Some patients with severe asthma may continue to have symptoms despite being treated with standard medicines, even at high doses. One possible reason is that some patients have fungi or mold in their airways or they are allergic to fungi or mold in the environment. However, there are limited tests to identify these patients, and we do not know whether having fungi that live in the lungs is the same as being allergic to fungi in the environment. We will try to better understand how allergy to fungi or having fungi in the lungs may lead to more severe asthma, and will test a new method of identifying fungi in the lungs.
Update: To date, we have studied 36 patients: 7 patients with severe, uncontrolled asthma; 15 patients with mild, controlled asthma; and 14 healthy controls. The results demonstrate that fungal sensitization (allergy to fungi) is significantly more common in patients with asthma (55 percent) compared with healthy patients (14 percent). However, there is no difference in fungal sensitization in patients with severe, uncontrolled asthma (43 percent) compared with mild, controlled asthma (60 percent). There were no significant differences in lifetime ICU stays or intubations in patients with asthma with versus those without fungal sensitization. Patients with asthma and fungal sensitization had higher levels of immunoglobulin E (IgE) antibodies compared with patients with asthma without fungal sensitization.