Sehgal Inderpaul Singh, Saxena Puneet, Dhooria Sahajal, Muthu Valliappan, Kathirvel Soundappan, Prasad Kuruswamy Thurai, Garg Mandeep, Rudramurthy Shivaprakash Mandya, Aggarwal Ashutosh Nath, Chakrabarti Arunaloke, Agarwal Ritesh
Department of Pulmonary Medicine, Army Hospital (R&R), New Delhi, India; Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Pulmonary and Critical Care Medicine, Army Hospital (R&R), New Delhi, India.
J Allergy Clin Immunol Pract. 2024 Dec;12(12):3269-3273.e1. doi: 10.1016/j.jaip.2024.09.002. Epub 2024 Sep 10.
Allergic bronchopulmonary aspergillosis (ABPA) is thought to occur more frequently in severe than in mild asthma. However, there are no precise data to support this hypothesis.
To determine the prevalence of ABPA in subjects with varying asthma severity.
We conducted a secondary analysis of prospectively collected data from 543 adult asthma subjects classified according to the 2004 Global Initiative for Asthma (GINA) guidelines. The asthma severity was categorized into mild, moderate, and severe. We report the prevalence of ABPA in each asthma category. We also performed multivariable logistic regression analysis to identify factors associated with ABPA in subjects with asthma.
We classified 81 (15%), 257 (47%), and 205 (38%) subjects as mild, moderate, and severe asthma. We diagnosed ABPA in 106 (19.5%) subjects. The prevalence of ABPA was 11.1% (9 of 81) in mild, 21% (54 of 257) in moderate, and 20.7% (43 of 205) in severe asthma (P = .12). Multivariable analysis identified age and asthma duration as significant factors associated with ABPA, whereas asthma severity was not significantly associated.
The prevalence of ABPA does not vary significantly with the severity of asthma. These findings support the revised International Society of Human and Animal Mycology (ISHAM) ABPA working group (AWG) recommendation for screening all asthma patients for ABPA, irrespective of asthma severity. Further large-scale studies across different geographic regions are warranted to validate these findings.
变应性支气管肺曲霉病（ABPA）被认为在重度哮喘患者中比在轻度哮喘患者中更频繁发生。然而，尚无确切数据支持这一假说。
确定不同哮喘严重程度患者中ABPA的患病率。
我们对根据2004年全球哮喘防治创议（GINA）指南分类的543例成年哮喘患者前瞻性收集的数据进行了二次分析。哮喘严重程度分为轻度、中度和重度。我们报告了各哮喘类别中ABPA的患病率。我们还进行了多变量逻辑回归分析，以确定哮喘患者中与ABPA相关的因素。
我们将81例（15%）、257例（47%）和205例（38%）患者分别分类为轻度、中度和重度哮喘。我们在106例（19.5%）患者中诊断出ABPA。ABPA在轻度哮喘中的患病率为11.1%（81例中的9例），中度哮喘中为21%（257例中的54例），重度哮喘中为20.7%（205例中的43例）（P = 0.12）。多变量分析确定年龄和哮喘病程是与ABPA相关的重要因素，而哮喘严重程度与之无显著相关性。
ABPA的患病率并不随哮喘严重程度的变化而显著不同。这些发现支持国际人类和动物真菌学会（ISHAM）ABPA工作组（AWG）修订后的建议，即对所有哮喘患者进行ABPA筛查，无论哮喘严重程度如何。有必要在不同地理区域进行进一步的大规模研究以验证这些发现。
