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Clinical and Translational Allergy
Published in: Clinical and Translational Allergy 1/2014

Open Access 01-12-2014 | Position article and guidelines

Fungal allergy in asthma–state of the art and research needs

Authors: David W Denning, Catherine Pashley, Domink Hartl, Andrew Wardlaw, Cendrine Godet, Stefano Del Giacco, Laurence Delhaes, Svetlana Sergejeva

Published in: Clinical and Translational Allergy | Issue 1/2014

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Abstract

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.
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Metadata
Title
Fungal allergy in asthma–state of the art and research needs
Authors
David W Denning
Catherine Pashley
Domink Hartl
Andrew Wardlaw
Cendrine Godet
Stefano Del Giacco
Laurence Delhaes
Svetlana Sergejeva
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Clinical and Translational Allergy / Issue 1/2014
Electronic ISSN: 2045-7022
DOI
https://doi.org/10.1186/2045-7022-4-14

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