Impact of Aspergillus fumigatus allergen sensitivity on allergic rhinitis and asthma: a single center retrospective study

Introduction:
Aspergillus fumigatus (A.f) is a common aeroallergen that can cause diseases such as allergic asthma, allergic rhinitis, and allergic bronchopulmonary aspergillosis (ABPA).

Aim:
To investigate the clinical characteristics of patients with A.f sensitivity and allergic respiratory diseases in the Istanbul region of Turkey.

Material and methods:
Patients with allergic rhinitis and A.f sensitivity, and patients with allergic rhinitis and sensitivities other than A.f were included in the study. Comparisons were conducted between A.f sensitive and A.f non-sensitive patients in terms of severity of allergic asthma, severity of allergic rhinitis, rhinitis visual analogue symptom (VAS) symptom scores, asthma and allergic rhinitis treatment steps, asthma frequency and asthma control.

Results:
A total of 157 patients with allergic rhinitis were included in the study. The median (IQR) age of the patients was 33 (25–45), and 106 of them were female (67.5%). Severe asthma was more frequent in patients with A.f sensitivity than in patients with other allergen sensitivities (p < 0.001). Presence of A.f sensitivity was related to a lower asthma control score and higher asthma treatment step than presence of other allergen sensitivities (p = 0.029, p < 0.001, respectively). Additionally, VAS symptom scores for allergic rhinitis before and after treatment and allergic rhinitis medication scores were higher in patients with A.f sensitivity than in patients without A.f sensitivity (p < 0.001, p = 0.015, p > 0.001, respectively).

Conclusions:
A.f sensitivity is associated with severe respiratory allergies. Clinicians should closely monitor these patients and remain vigilant for treatment unresponsiveness, exacerbations, and the potential progression of the disease to more complex clinical conditions such as ABPA.