title: Aspergillus sensitisation in bidi smokers with and without chronic obstructive lung disease.
abstract: Recent studies have described fungal sensitisation in patients with chronic obstructive pulmonary disease (COPD). However, no study has evaluated fungal sensitisation specifically in bidi smokers. Herein, we evaluate the prevalence of Aspergillus sensitisation in bidi smokers. Bidi smokers with and without COPD underwent chest radiography, spirometry, Aspergillus skin test, A. fumigatus precipitins, A. fumigatus-specific IgE and total IgE. Aspergillus sensitisation was defined as the presence of either immediate cutaneous hyperreactivity to Aspergillus antigen or raised A. fumigatus-specific IgE level >0.35 kUA/L. Bidis were obtained from a subset of cases and controls and cultured for the growth of any fungus. Two hundred subjects with COPD and 72 chronic bidi smokers without COPD were included in the study (258 men; mean age, 56.8 years). Aspergillus sensitisation was found to be significantly higher in bidi smokers without COPD (27.8%) compared to the COPD cases (16%). Age, COPD, lung function, severity of smoking and current smoking were not associated with Aspergillus sensitisation, on a multivariate logistic regression analysis. We found a high prevalence of Aspergillus sensitisation in bidi-smoking subjects. More studies are required to confirm the findings of our study.
authors.affiliation: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Ritesh
authors.identifier: http://orcid.org/0000-0003-2547-7668
authors.initials: R
authors.lastname: Agarwal
authors.affiliation: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Sumita
authors.initials: S
authors.lastname: Bhogal
authors.affiliation: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Hansraj
authors.initials: H
authors.lastname: Choudhary
authors.affiliation: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Ashutosh N
authors.initials: AN
authors.lastname: Aggarwal
authors.affiliation: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Inderpaul S
authors.initials: IS
authors.lastname: Sehgal
authors.affiliation: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Sahajal
authors.initials: S
authors.lastname: Dhooria
authors.affiliation: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Digambar
authors.initials: D
authors.lastname: Behera
authors.affiliation: Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Arunaloke
authors.identifier: http://orcid.org/0000-0003-1555-3807
authors.initials: A
authors.lastname: Chakrabarti
mesh_terms: D000946:Antigens, Fungal / Q000097:blood / Q000276:immunology; D001230:Aspergillus / Q000276:immunology / Q000472:pathogenicity*; D001232:Aspergillus fumigatus / Q000276:immunology / Q000472:pathogenicity*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000382:microbiology*; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000382:microbiology*; D012882:Skin Tests; D012907:Smoking / Q000009:adverse effects*
chemical_list: D000946:Antigens, Fungal; D007073:Immunoglobulin E
keywords: 
  Aspergillus
  ; bidi; chronic obstructive pulmonary disease; fungal sensitisation; obstructive airway disease; tobacco smoking