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Where We Are Now: The Science of Severe Asthma Is Shifting A Research Update from the World Asthma Foundation




Something has shifted in the science of severe asthma.

Not overnight. Not with a single breakthrough. But through the accumulation of peer-reviewed evidence, molecular diagnostic technology, federal policy acknowledgment, and the persistent questions of patients who refused to accept symptom management as a final answer — the field is arriving at a conclusion that changes the way we need to think about one of medicine’s most undertreated populations.

For a significant subpopulation of severe asthma patients, the disease is not primarily inflammatory. It is microbial. And the tools to find it have existed for years — they simply haven’t been applied.

This post documents where that conversation stands in 2026 — and why the World Asthma Foundation believes it represents one of the most important unaddressed gaps in respiratory medicine.

The Subpopulation We Can’t Count

Severe asthma affects approximately 30 million people globally — roughly 10% of the 300 million living with asthma worldwide. Of those, peer-reviewed evidence documents that 15–17% are complete non-responders to biologic therapy, 43–69% are only partial responders, and only 14–24% achieve the kind of remission that biologics promise.

That means the majority of severe asthma patients on the most sophisticated treatments available are not getting better. And for a subset of those patients — the size of which we cannot currently estimate — the reason may not be that the treatment is inadequate. It may be that the diagnosis is incomplete.

The Microbiome — The Missing Variable

The lung was once considered a sterile organ. It is not.

Peer-reviewed research now documents that the lung has its own microbiome — a complex ecosystem of organisms that, when in balance, supports healthy respiratory function, and when disrupted, may drive disease in ways that standard diagnostics cannot see and standard treatments cannot reach.

What disrupts the lung microbiome:

  • Long-term corticosteroid use suppresses the adaptive immune response that normally keeps opportunistic bacteria in check — creating conditions for pathogenic organisms to establish and dominate
  • Antibiotic exposure selects for resistant organisms while eliminating susceptible ones, progressively narrowing the microbial diversity that supports immune health
  • Gut microbiome disruption — through H. pylori eradication, antibiotic courses, diet, and environmental factors — alters the gut-lung immune axis in ways that affect respiratory microbiome composition over years and decades

The result, in a vulnerable subpopulation, is a lung ecosystem dominated by organisms that standard cultures cannot identify, that standard treatments cannot reach, and that standard diagnostics were never designed to find.

The Diagnostic Gap — Why We Can’t See What We’re Missing

Standard severe asthma diagnostics in 2026 rely primarily on spirometry, blood eosinophil counts, IgE levels, sputum cytology, and standard bacterial culture. These tools were designed to characterize the Type 2 inflammatory endotype. They are largely blind to the microbial endotype.

Molecular diagnostic sequencing — metagenomics, DNA-level analysis of bronchoscopic samples — can identify what is actually living in the lung with a precision that standard cultures cannot approach. This technology exists now. It is not experimental. It is not prohibitively expensive relative to the cost of years of failed biologic therapy. It is simply not part of the standard diagnostic algorithm for severe asthma.

That is the gap. And it is costing patients — in quality of life, in progressive disease burden, and in decades of misdirected treatment.

The Steroid Trap — When Treatment Compounds the Problem

This is the most uncomfortable finding in the current literature — and the one the severe asthma community most needs to confront.

Long-term corticosteroids suppress airway inflammation effectively. They also suppress the very immune mechanisms that would normally control bacterial colonization in the lung. The research is now explicit: steroid use is a documented risk factor for gut and lung microbiota disruption.

In a patient with an already-compromised lung ecosystem, long-term corticosteroids may be creating the conditions that allow opportunistic, drug-resistant organisms to establish dominance — while the treatment that finds and addresses those organisms is never ordered.

The treatment suppresses the symptom. The organism advances. This is not a reason to stop corticosteroid therapy. It is a reason to investigate the microbiome in every patient who requires long-term corticosteroid use.

The Gut-Lung Axis — The Origin Story That Goes Back Further

One of the most consequential findings in recent asthma research is the documented relationship between gut microbiome disruption and respiratory disease. The gut and lung are immunologically connected. Disruption of the gut microbiome — through antibiotic exposure, H. pylori eradication, dietary changes, or environmental factors — alters the systemic immune environment in ways that affect respiratory health over years and decades.

Research currently underway at the University of Kentucky — funded by the Global Lyme Alliance — is examining precisely this mechanism: how infection and antibiotic treatment disrupt the gut microbiome and weaken the intestinal barrier, driving systemic inflammation throughout the body. The implications for severe asthma patients with repeated antibiotic exposure or a history of H. pylori eradication are significant.

The origin of a patient’s severe asthma may not begin in the lung. It may begin in the gut — years or decades before the first wheeze.

The Polymicrobial Question — Beyond Single-Organism Thinking

Emerging research suggests that the microbial component of treatment-resistant asthma may not be a single-organism problem. Published evidence documents that immunosuppressed patients with respiratory bacterial colonization frequently carry co-existing organisms — bacterial, viral, and fungal — that interact with each other and with the host immune system in ways that single-organism treatment approaches cannot address.

For the patient who has failed multiple biologic therapies and whose disease continues to progress, a comprehensive polymicrobial assessment — molecular sequencing of bronchoalveolar lavage fluid, viral reactivation panels, gut microbiome profiling — may be the diagnostic step that changes everything.

The Neurological Dimension — When the Lung Isn’t the Limit

When systemic inflammation driven by an unidentified microbial burden is suppressed but not resolved, the consequences can extend beyond the respiratory system. Peer-reviewed research documents the gut-brain axis, the relationship between microbial dysbiosis and mast cell activation syndrome, and published cases of Small Fiber Neuropathy driven by infectious burden that resolved with targeted treatment.

For severe asthma patients with unexplained neurological symptoms — neuropathy, autonomic dysfunction, cognitive changes — the question of whether an undetected microbial burden is contributing deserves formal investigation. The lung may be where the disease presents. The microbiome may be where it lives.

What We Are Calling For

For patients with treatment-resistant severe asthma: Ask for molecular diagnostic sequencing before accepting that your disease is simply “refractory.” Ask specifically: “Has my lung microbiome been assessed by molecular sequencing?”

For pulmonologists: A bifurcated biologic response — improvement in one domain, none in others — is a diagnostic signal pointing toward an independent disease axis. Molecular diagnostics of bronchoalveolar lavage fluid should be considered in patients who have failed multiple biologic therapies.

For researchers: The microbial endotype of severe asthma needs its own epidemiological definition and research program. We do not know how many patients fall into this category. That is an unacceptable gap in 2026.

For diagnostic standards bodies: Molecular sequencing must be incorporated into the diagnostic pathway for severe asthma patients who fail conventional therapy. The technology exists. The evidence base is building.

For policymakers: Reimbursement for molecular diagnostic sequencing in treatment-resistant severe asthma is a health equity issue. The patients who most need better diagnostics are often those with the fewest resources to advocate for them.

What We Will Be Exploring Next

Over the coming months the World Asthma Foundation will publish a series examining these questions in depth:

  • The Origin Story — How gut microbiome disruption initiates the cascade that drives treatment-resistant asthma
  • The Microbial Endotype — What molecular diagnostics are finding in the lungs of patients who have failed standard care
  • The Polymicrobial Dimension — When the problem isn’t one organism but an ecosystem
  • The Neurological Connection — When untreated microbial burden extends beyond the lung
  • The Patient Roadmap — How to advocate for molecular diagnostics and navigate a specialist system that sees organs rather than patients

The observations in this post are informed by peer-reviewed literature, ongoing research programs at leading academic institutions, and the clinical experience of patients navigating treatment-resistant severe asthma. They represent the World Asthma Foundation’s current research-informed perspective — not clinical recommendations. Patients should discuss diagnostic and treatment decisions with their physicians.

World Asthma Foundation | worldasthmafoundation.org | worldasthmaday.org | May 2026

Subscribe to our newsletter for updates as this research series develops.


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Indoor Chemical Exposure: What the Public, Clinicians and Contractors Need to Know


What You Can’t See and Smell Can Harm: Protecting Others from Indoor Toxins

From: World Asthma Foundation
To: Clinicians, Nurses, Contractors, Project Managers, Painters, and DIY Home Improvers
Subject: Recognizing and Mitigating Risks of Chemical Odors and VOCs for Pregnant Women, and Individuals with Asthma

Bill Cullifer, Founder
Bill Cullifer, Founder

A Personal Note from Our Founder
I’m not just the founder of the World Asthma Foundation — I’m also a severe asthmatic, highly sensitive to chemicals, perfumes, and dyes. I require monthly biologic injections and have been on prednisone for 15 years.

Recently, I visited my daughter, who is six months pregnant. That same day, a painter was applying lacquered paint to a custom wood project in the entryway of her home.

She intuitively knew to stay outside for her safety but had questions and concerns regarding the fumes. I spoke with the painting contractor and asked if he could work with me on switching out the lacquer to a less offensive paint. He responded professionally, switching to a low-VOC, water-based paint product for the remainder of the project. My daughter spoke with the general contractor and he agreed as well.

I stayed outside the remainder of the day to supervise and returned over the next two days to help ventilate the home along with her husband. A day later, we cleaned all counter surfaces and vacuumed and wiped off the shutters, taking every possible precaution to eliminate the VOCs.

What Are VOCs and How Do They Work?
Volatile Organic Compounds (VOCs) are chemicals that easily evaporate into the air at room temperature. Many are found in paints, varnishes, cleaning products, adhesives, and building materials. Once airborne, they can enter the lungs, irritate the respiratory tract, and affect the nervous system, immune response, and more.

VOCs off-gas over time, meaning even after the initial odor fades, chemical residues may remain active — which is why sensitive individuals like pregnant women and asthmatics may still experience symptoms.

Despite all cleaning efforts, while I could no longer detect any chemical odor, my daughter still could — and she was right to be concerned. The odor triggered discomfort and unease. This isn’t just about sensitivity — it’s about biology.

I’ll be honest — I didn’t think it was that bad. I spent the afternoon wiping down counters, vacuuming floors, and washing bedding. But when my daughter told me she still found the smell strong, I took pause. That moment made me dig into the science — and what I found was eye-opening.

I learned something too. Pregnant women, children, and people with asthma often sense what others don’t. It’s science, and now we know. Knowledge is power.

If in doubt, err on the side of caution. Vacate if feasible. It’s the smarter thing to do.

For those who are pregnant: trust your instincts. Your body is often the best guide.
For doctors: listen to your patients. They often know when something is wrong.
The same goes for everyone else — just because you can’t smell it doesn’t mean it doesn’t exist.

The Science: Vulnerable Populations Are at Greater Risk
Pregnant Women: During pregnancy, hormonal changes — especially elevated estrogen and hCG — can increase olfactory sensitivity. Pregnant women may detect chemical odors at levels undetectable to others.

This is not just anecdotal: exposure to volatile organic compounds (VOCs) during pregnancy has been linked to adverse outcomes, including low birth weight and developmental delays in children.

Reference: Olfaction in Pregnancy: Systematic Review and Meta-analysis. Chem Senses. 2022;47:bjac035. [PMCID: PMC9780746]

Exposure to VOCs and pollutants like nitrogen dioxide (NO?) and PM2.5 has been linked to:

  • Increased risk of asthma and respiratory diseases
  • Cognitive and neurodevelopmental delays, including ADHD and autism spectrum disorders
  • Higher incidence of childhood leukemia linked to VOC exposure

Why Clinicians Must Listen and Act
Healthcare professionals are often the first line of defense. When patients — especially those from vulnerable populations — report symptoms related to indoor chemical exposures, it is critical to:

  • Validate their concerns and symptoms
  • Recommend immediate mitigation, including ventilation, product replacement, or temporary relocation
  • Educate patients about the risks associated with indoor air pollutants and VOCs

For Contractors, Painters, and DIY Enthusiasts: Protect Others — and Yourself
Using chemical products in indoor environments carries serious health implications — for clients and for you. Transparent communication and safe practices are essential, not optional.

Recommendations:

  • Inform Occupants: Share details about the products being used, possible health impacts, and how long odors/off-gassing may last
  • Implement Safety Measures: Seal off work areas, ventilate thoroughly, and avoid working while vulnerable individuals are present
  • Stay Informed: Learn about safer alternatives and industry best practices for indoor air quality
  • Use Zero-VOC Products: Choose certified zero-VOC paints, finishes, and adhesives whenever possible

Expert Insight
“Many products, even those labeled as ‘green’ or ‘organic’, emit hazardous air pollutants, including carcinogens. Transparency and caution are paramount when introducing chemicals into indoor environments.” — Dr. Anne C. Steinemann, Environmental Engineer and Indoor Air Quality Expert

Our Commitment
The World Asthma Foundation is dedicated to raising awareness about the health risks associated with indoor air pollutants. We serve healthcare professionals, policymakers, contractors, and the public with education, resources, and advocacy to protect those most at risk.

Together, we can create safer indoor environments for everyone.

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World Asthma Day 2025: Reframing Severe Asthma – From Root Causes to Real-World Solutions

May 6, 2025 – The World Asthma Foundation (WAF) is proud to announce a major new initiative on World Asthma Day aimed at transforming how we understand and manage severe asthma — a condition that continues to affect millions and defy conventional treatment.

Titled “Reframing Severe Asthma: From Ro,” this ongoing series will dig deep into the science and patient experience of severe asthma, exploring overlooked contributors and practical, cost-effective strategies for care. This initiative builds on WAF’s continuing collaboration with leading experts, including Dr. David Corry of Baylor College of Medicine, whose pioneering research into airway mycosis is helping redefine what drives severe asthma in many patients.

New Interview Available Now As part of this launch, WAF is proud to release a new in-depth interview with Dr. Corry, offering fresh insights into how fungal infections in the airways may contribute to severe asthma and how this condition can be diagnosed and treated. Watch or read the interview here: Breaking New Ground in Airway Mycosis: Insights from Dr. David Corry

“We believe the time has come to stop treating symptoms alone and start asking deeper, root cause, questions about what’s really causing severe asthma—and how we can affordably and effectively address them,” said David B. Corry, M.D., Professor of Medicine-Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, US.

But the scope goes well beyond fungi. The series will also examine:

  • Bacterial influences in asthma, including Streptococcus pseudopneumoniae and airway microbiome disruption
  • Mast cell activation and its role in chronic inflammation and systemic symptoms
  • Genetic predisposition (e.g., ADAM33) and airway remodeling
  • Environmental and chemical sensitivities increasingly reported by severe asthma sufferers

WAF’s Reframing Severe Asthma series will feature:

  • In-depth interviews and commentary from thought leaders
  • Patient stories and clinical case insights
  • Roundtable discussions and virtual events
  • A final White Paper and Action Plan for clinicians, researchers, and policymakers

Join Us This World Asthma Day, we invite clinicians, scientists, patients, and advocates to come together and reframe the conversation around severe asthma. Let’s work toward a future where treatment addresses not just symptoms, but causes — and where no patient is left behind.

Sign up today. Its FREE.

Follow along on Facebook and on X.

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Breaking New Ground in Airway Mycosis: Insights from Dr. David Corry

The World Asthma Foundation’s symposium continues to shed light on airway mycosis, an often-overlooked factor in severe asthma. On Day 2, Dr. David Corry delivered a compelling presentation that delved into the latest research, diagnostic challenges, and potential treatment strategies for fungal-related lung diseases.

Why Airway Mycosis Matters

Airway mycosis refers to fungal infections and colonization in the respiratory tract, which can significantly impact asthma severity and overall lung health. Despite its potential to worsen symptoms, increase hospitalizations, and complicate treatment, it remains underdiagnosed due to limited awareness and inadequate testing methods

.

Dr. Corry’s research highlights the growing recognition of fungi as key players in respiratory diseases, emphasizing the need for more precise detection, treatment, and management strategies.

Advancing Diagnostics: A Game-Changer

One of the most pressing issues in diagnosing airway mycosis is the lack of standardized testing protocols. Dr. Corry introduced an open-source, cost-effective culturing technique that has the potential to revolutionize fungal detection. Unlike traditional methods that often fail to identify the presence of fungi, his approach allows for more accurate and reliable diagnosis.

However, regulatory hurdles remain a challenge. While these new diagnostic techniques are promising, widespread clinical adoption requires changes in how fungal infections are perceived and tested in mainstream medicine.

The Way Forward: Solutions for a Neglected Condition

Dr. Corry’s insights highlight several critical steps needed to improve outcomes for patients suffering from airway mycosis:

  • Raising Awareness – Educating healthcare providers and the public about fungal-related lung diseases can lead to earlier diagnosis and better treatment strategies. The World Asthma Foundation symposium is playing a key role in fostering this conversation.
  • Enhanced Diagnostics – With improved culturing techniques and new testing protocols, diagnosing airway mycosis can become more accessible and reliable. However, regulatory bodies must be open to adopting these innovations.
  • Investment in Research – There is an urgent need for more research into the mechanisms, risk factors, and treatment options for airway mycosis. The symposium serves as a catalyst for collaboration among researchers, clinicians, and industry leaders.

Conclusion

Airway mycosis represents a hidden yet significant burden on patients and healthcare systems. Dr. Corry’s presentation underscores the urgency of better diagnostics, increased research, and enhanced clinical awareness to tackle this neglected issue.

By advocating for change, supporting innovative research, and fostering global collaboration, the World Asthma Foundation is leading the charge in addressing airway mycosis.

Stay tuned for more insights from the symposium as we continue to explore the evolving landscape of asthma and respiratory health.

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Welcome to the World Asthma Foundation Symposium

Unveiling the Role of Fungi in Severe Asthma

We’re honored to have you join us for this important event, where we explore the emerging role of fungi in severe asthma. Airway mycosis—a condition in which fungi colonize the lungs and contribute to asthma exacerbations—is an underrecognized but critical factor in the treatment of severe and steroid-resistant asthma.

While traditional asthma care focuses on allergens, bacteria, and inflammation, fungal infections are often overlooked in both diagnosis and treatment

Today, we will explore cutting-edge research, diagnostic advancements, and treatment strategies that may help improve outcomes for patients who struggle with chronic and severe asthma.

Unveiling the Role of Fungi in Severe Asthma

We’re honored to have you join us for this important event, where we explore the emerging role of fungi in severe asthma. Airway mycosis—a condition in which fungi colonize the lungs and contribute to asthma exacerbations—is an underrecognized but critical factor in the treatment of severe and steroid-resistant asthma. While traditional asthma care focuses on allergens, bacteria, and inflammation, fungal infections are often overlooked in both diagnosis and treatment.

Today, we will explore cutting-edge research, diagnostic advancements, and treatment strategies that may help improve outcomes for patients who struggle with chronic and severe asthma.

Understanding Airway Mycosis and Its Impact on Severe Asthma.

Asthma is a complex disease influenced by multiple factors, including allergens, pollution, and infections. However, an emerging area of research suggests that fungi may play a significant role in severe and treatment-resistant asthma. This condition, known as airway mycosis, involves fungal colonization in the airways, which can worsen inflammation, increase airway remodeling, and reduce treatment effectiveness. Despite its potential impact, airway mycosis remains underdiagnosed and misunderstood in clinical practice.

Patients often experience persistent wheezing, lung function decline, and steroid-resistant symptoms, yet standard diagnostic tools frequently overlook the role of fungi.

Recognizing fungal involvement in asthma could transform treatment approaches and improve outcomes for many patients.

The Hidden Connection Between Fungi and Asthma

Fungi can colonize the respiratory tract, triggering an immune response that exacerbates asthma symptoms. Some of the most commonly implicated fungi include: Aspergillus – A mold found in indoor and outdoor environments, linked to allergic reactions and lung inflammation Candida – A common fungal species that may contribute to chronic airway irritation and immune dysregulation

Other opportunistic fungi – Including species that thrive in damp environments and may worsen respiratory conditions

Why Is Airway Mycosis Often Misdiagnosed?

Despite mounting evidence, fungal involvement in asthma is often overlooked due to: Symptom overlap – Many signs of fungal-driven asthma mimic bacterial infections, allergies, or chronic bronchitis Lack of routine fungal testing – Most diagnostic protocols focus on bacteria and viruses, missing fungal colonization Limited clinical awareness – Many physicians are not yet trained to recognize fungal contributions to asthma Advancements in Diagnosis and Treatment New research is uncovering better ways to identify and treat airway mycosis, including: Molecular and serological testing – Advanced diagnostics can detect fungal DNA and immune markers linked to fungal colonization Antifungal therapies – Studies suggest that certain antifungal medications may improve symptoms in patients with fungal-associated asthma Personalized treatment approaches – Combining traditional asthma management with targeted antifungal strategies could improve patient outcomes Understanding the connection between fungi and asthma could pave the way for innovative treatment options. As research progresses, integrating fungal diagnostics into routine asthma care may help identify patients who can benefit from antifungal interventions, ultimately improving quality of life for those with severe asthma.

What’s Next?

Stay tuned for tomorrow’s in-depth interview with Dr. David Corry, where he shares groundbreaking insights into the evolving understanding of airway mycosis and its impact on severe asthma.

Thank you for being part of this critical conversation. Let’s work together to advance awareness, diagnostics, and treatment for severe asthma sufferers worldwide!

World Asthma Foundation Breathe Well, Live Well

Further Reading:

Could Fungi Be Playing a Hidden Role in Your Asthma?

Understanding Airway Mycoses

If you live with asthma, you’re likely very familiar with triggers like pollen, dust mites, and exercise. But have you ever considered the potential role of fungi in your respiratory health? While often overlooked, a growing body of evidence suggests that these microscopic organisms could be contributing to asthma symptoms and exacerbations.

This post is inspired by recent scientific discussions highlighting the increasing importance of respiratory mycoses – fungal involvement in the airways. It’s a topic that deserves more attention within the asthma community, and we want to shed some light on it.

What are Airway Mycoses?

You might be surprised to learn that the air around us contains millions of different types of fungi. While most of these are harmless, some can interact with our respiratory system in various ways.

This interaction, when it leads to sensitization, inflammation, or even infection, is broadly termed respiratory mycosis. As the scientific article we’re referencing points out, factors like medical progress and changes in our environment have led to more people becoming susceptible to fungal-related issues in their lungs.

How Might Fungi Affect People with Asthma?

The connection between fungi and asthma isn’t always straightforward, but here are some key ways they might interact: Fungal Sensitization: Just like you can be allergic to pollen, you can also develop sensitivities to certain airborne fungi. When you inhale these fungal spores, your immune system might overreact, leading to asthma symptoms like wheezing, coughing, and shortness of breath.

This sensitization can be a significant trigger for some individuals with asthma. Exacerbations: For those already living with asthma, fungal sensitization can contribute to more frequent or severe asthma attacks (exacerbations). The inflammatory response triggered by fungi can worsen existing airway inflammation.

Chronic Lung Conditions:

While the article also discusses more serious fungal infections, it’s important for the asthma community to be aware that in some cases, chronic exposure and reaction to fungi can contribute to the complexity of chronic lung conditions.

The Impact of Viral Infections: Interestingly, the article highlights that fungal infections can become more relevant after viral infections like the flu or even COVID-19. This underscores the importance of paying attention to respiratory symptoms even after recovering from a virus.

Why Haven’t I Heard Much About This?

The article we’re discussing points out that research into fungal diseases, especially those affecting the respiratory system, has historically received less funding compared to bacterial or viral infections. This means there are still knowledge gaps and that diagnostic tools and awareness are still developing in this area.

What Can You Do?

While more research is needed, being informed is the first step. Here are some things to consider:

Be Aware of Your Environment: Pay attention to environments that might have higher levels of mold or fungi, such as damp areas indoors or decaying vegetation outdoors.

Discuss Persistent Symptoms with Your Doctor: If you experience persistent or worsening asthma symptoms, especially if they seem linked to certain environments, discuss the possibility of fungal involvement with your doctor.

Stay Informed:

As research in this area progresses, more information and better diagnostic tools will likely become available. Stay updated through reputable sources and discussions with your healthcare team.

Looking Ahead:

The scientific community is increasingly recognizing the importance of respiratory mycoses. This awareness is crucial for improving our understanding of complex respiratory conditions like asthma.

By recognizing the potential role of fungi, we can work towards more comprehensive approaches to diagnosis, management, and ultimately, better respiratory health for everyone living with asthma.

This is just an introduction to a complex topic, but we hope it sparks important conversations with your healthcare providers and encourages further learning within the asthma community.

Addtional Review

Understanding Airway Mycosis and Its Impact on Severe Asthma.

Asthma is a complex disease influenced by multiple factors, including allergens, pollution, and infections.

However, an emerging area of research suggests that fungi may play a significant role in severe and treatment-resistant asthma. This condition, known as airway mycosis, involves fungal colonization in the airways, which can worsen inflammation, increase airway remodeling, and reduce treatment effectiveness.

Despite its potential impact, airway mycosis remains underdiagnosed and misunderstood in clinical practice. Patients often experience persistent wheezing, lung function decline, and steroid-resistant symptoms, yet standard diagnostic tools frequently overlook the role of fungi.

Recognizing fungal involvement in asthma could transform treatment approaches and improve outcomes for many patients.

The Hidden Connection Between Fungi and Asthma

Fungi can colonize the respiratory tract, triggering an immune response that exacerbates asthma symptoms. Some of the most commonly implicated fungi include: Aspergillus – A mold found in indoor and outdoor environments, linked to allergic reactions and lung inflammation Candida – A common fungal species that may contribute to chronic airway irritation and immune dysregulation.

Other opportunistic fungi – Including species that thrive in damp environments and may worsen respiratory conditions

Why Is Airway Mycosis Often Misdiagnosed?

Despite mounting evidence, fungal involvement in asthma is often overlooked due to: Symptom overlap – Many signs of fungal-driven asthma mimic bacterial infections, allergies, or chronic bronchitis

Lack of routine fungal testing – Most diagnostic protocols focus on bacteria and viruses, missing fungal colonization Limited clinical awareness – Many physicians are not yet trained to recognize fungal contributions to asthma

Advancements in Diagnosis and Treatment New research is uncovering better ways to identify and treat airway mycosis, including: Molecular and serological testing – Advanced diagnostics can detect fungal DNA and immune markers linked to fungal colonization Antifungal therapies – Studies suggest that certain antifungal medications may improve symptoms in patients with fungal-associated asthma

Personalized treatment approaches – Combining traditional asthma management with targeted antifungal strategies could improve patient outcomes Understanding the connection between fungi and asthma could pave the way for innovative treatment options.

As research progresses, integrating fungal diagnostics into routine asthma care may help identify patients who can benefit from antifungal interventions, ultimately improving quality of life for those with severe asthma.

What’s Next?

Stay tuned for tomorrow’s in-depth interview with Dr. David Corry, where he shares groundbreaking insights into the evolving understanding of airway mycosis and its impact on severe asthma. Thank you for being part of this critical conversation. Let’s work together to advance awareness, diagnostics, and treatment for severe asthma sufferers worldwide! World Asthma Foundation Breathe Well, Live Wel. Ml look

Could Fungi Be Playing a Hidden Role in Your Asthma?

Understanding Airway Mycoses If you live with asthma, you’re likely very familiar with triggers like pollen, dust mites, and exercise. But have you ever considered the potential role of fungi in your respiratory health? While often overlooked, a growing body of evidence suggests that these microscopic organisms could be contributing to asthma symptoms and exacerbations.

This post is inspired by recent scientific discussions highlighting the increasing importance of respiratory mycoses – fungal involvement in the airways. It’s a topic that deserves more attention within the asthma community, and we want to shed some light on it.

What are Airway Mycoses?

You might be surprised to learn that the air around us contains millions of different types of fungi. While most of these are harmless, some can interact with our respiratory system in various ways.

This interaction, when it leads to sensitization, inflammation, or even infection, is broadly termed respiratory mycosis. As the scientific article we’re referencing points out, factors like medical progress and changes in our environment have led to more people becoming susceptible to fungal-related issues in their lungs.

How Might Fungi Affect People with Asthma?

The connection between fungi and asthma isn’t always straightforward, but here are some key ways they might interact: Fungal Sensitization: Just like you can be allergic to pollen, you can also develop sensitivities to certain airborne fungi.

When you inhale these fungal spores, your immune system might overreact, leading to asthma symptoms like wheezing, coughing, and shortness of breath. This sensitization can be a significant trigger for some individuals with asthma. Exacerbations: For those already living with asthma, fungal sensitization can contribute to more frequent or severe asthma attacks (exacerbations). The inflammatory response triggered by fungi can worsen existing airway inflammation. Nnnjn,Chronic Lung Conditions: While the article also discusses more serious fungal infections, it’s important for the asthma community to be aware that in some cases, chronic exposure and reaction to fungi can contribute to the complexity of chronic lung conditions.

The Impact of Viral Infections: Interestingly, the article highlights that fungal infections can become more relevant after viral infections like the flu or even COVID-19. This underscores the importance of paying attention to respiratory symptoms even after recovering from a virus.

Why Haven’t I Heard Much About This?

The article we’re discussing points out that research into fungal diseases, especially those affecting the respiratory system, has historically received less funding compared to bacterial or viral infections. This means there are still knowledge gaps and that diagnostic tools and awareness are still developing in this area.

What Can You Do?

While more research is needed, being informed is the first step. Here are some things to consider: Be Aware of Your Environment: Pay attention to environments that might have higher levels of mold or fungi, such as damp areas indoors or decaying vegetation outdoors. Discuss Persistent Symptoms with Your Doctor: If you experience persistent or worsening asthma symptoms, especially if they seem linked to certain environments, discuss the possibility of fungal involvement with your doctor.

Stay Informed: As research in this area progresses, more information and better diagnostic tools will likely become available. Stay updated through reputable sources and discussions with your healthcare team.

Looking Ahead:

The scientific community is increasingly recognizing the importance of respiratory mycoses. This awareness is crucial for improving our understanding of complex respiratory conditions like asthma.

By recognizing the potential role of fungi, we can work towards more comprehensive approaches to diagnosis, management, and ultimately, better respiratory health for everyone living with asthma. This is just an introduction to a complex topic, but we hope it sparks important conversations with your healthcare providers and encourages further learning within the asthma community.

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Meet the Fungi: “Unveiling the Mysteries of Airway Mycosis” Symposium

Underwritten by the World Asthma Foundation

Introduction

Millions of severe asthma sufferers are searching for answers, often unaware that airway mycosis—a hidden fungal infection—could be the underlying cause of their chronic respiratory problems. April 5-6, 2025 the World Asthma Foundation is hosting a groundbreaking symposium to explore this critical issue, bringing together experts to shed light on the latest research and treatment strategies.

Call to Action

Cost: FREE. Registration is required.

David B. Corry, MD. Medicine-Immunology, Allergy and Rheumatology, Baylor College of Medicine

The World Asthma Foundation (WAF), in collaboration with Dr. David Corry, a renowned airway mycosis and severe Asthma specialist at Baylor University, is committed to raising awareness about this critical issue and the underlying mechanisms of severe asthma. 

To address this knowledge gap and improve patient outcomes, WAF is hosting an online symposium April 5-6, 2025. This blog post lays the groundwork for the event, which will bring together experts to discuss diagnosing and managing airway mycosis in severe Asthma patients.

By fostering collaboration, the symposium aims to unveil the hidden mechanisms of fungal asthma,  including the root fungal cause and empower better understanding and treatment options for patients with severe asthma.

Burden of Airway Mycosis

Misdiagnosis and Underdiagnosis: Airway mycosis often mimics other respiratory illnesses and is difficult to diagnose using standard methods, leading to misdiagnosis and delayed treatment. This can worsen symptoms and hinder overall patient outcomes.

Chronic Illness and Suffering: Airway mycosis can cause debilitating symptoms like chronic cough, wheezing, shortness of breath, and chest pain. It significantly reduces patients’ quality of life.

Economic Costs: The economic burden of airway mycosis is substantial. Direct medical costs associated with treatment and hospitalization are high. Additionally, indirect costs due to lost productivity are significant.

Challenges and Gaps in Knowledge

Incomplete Understanding of Causes: Dr. Corry’s research emphasizes the need for further investigation into the exact mechanisms by which fungi contribute to airway diseases. The complex interplay between fungal exposure, immune response, and airway inflammation remains unclear.

Mechanisms of fungal asthma are incompletely understood. Research into how fungi cause asthma has improved with the discovery of virulence factors such as proteases and candidalysin, but this has yet to translate into new therapies. Newer antifungal agents such as peptoids and many others hold great promise for better management of airway mycosis.

Limited Diagnostic Tools: Current diagnostic methods for airway mycosis are often insensitive and lack specificity. This makes timely and accurate diagnosis difficult.

Silos in Treatment Approaches: A fragmented approach often exists in managing airway mycosis. Improved collaboration between pulmonologists, allergists, immunologists, and infectious disease specialists is essential.

The Way Forward

Raising Awareness: Increased awareness among healthcare professionals and the public is crucial for earlier diagnosis and improved treatment outcomes. The WAF symposium directly addresses this need.

Enhanced Diagnostics: Dr. Corry’s work on culturing techniques offers promise for improved fungal detection. Development of more accurate and specific diagnostic tools remains essential for proper diagnosis of airway mycosis. These methods are open source and inexpensive; the main hindrance is regulatory acceptance of new protocols.

Investment in Research: Further research is required to elucidate the underlying causes of airway mycosis, identify new treatment options, and improve patient management strategies. The World Asthma Foundation symposium can serve as a catalyst for such research collaborations.

Conclusion

Airway mycosis poses a significant but under-recognized burden on patients and healthcare systems. By raising awareness, improving diagnostics, fostering collaboration, and investing in research, we can effectively address the challenges of this complex disease. The World Asthma Foundation symposium serves as a springboard for this critical work.

Register click here

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How Common Bacteria Evade the Immune System and Cause Persistent Illness

Haemophilus influenzae

Researchers at The University of Queensland have discovered a new way a common bacterium, Haemophilus influenzae, can manipulate the human immune system to survive and cause persistent respiratory infections. This finding could lead to the development of new treatments for these illnesses.

Key Takeaways:

 * Haemophilus influenzae can turn off the immune system’s response in human respiratory tissues.

 * This allows the bacteria to persist and cause chronic infections.

 * Researchers are looking into developing new treatments that can help the immune system recognize and eliminate the bacteria.

Why This Matters:

This discovery is important because it sheds light on how some bacterial infections become chronic. It could also lead to the development of new treatments for these infections, which can be especially harmful to vulnerable populations like young children, the elderly, and people with cystic fibrosis or asthma.

Implications for Asthmatics:

People with asthma are one of the groups particularly susceptible to worse symptoms from Haemophilus influenzae infections. This is because the bacteria’s ability to suppress the immune system can worsen existing inflammation in the airways. New treatments that target this bacteria could be helpful in preventing asthma flare-ups caused by Haemophilus influenzae.

Conclusion:

The discovery of Haemophilus influenzae’s immune-suppressing abilities paves the way for new treatment strategies for persistent respiratory infections. These treatments could be especially beneficial for vulnerable populations who are more likely to experience complications from such infections.

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Asthma News: Your Weekly Dose of Asthma Information

Welcome to Asthma News!

Asthma affects millions of people worldwide, disrupting daily life and causing significant distress. At the World Asthma Foundation, our mission is to improve the lives of those living with asthma by providing support, education, and advocating for better care. This blog is your go-to resource for the latest news, research, and practical advice on managing asthma.

Here, you’ll find a wealth of information tailored to your needs. From groundbreaking research studies to expert-led Q&A sessions, we’re committed to keeping you informed about the latest advancements in asthma treatment and management. We’ll share inspiring stories from the asthma community, offer practical tips for living well with asthma, and provide guidance on navigating the healthcare system.

Our goal is to empower you to take control of your asthma and live life to the fullest. We invite you to join our community by subscribing to this blog and sharing your experiences with us. Together, we can make a difference in the lives of people with asthma.
In the coming weeks, we’ll delve into a variety of topics, including:

  • Research highlights: Discover the latest breakthroughs in asthma research and their potential impact on treatment.
  • Treatment and management tips: Learn practical strategies for managing your asthma symptoms and preventing flare-ups.
  • Asthma-friendly lifestyle: Explore tips for incorporating healthy habits into your daily routine.
  • Advocacy and support: Learn about the World Asthma Foundation’s efforts to improve the lives of people with asthma.We’re excited to embark on this journey with you. Stay tuned for our next post, where we’ll dive deeper into a specific aspect of asthma management.
    What would you like to focus on for the next blog post?
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How Fungi Can Make Asthma Worse and What to Do About It

Hello, dear members and subscribers of the World Asthma Foundation! We hope you are doing well and breathing easy. In this post, we are going to share with you some news about our Defeating Asthma initiative and our continuing series on Severe Asthma.

As you may know, the World Asthma Foundation is a community-based non profit that aims to raise awareness, provide education and support, and advocate for better care and treatment for people living with Asthma. We believe that everyone deserves to breathe freely and enjoy life without the burden of Asthma.

One of our main goals is to shed light on the different types of asthma and how they affect people differently. As most of you already know, Asthma is not a one-size-fits-all condition. It has many subtypes or phenotypes and some yet to be discovered that have different causes, triggers, symptoms, and responses to treatment. Understanding your Asthma phenotype can help you and your doctor find the best management plan for you.

That’s why we continue our focus on Severe Asthma, a challenging form of Asthma that affects about 5-10% of people with Asthma and consumes 80 % of the dollars to treat. Severe Asthma is often difficult to control with standard medications and can have a significant impact on your quality of life, health, and well-being.

One of the possible factors that can contribute to severe asthma is fungi. Fungi are microscopic organisms that are found everywhere in the environment. They can grow on plants, animals, soil, water, food, or indoor surfaces. Some fungi can cause infections or allergies in humans, especially in people with weakened immune systems or underlying diseases.

  • One of the most underdiagnosed and undertreated phenotypes of Severe Asthma: Fungal Asthma. 
  • Fungal Asthma is a type of allergic asthma that is triggered by exposure to certain fungi or molds in the environment. 
  • Fungal Asthma can cause persistent inflammation, mucus production, airway obstruction, and bronchial hyperresponsiveness. 
  • Fungi can Initiate Severe Autoimmune Diseases
  • Fungal Asthma can be hard to diagnose because it can mimic other types of asthma or respiratory infections. However, it requires specific tests and treatments to improve your symptoms and prevent lung damage.

Fungi can affect the lungs and airways of asthmatics in different ways. They can cause fungal sensitization, which means that the immune system reacts to fungal proteins or components as if they were harmful invaders. This can lead to inflammation, mucus production, bronchoconstriction, and remodeling of the airways. Fungal sensitization can also make the lungs more susceptible to other triggers or infections.

Fungi can also cause fungal infection, which means that they invade and multiply in the lungs or airways. This can cause tissue damage, inflammation, and immune activation. Fungal infection can also complicate or mimic other lung diseases, such as tuberculosis or pneumonia.

Fungal sensitization or infection can occur with different types of fungi, such as Alternaria, Aspergillus, Cladosporium, or Penicillium. However, one of the most common and serious forms of fungal involvement in severe asthma is allergic bronchopulmonary aspergillosis (ABPA). ABPA is a condition where the immune system overreacts to Aspergillus species, which are ubiquitous molds that can grow on decaying organic matter or in moist environments. ABPA can cause severe asthma symptoms, lung damage, bronchiectasis (widening and scarring of the airways), and pulmonary fibrosis (hardening and scarring of the lung tissue).

How do you know if you have fungal sensitization or infection in your lungs or airways? Unfortunately, there is no simple or definitive test for this. The diagnosis of fungal sensitization or infection depends on a combination of clinical and immunological criteria, such as:

•  History of exposure to fungi or symptoms suggestive of fungal involvement

•  Skin testing with antigens derived from fungi or measurement of specific IgE levels in the blood

•  Chest imaging (such as X-ray or CT scan) showing signs of lung damage or infection

•  Sputum culture or analysis showing the presence of fungi or fungal components

•  Bronchoscopy (a procedure where a thin tube with a camera is inserted into the airways) showing signs of inflammation or infection

•  Biopsy (a procedure where a small sample of tissue is taken from the lungs) showing signs of inflammation or infection

The treatment of fungal sensitization or infection in severe asthma depends on the type and severity of the condition. The general goals of treatment are to:

•  Reduce the exposure to fungi or eliminate them from the environment

•  Control the asthma symptoms and prevent exacerbations

•  Reduce the inflammation and damage in the lungs and airways

•  Eradicate the fungal infection or reduce its load

The treatment options may include:

•  Asthma medications (such as bronchodilators, corticosteroids, leukotriene modifiers, biologics, etc.) to relieve the symptoms and prevent exacerbations

•  Antifungal medications (such as itraconazole, voriconazole, posaconazole, etc.) to kill or inhibit the growth of fungi

•  Immunotherapy (such as allergen-specific immunotherapy or omalizumab) to reduce the immune response to fungi

•  Surgery (such as lobectomy or pneumonectomy) to remove severely damaged parts of the lungs

The effectiveness and safety of these treatments may vary depending on the individual case and response. Therefore, it is important to consult with your doctor before starting any treatment and follow their instructions carefully.

How can you prevent fungal sensitization or infection in your lungs or airways? There are some measures that you can take to reduce your exposure to fungi or their effects on your health, such as:

•  Avoid or minimize contact with sources of fungi, such as compost, hay, soil, plants, animals, moldy food, or damp places

•  Use a mask, gloves, and protective clothing when handling or working with materials that may contain fungi

•  Clean and dry your home regularly and remove any visible mold or mildew

•  Use a dehumidifier or air conditioner to reduce the humidity and temperature in your home

•  Use a high-efficiency particulate air (HEPA) filter or vacuum cleaner to remove airborne fungi or dust from your home

•  Avoid smoking or exposure to secondhand smoke, as it can damage your lungs and increase your risk of infection

•  Take your asthma medications as prescribed and monitor your symptoms and lung function regularly

•  Seek medical attention promptly if you have any signs or symptoms of fungal sensitization or infection, such as worsening asthma, fever, cough, chest pain, weight loss, or blood in the sputum

Fungi can be a hidden but serious threat for people with severe asthma. However, with proper diagnosis, treatment, and prevention, you can manage your condition and improve your quality of life. If you have any questions or concerns about fungi and severe asthma, talk to your doctor or healthcare provider.

We hope you found this blog post informative and helpful. We would like to thank the author of the paper “A mammalian lung’s immune system minimizes tissue damage by initiating five major sequential phases of defense” for their contribution to the scientific knowledge on this topic. You can read the full paper here: <a href=”https://link.springer.com/article/10.1007/s10238-023-01083-4″>https://link.springer.com/article/10.1007/s10238-023-01083-4</a>

If you want to learn more about the World Asthma Foundation and our efforts to improve the lives of people with asthma, please visit our website: <a href=”https://worldasthmafoundation.org/”>https://worldasthmafoundation.org/</a>

Thank you for reading and stay tuned for more updates from us!

Sources:

How Major Fungal Infections Can Initiate Severe Autoimmune Diseases

https://www.sciencedirect.com/science/article/abs/pii/S0882401021004745#:~:text=However%2C%20major%20fungal%20infections%20can,fungal%20infections%2C%20including%20antibiotic%20usage.

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Unraveling the Role of Candidalysins in Severe Asthma

Candida Albicans

Welcome Message from the World Asthma Foundation

Hello to our dedicated community and newcomers alike.

The World Asthma Foundation (WAF) continues its mission to Defeat Asthma by fostering awareness, enhancing education, and promoting research to unravel the complexities of Asthma. We appreciate your interest and partnership as we work towards a world where Asthma is no longer a limiting factor in anyone’s life.

Building on our recent blog post discussing Candida’s role in inflammation and autoimmune response and its implications for severe Asthma, we’re excited to delve deeper into one of Candida’s potent weapons, Candidalysins. This topic is the focus of intensive research globally, including groundbreaking work from the Mayo Clinic, and shows promising potential in understanding the pathogenesis and exacerbation of severe asthma.

Thank you for being part of our mission. We encourage you to share this information with your healthcare provider and engage in open, productive conversations about your health.

Introduction

Last week, we explored the intricate interplay between Candida colonization, dysbiosis, inflammation, autoimmune responses, TNF-alpha dysregulation, and comorbidities in the pathogenesis and exacerbation of severe asthma. A critical piece of the puzzle involves a protein secreted by Candida, Candidalysins. These proteins play a significant role in Candida’s virulence and are instrumental in driving the inflammatory response, making them a critical research focus in the context of Asthma.

Candidalysins: A Closer Look

Candida albicans produces a group of cytolytic peptide toxins known as Candidalysins, which disrupt host epithelial barriers, leading to infection and promoting inflammation. Recent research indicates that Candidalysins also exacerbate the severity of asthma by enhancing airway inflammation, making the study of these proteins crucial in understanding and managing severe asthma.

The Inflammatory Role of Candidalysins

Candidalysins are known to damage epithelial cells, triggering an inflammatory response. In the context of asthma, this inflammation can intensify symptoms and exacerbate the severity of the condition. Understanding the specific role of Candidalysins in promoting this inflammation can provide insights into new therapeutic strategies for managing severe asthma.

Candidalysins and Immune Response

Research indicates that Candidalysins play a vital role in triggering a strong immune response, affecting immune cell recruitment and activation. This response is critical in the progression of asthma and can provide potential targets for therapeutic intervention.

Implications for Severe Asthma

The role of Candidalysins in promoting inflammation and triggering immune responses has significant implications for severe asthma. Understanding these implications is crucial for developing more effective management strategies, diagnostic tools, and potential treatments.

Candida in Pulmonary Secretions: A New Study

In addition to the role of Candidalysins in severe asthma, we also want to highlight another recent study that may be relevant to our readers. This study, published in The Open Respiratory Medicine Journal, examined the presence and significance of Candida in pulmonary secretions of patients with bronchitis, mucus plugging, and atelectasis. These are conditions that can affect people with asthma and make breathing difficult. The study found that Candida was often associated with these conditions and may play a role in causing or worsening them. The study also found that patients with Candida in their lungs had a higher risk of respiratory failure and death. The study suggested that treating Candida with antifungal drugs may help some patients improve their lung function and outcomes. However, the study was not conclusive and more research is needed to confirm these findings. This study adds to the growing evidence that Candida may be more than just a harmless colonizer of the lungs and may have important implications for severe asthma. You can read more about this study here.

Conclusion

Research into Candidalysins and their role in severe asthma is ongoing and promising. These cytolytic toxins provide a unique perspective on how Candida can influence the severity and progression of asthma, offering potential new avenues for therapeutic intervention. Another recent study also suggests that Candida may affect lung function and outcomes by causing or worsening bronchitis, mucus plugging, and atelectasis in some patients. These findings indicate that Candida may be more than just a harmless colonizer of the lungs and may have important implications for severe asthma. We’re excited to bring you the latest research on this subject and appreciate your interest and involvement in the Defeat Asthma mission. As we continue to unravel the complexities of Asthma, we hope to empower our readers with knowledge and tools to manage this chronic condition.

The Future of Asthma Research

As we understand more about the interactions between the Candidalysins and our body’s immune response, we will continue to see developments in diagnostic tools and therapies. Unraveling this complex relationship is critical in determining the trajectory of severe asthma and holds the key to future breakthroughs in its management.

Your Role in Our Mission

Our readers are a crucial part of our mission to Defeat Asthma. As we continue to share insights from the latest research, we encourage you to keep informed and to share these findings with your network. Conversations about research like this can help increase public understanding of Asthma, combat stigma, and ultimately contribute to better outcomes for those living with Asthma.

What’s Coming Up Next

In our upcoming posts, we will continue to keep you updated on research into the role of Candidalysins and other pathogenic factors contributing to severe asthma. We will also be delving into lifestyle and environmental factors that affect asthma, and how we can manage these to better control this chronic condition.

Stay Tuned for More

Stay connected with us to get the latest information and insights in the world of Asthma research, management, and advocacy. Subscribe to our newsletter, follow us on social media, and share our resources with your community.

Thank You

Thank you for being a part of the World Asthma Foundation community. Your involvement, whether as a reader, donor, advocate, or patient, is critical in our fight to Defeat Asthma. We appreciate your commitment and look forward to a future where Asthma no longer limits anyone’s potential.