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Original Research: ASTHMA |

Specific IgE Response to Trichophyton and Asthma Severity

Hirofumi Matsuoka, MD; Akio Niimi, MD, PhD; Hisako Matsumoto, MD, PhD; Tetsuya Ueda, MD; Masaya Takemura, MD; Masafumi Yamaguchi, MD; Makiko Jinnai, MD; Kojiro Otsuka, MD; Tsuyoshi Oguma, MD; Tomoshi Takeda, MD; Isao Ito, MD, PhD; Kazuo Chin, MD, PhD; Ryoichi Amitani, MD, PhD; Michiaki Mishima, MD, PhD
Author and Funding Information

*From the Departments of Respiratory Medicine (Drs. Matsuoka, Niimi, Matsumoto, Ueda, Takemura, Yamaguchi, Jinnai, Otsuka, Oguma, Takeda, Ito, and Mishima) and Respiratory Care and Sleep Control Medicine (Dr. Chin), Graduate School of Medicine, Kyoto University, Kyoto, Japan; and the Department of Respiratory Medicine (Dr. Amitani), Osaka Red Cross Hospital, Osaka, Japan.

Correspondence to: Akio Niimi, MD, PhD, Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto 606-8507, Japan; e-mail: niimi@kuhp.kyoto-u.ac.jp


The authors have no conflicts of interest to disclose.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

For editorial comment see page 887


Chest. 2009;135(4):898-903. doi:10.1378/chest.08-1783
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Background:  Sensitization to Trichophyton, a major dermatophyte, has been associated with asthma. Whether such sensitization is generally associated with the severity of asthma, like other molds such as Alternaria, is unknown.

Methods:  We compared 258 patients with asthma, which was classified by severity as mild (n = 123), moderate (101), or severe (34), and 114 healthy control subjects, with regard to specific IgE titers against Trichophyton rubrum and other common allergens such as mixed molds, house-dust mite, cat dander, dog dander, Japanese cedar pollen, mixed Graminea pollens and mixed weed pollens.

Results:  Positive rate of Trichophyton-specific IgE was higher in the patients with moderate asthma (15.8%) than in the control subjects (7.0%, p = 0.04) and patients with mild asthma (4.9%, p < 0.006), and it was also higher in the patients with severe asthma (32.4%) than in control subjects (p = 0.0001), and patients with mild asthma (p < 0.0001) and moderate asthma (p = 0.04), but it did not differ between the control subjects and patients with mild asthma. The positive rates of mixed molds, cat dander, and dog dander were almost invariably higher in patients in all asthma subgroups than in the control subjects but did not differ among patients in the three asthma subgroups. The positive rates of other allergens were not different in all groups. Reanalysis of positive rate of Trichophyton-specific IgE after excluding 52 subjects with positive results for mixed molds showed a similar statistical trend to that of the original cohort. This may negate the potential effect of cross-reactivity to these molds. Multivariate analysis of asthma subgroups identified positive IgE results for Trichophyton as an independent determinant of asthma severity.

Conclusions:  Specific IgE response to Trichophyton may be associated with more severe asthma.

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