TY - JOUR
T1 - Tracheobronchial mycosis in a retrospective case-series study of five status asthmaticus patients
AU - Mak, Garbo
AU - Porter, Paul C.
AU - Bandi, Venkata
AU - Kheradmand, Farrah
AU - Corry, David
PY - 2013/2
Y1 - 2013/2
N2 - The etiology of status asthmaticus (SA), a complication of severe asthma, is unknown. Fungal exposure, as measured by fungal atopy, is a major risk factor for developing asthma, but the relationship of fungi in SA per se has not previously been reported. In this five patient retrospective case series study, lower respiratory tract cultures were performed on bronchoalveolar lavage or tracheal aspirate fluid, comparing standard clinical laboratory cultures with a specialized technique in which respiratory mucus was removed prior to culture. We show that mucolytic treatment allows an increased detection of fungal growth, especially yeast, from the lower airways of all SA patients. We also demonstrate that inhalation of the yeast Candida albicans readily induces asthma-like disease in mice. Our observations suggest that SA may represent a fungal infectious process, and support additional prospective studies utilizing anti-fungal therapy to supplement conventional therapy, broad-spectrum antibiotics and high-dose glucocorticoids, which can promote fungal overgrowth.
AB - The etiology of status asthmaticus (SA), a complication of severe asthma, is unknown. Fungal exposure, as measured by fungal atopy, is a major risk factor for developing asthma, but the relationship of fungi in SA per se has not previously been reported. In this five patient retrospective case series study, lower respiratory tract cultures were performed on bronchoalveolar lavage or tracheal aspirate fluid, comparing standard clinical laboratory cultures with a specialized technique in which respiratory mucus was removed prior to culture. We show that mucolytic treatment allows an increased detection of fungal growth, especially yeast, from the lower airways of all SA patients. We also demonstrate that inhalation of the yeast Candida albicans readily induces asthma-like disease in mice. Our observations suggest that SA may represent a fungal infectious process, and support additional prospective studies utilizing anti-fungal therapy to supplement conventional therapy, broad-spectrum antibiotics and high-dose glucocorticoids, which can promote fungal overgrowth.
KW - Allergic
KW - Asthma
KW - Candidiasis
KW - Status asthmaticus
KW - Tracheobronchial
UR - http://www.scopus.com/inward/record.url?scp=84875582107&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84875582107&partnerID=8YFLogxK
U2 - 10.1016/j.clim.2012.11.005
DO - 10.1016/j.clim.2012.11.005
M3 - Article
C2 - 23280490
AN - SCOPUS:84871840338
VL - 146
SP - 77
EP - 83
JO - Clinical immunology (Orlando, Fla.)
JF - Clinical immunology (Orlando, Fla.)
SN - 1521-6616
IS - 2
ER -