Asthma is a chronic (long-term) inflammatory disease of the airways. Symptoms include airflow obstruction, bronchospasms, chest tightness, shortness of breath, coughing and wheezing. It is believed that this medical condition is brought about by a combination of environmental factors, such as fungal allergies and genetics.
Asthma treatment generally involves the use of inhaled, short-acting beta-2 agonist and oral corticosteroids. To avoid symptoms, the patient needs to stay away from triggers, such as allergens and irritants. The incidence of asthma has increased over the past four decades, and some 300 million individuals are currently affected globally.
Individuals who are sensitized to fungi and have long-term or uncontrolled fungal infections are linked to poor control of asthma. This increases the probability that they will develop more severe disease such as bronchiectasis and long-term pulmonary aspergillosis. Modeling indicates that more than 6.5 million people have a severe form of fungal sensitization (SAFS), up to 50 percent of adult asthmatics attending secondary care have fungal sensitization, and an estimated 4.8 million adults have allergic bronchopulmonary aspergillosis (ABPA).
Currently, much is still unknown regarding SAFS, such as the history of sensitization of fungi, the pathology and frequency of exacerbations and complications, if there is an exposure response relationship for fungal allergy, and which fungi and fungal allergens are significant to asthma. So far, genetic links have been reported, but only weakly associated with phenotypes. To date, there is little evidence for management strategies in ABPA and SAFS, nevertheless, clinical practice guidelines are necessary.
Current research in the U.K., Germany and France is taking a look at the importance of environmental monitoring and means of controlling asthma to prevent complications as these areas are not well understood. The goal of current research is to find key evidence supporting the role of fungal exposure, sensitization and infection, as well as to determine what is understood about pathogenesis and natural history and identify the areas for future research studies. The report is available as a provisional PDF as the fully formatted PDF and HTML versions are in production. Please click here for the results.