Allergy Asthma Immunol Res.  2017 Nov;9(6):509-516. 10.4168/aair.2017.9.6.509.

Association Between Sensitization to Mold and Impaired Pulmonary Function in Children With Asthma

• Byeon JH
• Ri S
• Amarsaikhan O
• Kim E
• Ahn SH
• Choi IS
• Kim HJ
• Seo S
• Yoon W
• Yoo Y

• KMID: 2421661
• DOI: http://doi.org/10.4168/aair.2017.9.6.509

Abstract

PURPOSE
Recent data indicate that sensitization to mold contributes to the severity and persistence of asthma. In this study, we investigated the relationships between sensitization to mold and lung function parameters in children with asthma.
METHODS
We retrospectively reviewed clinical data from 551 asthmatic subjects. We selected subjects who met clinical diagnostic criteria of asthma. Their spirometry, methacholine challenge tests, and measurements of blood eosinophils, serum IgE, eosinophil cationic protein (ECP) and fractional exhaled nitric oxide (FeNO) results were included. Skin prick testing (SPT) results with 13 common aeroallergens in Korea including house dust mites, animal dander, pollen, cockroach and mold were reviewed. Subjects were divided into 3 groups according to their SPT results. Subjects who showed no positive result to any aeroallergen were designated as group 1 (non-sensitized). Group 2 represented subjects who were sensitized to aeroallergens other than mold (other allergen-sensitized) and group 3 included subjects who were sensitized to mold allergens (mold-sensitized).
RESULTS
Among the 551 asthmatic subjects, 67 (12.2%) were sensitized to mold and 366 (66.4%) were sensitized to other aeroallergens. The log mean IgE levels were higher in groups 2 (5.96±1.14 IU/mL) and 3 (5.81±0.97 IU/mL) compared to group 1 (3.88±1.68 IU/mL). Blood eosinophils, ECP and FeNO concentrations were significantly higher in groups 2 and 3, but no significant difference was found between the 2 groups. The mean FEV1 value was significantly lower in group 3 (86.9±12.1%pred) than in groups 2 (92.0±14.8%pred) and 1 (93.4±15.4%pred). The log mean methacholine PC20 was significantly lower in group 3 (0.08±1.91 mg/mL) than in groups 2 (1.31±1.69 mg/mL) and 1 (2.29±1.66 mg/mL).
CONCLUSIONS
We observed a differential association between mold and other aeroallergen sensitization, and severity of asthma. Sensitization to mold is associated with lower lung function and increased airway hyper-responsiveness in children with asthma. Mold sensitization could be an important factor determining asthma severity particularly airflow limitation in children.

Keyword

Asthma; mold; severity

MeSH Terms

Allergens
Animals
Asthma*
Child*
Cockroaches
Dander
Eosinophil Cationic Protein
Eosinophils
Fungi*
Humans
Immunoglobulin E
Korea
Lung
Methacholine Chloride
Nitric Oxide
Pollen
Pyroglyphidae
Respiratory Hypersensitivity
Retrospective Studies
Skin
Spirometry
Allergens
Eosinophil Cationic Protein
Immunoglobulin E
Methacholine Chloride
Nitric Oxide

Figure

• 

  Fig. 1 Sensitization profiles in asthmatic subjects by sex (left bar: boy, right bar: girl) (A). The prevalence of sensitization to any aeroallergen (center bar) and mold (right bar) by age group among the total asthmatic children (left bar) (B).

• 

  Fig. 2 The FEV1 %predicted values (A) and FVC %predicted values (B) of asthmatic subjects with non-sensitized, other allergen-sensitized and mold-sensitized.FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity.

• 

  Fig. 3 The FEV1/FVC ratio (A) and log methacholine PC20 levels (B) of asthmatic subjects with non-sensitized, other allergen-sensitized, and mold-sensitized.FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity.

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