, asthma severity or control. The presence of Aspergillus within the airway did not relate to serum IgE positivity for Aspergillus. Conclusions: Fungi were present in a large proportion of our asthmatic patients’ airways, but their presence was not predicted by traditional markers of sensitization, nor did it appear to be related to measures of disease severity or control. en
dc.description.sponsorship University College Cork (UCC School of Medicine TRAP award 2015; Denis O Sullivan award from UCC; The Wilton Respiratory Research Fund) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Wiley en
dc.rights © 2019 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd. This is the peer reviewed version of the following article: Sullivan, AF, Hunt, EB, Ward, C, et al. The presence of Aspergillus fumigatus in asthmatic airways is not clearly related to clinical disease severity. Allergy. 2019; 00: 1– 9, which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving." en
dc.subject Allergy en
dc.subject Aspergillus fumigatus en
dc.subject Asthma en
dc.subject Bronchoscopy en
dc.subject Fungi en
dc.title The presence of Aspergillus fumigatus in asthmatic airways is not clearly related to clinical disease severity en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Desmond Murphy, Medicine, University College Cork, Cork, Ireland. +353-21-490-3000 Email: en
dc.internal.availability Full text available en Access to this article is restricted until 12 months after publication by request of the publisher. en 2020-10-12 2020-01-06T15:24:48Z
dc.description.version Accepted Version en
dc.internal.rssid 500166475
dc.contributor.funder Irish Lung Foundation en
dc.contributor.funder University College Cork en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Allergy en
dc.internal.copyrightchecked Yes
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress en
dc.internal.IRISemailaddress en
dc.internal.bibliocheck In press. Check vol / issue / page range. Amend citation as necessary. en
dc.relation.project info:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2273/IE/Alimentary Pharmabiotic Centre (APC) - Interfacing Food & Medicine/ en

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