An international research team from Singapore has found that patients with the lung disease bronchiectasis also often display sensitivity to airborne allergens, and has highlighted the particular role that fungi appear to play.
Their discovery suggests that bronchiectasis patients should be examined for a range of allergies, since the treatment for allergies already exists and controlling them could prevent the bronchiectasis from worsening.
Bronchiectasis is a chronic disease in which parts of the airways have enlarged, due to irreversible damage to the lungs. Patients find it hard to cough out phlegm and are more prone to bacterial, viral or fungal infection. These complications can be fatal if left untreated, and the disease itself has no effective cure.
Led by Assistant Professor Sanjay Haresh Chotirmall from the Lee Kong Chian School of Medicine (LKCMedicine) at NTU, the team included researchers from Tan Tock Seng Hospital, Singapore General Hospital, Changi General Hospital, National University of Singapore, Agency for Science, Technology and Research (A*STAR), National University of Malaysia, and the University of Dundee in Scotland. Their findings have been published in the American Journal of Respiratory and Critical Care Medicine.1
They assessed fungal infection in over 200 bronchiectasis patients from Singapore, Malaysia and Scotland. While previous bronchiectasis research focused on non-Asian populations, this new study matched patients in Asia (Singapore and Malaysia) to patients in Europe (Scotland) in terms of age, gender and the severity of bronchiectasis.
The matching of patients allowed researchers to control the influence of these factors and hence show that the types and causes of allergies associated with bronchiectasis vary across regions.
They found that overall, bronchiectasis patients have high allergy rates to fungi and the common house dust mite. The study showed that 58% of bronchiectasis patients were sensitive to at least one allergen, compared to a group of patients with allergic rhinitis where 27% were sensitive.
Asst Prof Chotirmall, NTU Provost’s Chair in Molecular Medicine, said, “We have found that bronchiectasis is often associated with allergic reactions to fungi and to the house dust mite. There are already existing treatments for these allergies, for example, steroids are commonly used to treat fungal allergy. Our finding is important for improving the quality of life of those with bronchiectasis, as currently there are no licensed treatments for it.”
- Aogáin M et al. Distinct “Immunoallertypes” of disease and high frequencies of sensitization in non-cystic fibrosis bronchiectasis. Am J Resp Crit Care Med 2019;199(7):842.