Association between sensitization to common fungi and severe asthma.

BACKGROUND

The term severe asthma with fungal sensitization (SAFS) has been coined due to the non-negligible role of fungal sensitization in the development of asthma. These patients typically exhibit poorer lung function, worse clinical prognosis, and a significantly elevated risk of life-threatening asthma exacerbations.

METHODS

We conducted electronic searches in three databases as of October 31, 2024. Two evaluators independently screened titles and abstracts to identify studies for full-text review. For studies meeting inclusion and exclusion criteria, the investigators used the JBI Critical Appraisal Checklist and the Newcastle-Ottawa Scale (NOS) to evaluate the quality of cross-sectional studies and a case-control study, respectively, followed by data extraction from included studies.

RESULTS

Among the 10 fungal genera examined, sensitization to , , and spp. was significantly associated with an increased risk of severe asthma, with pooled odds ratios (ORs) and 95% confidence intervals (CIs) of 2.36 (1.29-4.31), 1.75 (1.02-3.03), and 2.63 (1.76-3.92), respectively. Within the spp., -specific sensitization demonstrated a stronger association with severe asthma (OR = 2.98, 95% CI: 1.32-6.75). Subgroup analyses further revealed that () sensitization was more strongly linked to severe asthma risk in younger and male populations: ORs with 95% CIs were 2.55 (1.35-4.83) in the ≥40 years subgroup, 3.04 (1.01-9.12) in the <40 years subgroup, and 2.77 (1.16-6.62) in the female-majority subgroup.

CONCLUSION

In this study, we quantified the risk of sensitization to distinct fungal genera/species, aiming to provide a scientific rationale for screening high-risk fungal sensitization, early detection of severe asthma risk, and personalized health management for patients.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO/, identifier [CRD42024620737].