The utility of antifungal agents for asthma.
OBJECTIVE
Recent work demonstrates that patients with refractory asthma are likely to be sensitized to environmental fungi and that specific antifungal treatments may be of benefit to this group.


RESULTS
The relationships among fungal sensitization, exposure and asthma severity are imperfectly understood. Exposure to environmental fungi occurs ubiquitously and there is emerging evidence that internal airways colonization could be a source of ongoing exposure. Antifungal treatments appear to improve asthma-related quality of life. Such treatments are generally well tolerated but there are potential side-effects. The mechanisms behind the clinical improvements are not yet fully established.


CONCLUSIONS
Antifungal treatments are used in some centres for patients with refractory asthma. Further research needs to explore the questions of patient selection, optimum duration of therapy and the prediction and management of azole-corticosteroid drug interactions. Advances in our understanding of the fungal molecular allergome and in our understanding of the allergic importance of small hyphal fragments may help to more precisely define the relationships among fungal sensitization, exposure and asthma severity.
Gore
Robin B
RB
The University of Manchester, Manchester Academic Health Science Centre, University Hospitals of South Manchester NHS Foundation Trust, Manchester, UK. robin.gore@manchester.ac.uk
D000935:Antifungal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000382:microbiology; D005658:Fungi / Q000472:pathogenicity; D006801:Humans; D012137:Respiratory System / Q000382:microbiology; D012720:Severity of Illness Index
D000935:Antifungal Agents