IgE-mediated sensitization to mould allergens among patients with allergic respiratory diseases in a desert environment.
BACKGROUND
The importance of fungal allergens in the development of allergic diseases in a desert environment is uncertain. This study evaluated the prevalence of IgE sensitization to moulds among patients with allergic respiratory diseases in Kuwait - a desert country.


METHODS
A total of 810 patients (male:female ratio 1.4) with a mean age of 32.3 years (range 2-76 years) with extrinsic asthma or allergic rhinitis were studied. Sera from the patients were tested by the CAP-RAST method for specific IgE to 6 fungi (Penicillium, Cladosporium, Aspergillus, Candida, Alternaria and Helminthosporium). For comparison house dust mite and Bermuda grass were also assessed.


RESULTS
The overall positivity to at least one mould was 20.9%. Among 120 matched control subjects, the value was 5. 8%. The value was much higher among patients with asthma alone (45. 8%) or both asthma and rhinitis (28.3%) than those with rhinitis alone (11.8%; p < 0.001). Asthmatic children had the highest sensitization rate (66.0% in the 7- to 12-year age group), which declined sharply with age. Among asthmatics, Candida and Aspergillus had the highest sensitization rates (23.1 and 21.3%, respectively), followed by Helminthosporium (18.8%), Cladosporium (15.9%), Alternaria (14.6%) and Penicillium (13.9%). The values for mite and Bermuda grass were 41.2 and 54.6%, respectively. Among asthmatic children, severe asthma was significantly more frequent among mould-positive (51.6%) than mould-negative patients (17.5%; p < 0. 0001).


CONCLUSIONS
Even in this desert environment, sensitization to moulds is quite common among patients with allergic respiratory diseases, with a striking preponderance among children with asthma. Mould allergy could also be an important factor determining asthma severity in this environment.
Ezeamuzie
C I
CI
Department of Pharmacology and Toxicology, Faculty of Medicine, Kuwait University, Kuwait. ezeamuzie@hsc.kuniv.edu.kw
Al-Ali
S
S
Khan
M
M
Hijazi
Z
Z
Dowaisan
A
A
Thomson
M S
MS
Georgi
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000276:immunology; D001249:Asthma / Q000150:complications* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003889:Desert Climate; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology / Q000276:immunology*; D007073:Immunoglobulin E / Q000097:blood*; D007730:Kuwait; D008297:Male; D008875:Middle Aged; D003904:Mitosporic Fungi / Q000276:immunology*; D011852:Radioallergosorbent Test; D012221:Rhinitis, Allergic, Perennial / Q000150:complications* / Q000276:immunology
D000485:Allergens; D007073:Immunoglobulin E