BACKGROUND AND OBJECTIVE: Some studies have pointed to Alternaria alternata as a trigger of fatal and near-fatal asthma (NFA) crises. The objective of this study was to determine the clinical characteristics of fatal and NFA crisis in patients sensitized to Alternaria. PATIENTS AND METHOD: One hundred ninety four patients with fatal or NFA attacks were enrolled in a multicenter (33 Spanish hospitals), prospective study. We gathered the characteristics and clinical course of the crises. We performed the following tests: spirometry, prick-test to common allergens, and specific IgE to Alternaria when patients were in stable condition. The sensitization test to Alternaria was performed when the prick-test and/or specific IgE levels were positive. RESULTS: Twenty (10%) patients were sensitized to Alternaria. When compared to non-sensitized patients, Alternaria sensitized patients were significantly younger, 35 (15) vs 50 (21) years old (p<0.001); their hospital admission length was shorter, 6.5 (5.5) against 9 (7) days (p=0.039); they had a higher number of deaths or severe neurological sequelae, 15 vs 3% (p=0.026); they had a higher sensitization frequency to the remaining allergens, 68 against 22% (p=0.003); and they exhibited a fewer bronchodilation response upon inhaled salbutamol, 6 vs 10% (p=0.013). CONCLUSIONS: The clinical characteristics of Alternaria sensitised, fatal-and NFA-patients, seem to identify a particular phenotype. Specific avoidance strategies could be useful to prevent fatal and NFA attacks.
BACKGROUND AND OBJECTIVE: Some studies have pointed to Alternaria alternata as a trigger of fatal and near-fatal asthma (NFA) crises. The objective of this study was to determine the clinical characteristics of fatal and NFA crisis in patients sensitized to Alternaria. PATIENTS AND METHOD: One hundred ninety four patients with fatal or NFA attacks were enrolled in a multicenter (33 Spanish hospitals), prospective study. We gathered the characteristics and clinical course of the crises. We performed the following tests: spirometry, prick-test to common allergens, and specific IgE to Alternaria when patients were in stable condition. The sensitization test to Alternaria was performed when the prick-test and/or specific IgE levels were positive. RESULTS: Twenty (10%) patients were sensitized to Alternaria. When compared to non-sensitized patients, Alternaria sensitized patients were significantly younger, 35 (15) vs 50 (21) years old (p<0.001); their hospital admission length was shorter, 6.5 (5.5) against 9 (7) days (p=0.039); they had a higher number of deaths or severe neurological sequelae, 15 vs 3% (p=0.026); they had a higher sensitization frequency to the remaining allergens, 68 against 22% (p=0.003); and they exhibited a fewer bronchodilation response upon inhaled salbutamol, 6 vs 10% (p=0.013). CONCLUSIONS: The clinical characteristics of Alternaria sensitised, fatal-and NFA-patients, seem to identify a particular phenotype. Specific avoidance strategies could be useful to prevent fatal and NFA attacks.
Authors: Taylor A Doherty; Naseem Khorram; Kotaro Sugimoto; Dean Sheppard; Peter Rosenthal; Jae Youn Cho; Alexa Pham; Marina Miller; Michael Croft; David H Broide Journal: J Immunol Date: 2012-02-10 Impact factor: 5.422
Authors: Hee-Kyoo Kim; Sean Lund; Rachel Baum; Peter Rosenthal; Naseem Khorram; Taylor A Doherty Journal: Int Arch Allergy Immunol Date: 2013-11-30 Impact factor: 2.749
Authors: Taylor A Doherty; Naseem Khorram; Jinny E Chang; Hee-Kyoo Kim; Peter Rosenthal; Michael Croft; David H Broide Journal: Am J Physiol Lung Cell Mol Physiol Date: 2012-08-03 Impact factor: 5.464
Authors: Kira M Hughes; Dwan Price; Angel A J Torriero; Matthew R E Symonds; Cenk Suphioglu Journal: Int J Mol Sci Date: 2022-04-13 Impact factor: 6.208