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. February 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.
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 February 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.
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?
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.
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.
Hello and welcome to the World Asthma Foundation blog, where we share the latest news and information on asthma and related topics. We are a non-profit organization that pursues our mission and vision with a strategy to support the asthma community with educational resources. Our goal is to foster improved outcomes, better doctor-patient relationships, and support joint decision-making. In this way, asthmatics can take charge of their own health.
One of our main areas of focus is Infectious Asthma, which is a term that describes asthma that is triggered or worsened by infections, such as bacteria, viruses, fungi or parasites. Infectious Asthma can affect anyone, but it is more common and severe in children, elderly, immunocompromised or low-income populations. Infectious Asthma can cause more frequent and severe asthma attacks, lung damage, chronic sinusitis, nasal polyps and other complications.
In this article, we will review the current knowledge on one of the most common and potentially harmful triggers of Infectious Asthma: Staphylococcus aureus (S. aureus), a bacterium that can colonize the skin and mucous membranes of humans. S. aureus can produce various toxins, such as staphylococcal enterotoxins (SE), that can act as superantigens and induce an intense immune response in the airways. This can result in increased production of immunoglobulin E (IgE), a type of antibody that mediates allergic reactions, and activation of eosinophils, a type of white blood cell that causes inflammation and tissue damage.
We will also discuss how measuring SE specific IgE (SE-IgE) may help to identify a subgroup of patients with severe asthma who may benefit from specific interventions. Finally, we will provide some key takeaways and recommendations for asthmatics and clinicians.
We hope that this article will be informative and helpful for you. If you have any questions or comments, please feel free to contact us. Thank you for reading.
Summary
In this article, we have reviewed the current knowledge on the role of S. aureus and its enterotoxins in asthma, especially severe asthma. We have summarized the main findings from five recent studies that have investigated the association between SE sensitization and asthma severity, phenotype and inflammation. We have also discussed how measuring SE-IgE may help to phenotype asthmatics and guide treatment decisions. We have provided some key takeaways and recommendations for asthmatics and clinicians. Here are the main points:
• S. aureus and its enterotoxins are important factors in the pathogenesis of asthma, especially severe asthma.
• SE can act as superantigens and induce an intense T cell activation causing local production of polyclonal IgE and resultant eosinophil activation.
• SE can also manipulate the airway mucosal immunology at various levels via other proteins, such as serine-protease-like proteins (Spls) or protein A (SpA), and trigger the release of IL-33, type 2 cytokines, mast cell mediators and eosinophil extracellular traps.
• SE sensitization is associated with increased risk of asthma, more asthma exacerbations, nasal polyps, chronic sinusitis, lower lung function and more intense type-2 inflammation.
• SE sensitization is also linked to allergic poly-sensitization and allergic multimorbidity, such as rhinitis, eczema and food allergy, indicating a possible role of S. aureus in the development of allergic diseases.
• Measuring SE-IgE may help to identify a subgroup of patients with severe asthma who may benefit from specific interventions, such as anti-IgE therapy or antibiotics.
Key Takeaways
• Asthmatics should be aware of the potential role of S. aureus and its enterotoxins in triggering and worsening their asthma symptoms and seek medical advice if they suspect an infection or colonization.
• Asthmatics should avoid contact with S. aureus carriers or sources of contamination, such as contaminated food or water, and practice good hygiene and wound care to prevent infection or colonization.
• Asthmatics should ask their doctors about testing for SE-IgE as part of their asthma phenotyping and management, as it may help to identify a subgroup of patients with severe asthma who may benefit from specific interventions.
• Clinicians should consider measuring SE-IgE in asthmatics, especially those with severe asthma, nasal polyps, chronic sinusitis or allergic multimorbidity, as it may provide valuable information on the underlying mechanisms and phenotypes of asthma and suggest novel therapeutic targets and strategies.
• Clinicians should also monitor the SE-IgE levels and response to treatment in asthmatics who are receiving anti-IgE therapy or antibiotics, as it may help to evaluate the efficacy and safety of these interventions.
Conclusion
Asthma is a complex and heterogeneous disease that can be influenced by various factors, such as allergens, irritants, infections and stress. Among these factors, S. aureus and its enterotoxins have emerged as important triggers and modulators of asthma, especially severe asthma. SE can act as superantigens and induce an intense immune response in the airways, resulting in increased production of IgE and activation of eosinophils. SE can also manipulate the airway mucosal immunology at various levels via other proteins, such as Spls or SpA, and trigger the release of IL-33, type 2 cytokines, mast cell mediators and eosinophil extracellular traps. These mechanisms can lead to more severe asthma phenotype and type-2 inflammation.
SE sensitization is associated with increased risk of asthma, more asthma exacerbations, nasal polyps, chronic sinusitis, lower lung function and more intense type-2 inflammation. SE sensitization is also linked to allergic poly-sensitization and allergic multimorbidity, such as rhinitis, eczema and food allergy, indicating a possible role of S. aureus in the development of allergic diseases. Measuring SE-IgE may help to identify a subgroup of patients with severe asthma who may benefit from specific interventions, such as anti-IgE therapy or antibiotics.
In this article, we have reviewed the current knowledge on the role of S. aureus and its enterotoxins in asthma, especially severe asthma. We have summarized the main findings from five recent studies that have investigated the association between SE sensitization and asthma severity, phenotype and inflammation. We have also discussed how measuring SE-IgE may help to phenotype asthmatics and guide treatment decisions. We have provided some key takeaways and recommendations for asthmatics and clinicians.
We hope that this article has been informative and helpful for you. If you have any questions or comments, please feel free to contact us. Thank you for reading.
References
: Bachert C., Humbert M., Hanania N.A., Zhang N., Holgate S., Buhl R., Bröker B.M. Staphylococcus aureus and its IgE-inducing enterotoxins in asthma: current knowledge. Eur Respir J. 2020;55(4):1901592. doi: 10.1183/13993003.01592-2019.
: Kanemitsu Y., Taniguchi M., Nagano H., Matsumoto T., Kobayashi Y., Itoh H. Specific IgE against Staphylococcus aureus enterotoxins: an independent risk factor for asthma. J Allergy Clin Immunol. 2012;130(2):376–382.e3. doi: 10.1016/j.jaci.2012.04.027.
: Soh J.Y., Lee B.W., Goh A. Staphylococcal enterotoxin specific IgE and asthma: a systematic review and meta-analysis. Pediatr Allergy Immunol. 2013;24(3):270–279.e1-4. doi: 10.1111/pai.12056.
: Schleich F., Brusselle G.G., Louis R., Vandenplas O., Michils A., Van den Brande P., Lefebvre W.A., Pilette C., Gangl M., Cataldo D.D., et al. Asthmatics only sensitized to Staphylococcus aureus enterotoxins have more exacerbations, airflow limitation, and higher levels of sputum IL-5 and IgE. J Allergy Clin Immunol Pract. 2023;11(5):1658–1666.e4. doi: 10.1016/j.jaip.2023.01.021.
: James A., Gyllfors P., Henriksson E.L., Lundahl J., Nilsson G., Alving K., Nordvall L.S., van Hage M., Cardell L.O. Staphylococcus aureus enterotoxin sensitization is associated with allergic poly-sensitization and allergic multimorbidity in adolescents. Clin Exp Allergy. 2015;45(6):1099–1107. doi: 10.1111/cea.12519.
Sidebar: What is Staphylococcus aureus?
Staphylococcus aureus is a type of bacteria that can cause various infections in humans and animals. It is found in the environment and also in the normal flora of the skin and mucous membranes of most healthy individuals. It can colonize the anterior nares (the front part of the nose), the throat, the skin, and the gastrointestinal tract. It is estimated that up to half of all adults are colonized by S. aureus, and approximately 15% of them persistently carry it in their noses.
S. aureus can cause infections when it breaches the skin or mucosal barriers and enters the bloodstream or internal tissues. These infections can range from mild skin infections, such as boils or impetigo, to more serious infections, such as pneumonia, endocarditis, osteomyelitis, septic arthritis, or sepsis. S. aureus can also produce toxins that can cause food poisoning, toxic shock syndrome, or scalded skin syndrome.
S. aureus is a very adaptable and versatile bacterium that can acquire resistance to various antibiotics. The most notorious example is methicillin-resistant S. aureus (MRSA), which is resistant to most beta-lactam antibiotics, such as penicillins and cephalosporins. MRSA can cause infections both in community-acquired and hospital-acquired settings and poses a major public health challenge.
S. aureus is believed to have originated in Central Europe in the mid-19th century and has since evolved and diversified into many different strains or clones. Some of these strains are more virulent or resistant than others and have spread globally through human migration and travel. One of these strains is ST8, which includes the USA300 clone that is responsible for most community-acquired MRSA infections in the United States.
S. aureus is one of the most common and potentially harmful triggers of Infectious Asthma, especially severe asthma. It can produce various toxins, such as staphylococcal enterotoxins (SE), that can act as superantigens and induce an intense immune response in the airways. This can result in increased production of immunoglobulin E (IgE), a type of antibody that mediates allergic reactions, and activation of eosinophils, a type of white blood cell that causes inflammation and tissue damage.
Hello to our dedicated community and newcomers alike.
At the World Asthma Foundation (WAF), we’re united by a singular, important mission: to Defeat Asthma. Our approach is rooted in fostering awareness, enhancing education, and promoting research that seeks to unravel the complexities of Asthma. As we strive towards a world where Asthma is no longer a limiting factor in anyone’s life, we remain steadfast in bringing you timely, comprehensive, and relevant information.
We’re excited to share our latest blog post with you. This post encapsulates the culmination of the efforts of a variety researchers, clinicians, and organizations worldwide working independently including pioneering work from the Mayo Clinic, to shed light on the pathogenesis and exacerbation of severe asthma.
Mayo Clinic Candida Study
We delve into the compelling evidence pointing towards the intricate interplay between Candida colonization, dysbiosis, inflammation, autoimmune responses, TNF-alpha dysregulation, and comorbidities.
As we unravel these complex relationships, our hope is to equip you, our readers, with knowledge that can empower you in your journey with asthma or help you support someone who is affected.
Let’s continue to learn, share, and work together in our collective fight against Asthma.
Thank you for being a part of our mission. We encourage you to share this information with your healthcare provider.
Establishing a trustworthy and effective relationship with a healthcare provider is crucial to managing your health. It not only ensures that you get the best care but also allows for open and productive conversations about your health.
Introduction
Managing Severe Asthma remains a complex task for many pulmonary practitioners, despite available medication and trigger avoidance strategies. Frequent attacks and poor symptom control often plague patients. Recent investigations, pieced together by the World Asthma Foundation over time have uncovered dozens of notable research groups that have illuminated the complex relationship between Candida colonization, dysbiosis, inflammation, autoimmune response, TNF-alpha dysregulation, and comorbidities in the pathogenesis and exacerbation of Severe Asthma. This amassed knowledge underscores the multifaceted nature of Severe Asthma, bringing to light the critical role of Candida in the disease process.
Recent studies reveal a potential link between Candida colonization, dysbiosis, inflammation, autoimmune response, TNF-alpha dysregulation, and comorbidities in the pathogenesis and exacerbation of Severe Asthma. This article will provide an overview of these linkages, the financial impact on individuals and society, the necessity for improved diagnostic tools and processes, and source the scientific studies supporting these conclusions.
Candida Colonization, Dysbiosis, and Fungal Sensitization
Candida albicans, a common fungal inhabitant of the mouth, gut, and genital tract, can also colonize the respiratory tract. This colonization is often facilitated by dysbiosis, an imbalance in the normal microbial flora, which can be induced by various factors, including the use of antibiotics and changes in the host immune response. Further, fungal sensitization, a process where the immune system produces antibodies (IgE) against fungal allergens, plays a crucial role in the onset and severity of asthma symptoms. Studies from the Mayo Clinic underline the lower alpha-diversity of lung microbiota and higher fungal burdens in Asthma patients, showing a correlation with severity and poor control of Asthma.
Case in Point
A recent study presented at the CHEST Annual Meeting 2021 by researchers from Mayo Clinic and University of California Davis confirmed the association between intestinal fungal dysbiosis and asthma severity in humans, particularly hospital use in the past year. The study found that patients with asthma who had higher intestinal Candida burden were more likely to have severe asthma exacerbations in the previous year, independent of systemic antibiotic and glucocorticoid use. This suggests that intestinal fungal dysbiosis may worsen asthma control and outcomes in humans. The study also showed that intestinal fungal dysbiosis can enhance the severity of allergic asthma in mice by increasing lung resident group 2 innate lymphoid cells (ILC2) populations, which are important mediators of the gut-lung axis effect. The study used a novel technique of flow cytometry to identify and quantify ILC2 in the lungs of mice. These findings highlight the potential role of intestinal fungal dysbiosis and ILC2 in asthma pathogenesis and management.
Role of Antibiotics and Gut-Lung Axis
Studies show that certain antibiotics prescribed for infections, such as Helicobacter pylori, can lead to gut microbiota dysbiosis, promoting Candida colonization. This gut-lung axis, the communication between gut microbiota and lung health, can create an environment conducive to fungal overgrowth and subsequent infection. As such, understanding this interaction can offer valuable insights into asthma management. Research from the Mayo Clinic suggests that antibiotic usage can significantly contribute to these interactions and, consequently, the pathogenesis of Severe Asthma.
Mechanisms of Candida Colonization
Candida albicans utilizes several mechanisms to cross the intestinal epithelial barrier, including adherence to epithelial cells, invasion, and translocation. Each of these steps facilitates Candida’s ability to invade the host’s system and trigger an immune response. Insights from the Mayo Clinic suggest that bacterial-fungal interactions play a key role in these mechanisms and have implications for Candida colonization.
Candida-Induced Inflammation, Autoimmune Response, and TNF-alpha Dysregulation
Once established, Candida colonization can incite inflammation by provoking the immune system to produce pro-inflammatory cytokines, such as TNF-alpha. While TNF-alpha aids in fighting off infections by initiating inflammation, its dysregulation can lead to chronic inflammation and autoimmune diseases, enhancing the severity of asthma. Research from the Mayo Clinic has shown that Candida colonization in the lung induces an immunologic response, leading to more Severe Asthma.
Autoimmune Response, Comorbidities, and Severe Asthma
Recent studies propose that an autoimmune response could be involved in the onset and exacerbation of Severe Asthma, with TNF-alpha dysregulation playing a pivotal role. Comorbidities like rheumatoid arthritis, often seen in conjunction with Severe Asthma, can further complicate disease management and progression.
Burden, Financial Impact, and Comorbidities
Severe Asthma imposes a substantial burden on individuals and society, financially and otherwise. Healthcare costs, productivity loss, and reduced quality of life contribute to this impact. Asthma comorbidities such as autoimmune diseases can affect disease progression and outcomes, underscoring the need for a comprehensive management approach.
The Necessity for Improved Diagnostic Tools
An accurate diagnosis of Candida colonization, inflammation, and autoimmune response in severe asthma is crucial for optimal patient management. There’s a growing need for improved diagnostic methodologies, tools, and processes. Advances in diagnostic techniques, such as bronchoscopy and bronchoalveolar lavage (BAL), can offer valuable insights into Candida colonization and the associated inflammatory and autoimmune processes. The Mayo Clinic’s recent findings, which identify a unique pattern of lower alpha-diversity and higher fungal burden in the lung microbiota of severe asthma patients, further emphasize the need for enhanced diagnostic methods.
Conclusion
Understanding the link between Candida colonization, dysbiosis, inflammation, autoimmune response, TNF-alpha dysregulation, comorbidities, and severe asthma is crucial for medical practitioners dealing with this chronic disease. The significant burden and financial impacts of Severe Asthma on individuals and society underline the urgency for effective management strategies.
Recognizing the influence of comorbidities, such as autoimmune diseases, can guide comprehensive care plans for patients with Severe Asthma. Moreover, enhanced diagnostic tools and processes will aid in early identification and more personalized treatment approaches, ultimately improving patient outcomes.
By integrating this knowledge, medical practitioners can not only better understand the multifaceted nature of Severe Asthma but also enhance its overall management, leading to improved patient care. With ongoing research, we can continue to unravel the complex relationships and mechanisms in asthma pathogenesis, providing new avenues for therapeutic interventions and improved patient outcomes.
Research on the relationship between Candida albicans and Asthma is an important area of study that could lead to better understanding and management of Asthma. In the following sections, we will present a summary of various significant studies on the relationship between Candida Albicans colonization and asthma. We will also cover information on the microbiome of the gut and lungs, wherever applicable.
Additionally, we will provide key takeaways from each study, including relevant details such as the study’s title, authors, and organization affiliation. Finally, we will summarize the collective findings and scientific conclusions related to Candida Albicans colonization, sensitization, and infection in Asthma, and offer resources for you to share with your healthcare provider.
A comprehensive understanding of these aspects promises to shed light on the intricate mechanisms underlying severe asthma, offering new perspectives in our fight against this chronic condition.
Further Study
Name of study: Fungal Dysbiosis and Its Clinical Implications in Severe Asthma Patients Date: 2023 Authors: Allison N. Imamura, Hannah K. Drescher, Mai Sasaki, Daniel J. Peaslee, David S. Crockett, Alexander S. Adams, Marcia L. Wills, Stephen C. Meredith, and Andrew H. Limper Organization: Mayo Clinic, Rochester, MN Summary: This study discusses the fungal dysbiosis in severe asthma patients. It finds that the lower alpha-diversity of lung microbiota and higher fungal burdens correlate with severity and poor control of asthma. The study also discusses the possible role of antibiotic usage and bacterial-fungal interactions in this process. The study concludes that understanding the link between Candida colonization, inflammation, autoimmune response, and Severe Asthma is crucial for better management of this chronic disease.
Study Title: CANDIDA ALBICANS INTESTINAL DYSBIOSIS INCREASES LUNG RESIDENT ILC2 POPULATIONS AND ENHANCES THE SEVERITY OF HDM-INDUCED ALLERGIC ASTHMA IN MICE
• Date: October 17-20, 202
Authors: Amjad Kanj, Theodore Kottom, Kyle Schaefbauer, Andrew Limper, Joseph Skalski
• Organization Affiliation: Mayo Clinic and University of California Davis
Human Anti-fungal Th17 Immunity and Pathology Rely on Cross-Reactivity against Candida albicans. Cell 2019. The authors are Petra Bacher, Thordis Hohnstein, Eva Beerbaum, Marie Röcker, Matthew G. Blango, Svenja Kaufmann, Jobst Röhmel, Patience Eschenhagen, Claudia Grehn, Kathrin Seidel, Volker Rickerts, Laura Lozza, Ulrik Stervbo, Mikalai Nienen, Nina Babel, Julia Milleck, Mario Assenmacher, Oliver A. Cornely, Maren Ziegler, Hilmar Wisplinghoff, Guido Heine, Margitta Worm, Britta Siegmund, Jochen Maul, Petra Creutz, Christoph Tabeling, Christoph Ruwwe-Glösenkamp, Leif E. Sander, Christoph Knosalla, Sascha Brunke, Bernhard Hube, Olaf Kniemeyer, Axel A. Brakhage and Carsten Schwarz. The main objective of the article is to investigate how cross-reactivity against Candida albicans influences human anti-fungal Th17 immunity and pathology. • C. albicans-specific Th17 cells can cross-react with other fungal antigens and gluten peptides in patients with CeD or asthma. • Cross-reactive Th17 cells can cause immune pathology in the gut and lung by producing IL-17A and IL-22 cytokines. Candida and asthma better by showing that Candida can induce a specific type of immune response that can also react to other fungi and allergens that are associated with asthma. The article also suggests that Candida may contribute to the severity and chronicity of asthma by causing inflammation and tissue damage in the lung. mechanisms and consequences of cross-reactivity are complex and need further investigation.
Name of study: Candida auris: Epidemiology, biology, a:Authors:ntifungal resistance, and virulence Date: 2020 Authors: Du, H., Bing, J., Hu, T., Ennis, C. L., Nobile, C. J., & Huang, G. M
Name of study: Candida albicans pathogenicity and epithelial immunity Date: 2014 Abstract Naglik, J. R., Richardson, J. P., & Moyes, D. L. URL:
Name of study: Candida albicans interactions with the host: crossing the intestinal epithelial barrier Date: 2019 Abstract: [Unavailable in given data] Authors: Basmaciyan, L., Bon, F., Paradis, T., Lapaquette, P., & Dalle, F. URL: https://doi.org/10.1080/21688370.2019.1612661
Name of study: ACG Clinical Guideline: Treatment of Helicobacter pylori Infection Date: 2017 Abstract: Authors: Chey WD, Leontiadis GI, Howden CW, Moss SF. URL: https://doi.org/10.1038/ajg.2016.563
Name of study: Asthma is inversely associated with Helicobacter pylori status in an urban population Date: 2008 Abstract: [Unavailable in given data] Authors: Reibman J, Marmor M, Filner J, et al. URL: https://doi.org/10.1371/journal.pone.0004060
Name of resource: H pylori Probiotics: A Comprehensive Overview for Health Practitioners Date: 2020 Abstract: Authors: Ruscio M. URL: https://drruscio.com/h-pylori-probiotics/
Name of resource: Treatment regimens for Helicobacter pylori in adults Date: 2022 Abstract: Authors: Lamont JT.
Name of study: Effects of probiotics on the recurrence of bacterial vaginosis: a review Date: 2014 Abstract: Authors: Homayouni A, Bastani P, Ziyadi S, et al.
Severe asthma is a type of asthma that is difficult to control and can have a significant impact on a person’s daily life. Symptoms of severe asthma can include frequent exacerbations (attacks), high levels of asthma symptoms, and a need for high doses of medication to manage symptoms. Causes of severe asthma can include allergies, exposure to environmental triggers, and genetics. Treatment for severe asthma typically includes a combination of long-term control medications, such as inhaled corticosteroids and bronchodilators, as well as quick-relief medications to be taken during exacerbations. In some cases, additional treatments such as biologic medications or immunomodulators may be needed to manage symptoms.
Types of severe Asthma
There are several subtypes of severe asthma that can be characterized based on specific symptoms and causes. These include:
It’s important to note that some people may have characteristics of more than one subtype of severe asthma. It’s important to work with a healthcare professional to identify your specific subtype of asthma and develop a treatment plan that works for you.
Allergic Asthma
Allergic asthma is a subtype of severe asthma that is caused by an allergic reaction to a specific trigger, such as dust mites, mold, animal dander, pollen, or certain foods. The allergens cause the immune system to overreact and release chemicals, such as histamine, which can lead to inflammation and narrowing of the airways.
Allergic asthma: characterized by an allergic reaction to a specific trigger, such as dust mites, mold, or pet dander.
Non-allergic asthma: characterized by symptoms that are not caused by an allergic reaction, but rather by triggers such as viral infections, cold air, or exercise.
Aspirin-exacerbated respiratory disease (AERD): characterized by severe asthma symptoms that are triggered by the use of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs)
Obesity-related asthma: characterized by asthma symptoms that are made worse by being overweight or obese.
Occupational asthma: characterized by symptoms caused by exposure to specific triggers in the workplace, such as chemicals or dusts.
Bronchial thermoplasty: characterized by symptoms caused by structural changes in the airways, such as thickening of the muscle layers that can make it harder to breathe.
Eosinophilic asthma: characterized by a high number of white blood cells called eosinophils in the airways.
Symptoms of allergic asthma can include:
Shortness of breath
Wheezing
Chest tightness
Coughing, especially at night or early in the morning
Difficulty breathing, especially during physical activity
Rapid breathing
Allergic asthma is diagnosed through a combination of medical history, physical examination, and laboratory tests such as skin prick test or blood test (specific IgE) to determine the specific allergens to which an individual is sensitive.
Treatment for allergic asthma typically includes:
Avoiding exposure to allergens as much as possible
Long-term control medications, such as inhaled corticosteroids and bronchodilators
Quick-relief medications to be taken during exacerbations, such as short-acting bronchodilators
Allergen-specific immunotherapy (allergy shots) to help reduce sensitivity to specific allergens over time.
It’s important to note that many people with allergic asthma also have other allergic conditions, such as hay fever, eczema, or hives. They may have benefit from a comprehensive allergy management plan, including allergy testing and immunotherapy.
Non allergic asthma
Non-allergic asthma is a subtype of severe asthma that is not caused by an allergic reaction, but rather by other triggers such as viral infections, cold air, exercise, stress, or exposure to certain chemicals or pollutants. The exact cause of non-allergic asthma is not known, but it is thought to be related to changes in the airways that make them more sensitive to certain triggers.
Symptoms of non-allergic asthma can include:
Shortness of breath
Wheezing
Chest tightness
Coughing, especially at night or early in the morning
Difficulty breathing, especially during physical activity
Rapid breathing
Non-allergic asthma is diagnosed through a combination of medical history, physical examination, and laboratory tests such as pulmonary function test, to rule out other causes of asthma like infections or structural changes.
Treatment for non-allergic asthma typically includes:
Identifying and avoiding triggers as much as possible
Long-term control medications, such as inhaled corticosteroids and bronchodilators
Quick-relief medications to be taken during exacerbations, such as short-acting bronchodilators
Monitoring of symptoms and lung function regularly
It’s important to note that non-allergic asthma and allergic asthma can have similar symptoms and the distinction between the two subtypes can be difficult. A healthcare professional will work with you to identify the specific triggers of your asthma and create an individualized treatment plan.
Mucus Plugs and Asthma
Mucus plugs, also known as bronchial plugs, can be a complication of asthma. Mucus plugs are clumps of thick, sticky mucus that can block the airways and make it harder to breathe. They can form in the airways of people with asthma as a result of inflammation and increased mucus production in the lungs.
Symptoms of mucus plugs in asthma can include:
Shortness of breath
Wheezing
Chest tightness
Coughing, especially at night or early in the morning
Difficulty breathing, especially during physical activity
Rapid breathing
Wet or gurgling sounds when breathing
Increased mucus production and difficulty clearing mucus from the lungs
Mucus plugs can be caused by a number of factors, including exposure to triggers such as allergens, viral infections, or pollutants, as well as by changes in the airways that make them more sensitive to certain triggers.
Treatment for mucus plugs in asthma typically includes:
If you have asthma and are experiencing symptoms of mucus plugs, it’s important to speak with your healthcare professional to develop an individualized treatment plan. In some cases, additional treatments such as biologic medications or immunomodulators may be needed to manage symptoms.
Wheezing and Severe Asthma
Wheezing is a common symptom of severe asthma, as well as other types of asthma. It is a whistling or whistling sound that can be heard when breathing, especially during exhalation. Wheezing is caused by narrowed or obstructed airways, which can make it harder to breathe.
In severe asthma, wheezing can be a sign of increased inflammation and narrowing of the airways, which can lead to difficulty breathing and increased risk of exacerbations. The increased airflow resistance leads to increased air movement velocity, generating the wheezing sound.
Symptoms of severe asthma can include:
Frequent exacerbations (attacks)
High levels of asthma symptoms, such as shortness of breath, chest tightness, and coughing
A need for high doses of medication to manage symptoms
Increased risk of hospitalization
Difficulty with daily activities and impairment of quality of life
Treatment for severe asthma typically includes a combination of long-term control medications, such as inhaled corticosteroids and bronchodilators, as well as quick-relief medications to be taken during exacerbations. In some cases, additional treatments such as biologic medications or immunomodulators may be needed to manage symptoms.
It’s important to work closely with a healthcare professional to develop an individualized treatment plan for severe asthma. This may include regular monitoring of symptoms and lung function, as well as a plan to manage exacerbations and prevent future attacks.
Identifying and avoiding triggers as much as possible
Long-term control medications, such as inhaled corticosteroids and bronchodilators
Quick-relief medications to be taken during exacerbations, such as short-acting bronchodilators
Chest physical therapy, such as chest clapping and vibration, to help remove mucus from the lungs
Monitoring of symptoms and lung function regularly
Common food dye can trigger inflammatory processes, say university researchers
A recent university study funded by the Canadian Institutes of Health Research reflects that long-term consumption of Allura Red food dye can be a potential trigger of inflammatory bowel diseases (IBDs) and potentially other inflammatory diseases processes as well.
Researchers using experimental animal models of IBD found that continual exposure to Allura Red AC harms gut health and promotes inflammation. Researchers using experimental animal models of IBD found that continual exposure to Allura Red AC harms gut health and promotes inflammation.
‘This further understanding will benefit Asthmatics as well,’ said Alan Gray, Director at the World Asthma Foundation . The human gastrointestinal (GI) tract is home to a diverse ecosystem of microbes, known collectively as the microbiota. Among its many roles, the gut microbiota regulates the immune system and protects against harmful pathogens. In fact, the largest part of the immune system, the gut-associated lymphoid tissue, is found in the gut. This network of immune cells and tissues interacts closely with the gut microbiota, influencing inflammation throughout the body including the lungs.
The dye directly disrupts gut barrier function and increases the production of serotonin, a hormone/neurotransmitter found in the gut, which subsequently alters gut microbiota composition leading to increased susceptibility to colitis.
Khan said Allura Red (also called FD&C Red 40 and Food Red 17), is a common ingredient in candies, soft drinks, dairy products and some cereals. The dye is used to add colour and texture to foodstuffs, often to attract children.
The use of synthetic food dyes such as Allura Red has increased significantly over the last several decades, but there has been little earlier study of these dyes’ effects on gut health. Khan and his team published their findings in Nature Communications. Yun Han (Eric) Kwon, who recently completed PhD in Khan’s laboratory, is first author.
“This study demonstrates significant harmful effects of Allura Red on gut health and identifies gut serotonin as a critical factor mediating these effects. These findings have important implication in the prevention and management of gut inflammation,” said Khan, the study’s senior author, a professor of the Department of Pathology and Molecular Medicine and a principal investigator of Farncombe Family Digestive Health Research Institute.
“What we have found is striking and alarming, as this common synthetic food dye is a possible dietary trigger for IBDs. This research is a significant advance in alerting the public on the potential harms of food dyes that we consume daily,” he said.
“The literature suggests that the consumption of Allura Red also affects certain allergies, immune disorders and behavioural problems in children, such as attention deficit hyperactivity disorder.”
Khan said that IBDs are serious chronic inflammatory conditions of the human bowel that affect millions of people worldwide. While their exact causes are still not fully understood, studies have shown that dysregulated immune responses, genetic factors, gut microbiota imbalances, and environmental factors can trigger these conditions.
In recent years there has been significant progress in identifying susceptibility genes and understanding the role of the immune system and host microbiota in the pathogenesis of IBDs. However, similar advances in defining environmental risk factors have lagged, he said.
Khan said that environmental triggers for IBDs include the typical Western diet, which includes processed fats, red and processed meats, sugar and a lack of fibre. He added that the Western diet and processed food also includes large amounts of various additives and dyes.
He added that the study suggests a link between a commonly used food dye and IBDs and warrants further exploration between food dyes and IBDs at experimental, epidemiological and clinical levels.
On the day after World Asthma Day, May 3, 2022, we scanned the globe to find a statement that best sums up the current state of affairs regarding Asthma.
Kudos to tbe U.S National Institute of Environmental Health NIH Statement on World Asthma Day 2022: Toward Improved Asthma Care
Good enough of summary that we want to publish this in its entirety.
Asthma is a serious lung disease; causes chest tightness, wheezing, and coughing; can often be controlled with proper treatment.
Today (May 3, 2022) on World Asthma Day, the National Institutes of Health reaffirms its commitment to biomedical research aimed at preventing the onset of asthma, understanding its underlying causes, and improving the treatment of it. This chronic airway disease, which is characterized by periodic worsening of inflammation that can make it hard to breathe, affects more than 25 million people in the United States, including more than 5 million children. Left untreated, it can be life-threatening.
While scientists have made substantial progress in understanding asthma diagnosis, management, and treatment, therapies to permanently improve breathing for those who suffer from asthma remain elusive. Researchers around the globe are working steadily toward this goal while they seek to better understand and find new ways to manage the disease. They also are continuing research on the underlying causes of disparities in the incidence, care, and prevention of the disease. On the heels of recently updated management and treatment guidelines, researchers anticipate a brighter future for people living with asthma.
Three NIH institutes primarily support and conduct studies on asthma — the National Heart, Lung, and Blood Institute (NHLBI); the National Institute of Allergy and Infectious Diseases (NIAID); and the National Institute of Environmental Health Sciences (NIEHS). Other NIH Institutes and Centers also support and conduct asthma research. NIH scientists and grantees made important advances in understanding, treating, and managing asthma in 2021, which are briefly highlighted as follows:
Asthma and COVID-19
An NHLBI-funded study showed that during the pandemic, asthma attacks, also known as asthma exacerbations, significantly decreased in a large group of children and adolescents, compared to the year before the pandemic. The study also found that telehealth visits among these patients increased dramatically during this time. The study included nearly 4,000 participants aged 5-17 years with a prior diagnosis of asthma. Researchers believe a better understanding of the factors that contributed to these improved outcomes could lead to better asthma control in all children and adolescents, as researchers noted no racial or ethnic differences in health outcomes in this population.
A NIAID-funded study found that asthma does not increase the risk of becoming infected with SARS-CoV-2, the virus that causes COVID-19. This finding came from a six-month household survey of more than 4,000 children and adults conducted between May 2020 and February 2021.
Asthma Disparities
Researchers have known for decades that social determinants of health – conditions like housing, neighborhood, education, income, and healthcare access – can affect the quality of life and asthma-related health outcomes of people living with the disease. NIH scientists are now reporting new advances in understanding the relationship between social determinants of health and asthma.
Black and Hispanic children who live in low-income urban environments in the United States are at particularly high risk for asthma attacks. These children tend to be underrepresented in large trials of new biologic therapies for asthma.
In a recent NIAID-supported clinical trial, the monoclonal antibody mepolizumab decreased asthma attacks by 27% in Black and Hispanic children and adolescents who have a form of severe asthma, are prone to asthma attacks, and live in low-income urban neighborhoods.
In one study, NHLBI-funded investigators demonstrated the importance of housing interventions in improving the health of children with asthma. Poor quality housing is associated with a high level of asthma triggers – including mold, cockroach, mouse, and dust mite allergens – that can pose a health threat to children with asthma. The study showed the feasibility of using targeted interventions – including better pest management, improved ventilation, and moisture reduction – to achieve healthy housing. It showed that such interventions can result in reduced symptoms and hospitalizations due to asthma.
Environmental Exposures and Asthma
Researchers have known for years that asthma can be triggered by substances in the indoor and outdoor environment. New research shows that exposure to some asthma triggers might even occur before birth.
In an NIH-supported study that included grant support from NIEHS and the NHLBI, researchers reported that prenatal exposure to tiny air pollution particles significantly increased the risk for developing asthma in children. The study, which analyzed data from two different study cohorts, focused on a group of mothers and their children, mostly Black or Hispanic, in the Boston area who lived near major roadways with heavy traffic. It found that more than 18% of the children who were exposed to high levels of these so-called ultrafine particles in the womb developed asthma in their preschool years, compared to 7% of children overall in the United States.
An NIEHS clinical study will assess how environmental factors affect disease progression in non-smoking adults who have moderate or severe asthma. The study will focus on the microbiological and genetic factors associated with atopic asthma, also known as allergic asthma, which is triggered by pollen, dust mites, and other allergens. A better understanding of this data might lead to improved treatments for people with this type of asthma, researchers say.
Climate Change and Asthma
Studies have shown that climate change can increase air pollutants such as ground-level ozone, fine particulates, wildfire smoke, and dust, and that these pollutants can exacerbate asthma. Climate change can also affect the production, distribution, and severity of airborne allergens.
NIEHS, NHLBI, and other NIH institutes and centers are leading the NIH Climate Change and Health Initiative. This is a cross-cutting NIH effort to reduce health threats such as asthma that can develop or worsen because of climate change. The initiative will look at these threats across the lifespan and find ways to build health resilience in individuals, communities, and nations around the world. A strategic framework for the Initiative will help guide NIH investments in this area.
An NIEHS-funded study provides examples of how extreme weather events can affect asthma outcomes. For example, as heat waves and droughts become more frequent and prolonged, the risk of large wildfires will likely increase, resulting in poor air quality that makes it more difficult to control asthma. Other climate-change events can lead to longer and more intense pollen seasons, while mold and dampness in homes may cause asthma to develop or worsen preexisting cases.
About the National Institute of Allergy and Infectious Diseases (NIAID): NIAID conducts and supports research—at NIH, throughout the United States, and worldwide—to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID website.
About the National Heart, Lung, and Blood Institute (NHLBI): NHLBI is the global leader in conducting and supporting research in heart, lung, and blood diseases and sleep disorders that advances scientific knowledge, improves public health, and saves lives. For more information, visit www.nhlbi.nih.gov. For additional information about NHLBI’s asthma resources, visit https://www.nhlbi.nih.gov/BreatheBetter.
About the National Institute of Environmental Health Sciences (NIEHS): NIEHS supports research to understand the effects of the environment on human health and is part of the National Institutes of Health. For more information on NIEHS or environmental health topics, visit
About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
The Barcelona Institute for Global Health supported study concludes suggests that in utero BPA exposure may be associated with higher odds of asthma and wheeze among school-age girls.
Study Background
In utero, (before birth) exposure to bisphenols, widely used in consumer products, may alter lung development and increase the risk of respiratory morbidity in the offspring. However, evidence is scarce and mostly focused on bisphenol A (BPA) only.
Study Objectives
There is growing concern over the role of chemical pollutants on early life origins of respiratory diseases (Gascon et al., 2013, Vrijheid et al., 2016, Casas and Gascon, 2020, Abellan and Casas, 2021), specifically on bisphenols due to their large production worldwide (CHEMTrust, 2018) and its widespread exposure to human populations (Calafat et al., 2008, Haug et al., 2018). Bisphenol A (BPA) is the most commonly used bisphenol. It is present in polycarbonate plastics and epoxy resins, used in many consumer products, and diet is the main source of exposure (Liao and Kannan, 2013). In 2017, the European Chemical Agency considered BPA as a “substance of very high concern” (Calafat et al., 2008, Agency and Bisfenol, 2017). Consequently, BPA production is restricted in some countries, which has resulted in the emergence of substitutes such as bisphenol F (BPF) and bisphenol S (BPS), with suspected similar toxicity (Lehmler et al., 2018, Rochester and Bolden, 2015). Bisphenols can cross the placenta and are also found in breastmilk, which results in exposure to foetuses and newborns (Lee et al., 2018). To examine the associations of in utero exposure to BPA, bisphenol F (BPF), and bisphenol S (BPS) with asthma, wheeze, and lung function in school-age children, and whether these associations differ by sex.
Methods
We included 3,007 mother–child pairs from eight European birth cohorts. Bisphenol concentrations were determined in maternal urine samples collected during pregnancy (1999–2010). Between 7 and 11 years of age, current asthma and wheeze were assessed from questionnaires and lung function by spirometry. Wheezing patterns were constructed from questionnaires from early to mid-childhood. We performed adjusted random-effects meta-analysis on individual participant data.
In utero exposure to bisphenols, widely used in consumer products, may alter lung development and increase the risk of respiratory morbidity in the offspring. However, evidence is scarce and mostly focused on bisphenol A (BPA) only.
Study Objective
To examine the associations of in utero exposure to BPA, bisphenol F (BPF), and bisphenol S (BPS) with asthma, wheeze, and lung function in school-age children, and whether these associations differ by sex.
Results
Exposure to BPA was prevalent with 90% of maternal samples containing concentrations above detection limits. BPF and BPS were found in 27% and 49% of samples. In utero exposure to BPA was associated with higher odds of current asthma (OR = 1.13, 95% CI = 1.01, 1.27) and wheeze (OR = 1.14, 95% CI = 1.01, 1.30) (p-interaction sex = 0.01) among girls, but not with wheezing patterns nor lung function neither in overall nor among boys. We observed inconsistent associations of BPF and BPS with the respiratory outcomes assessed in overall and sex-stratified analyses.
Conclusion
This study suggests that in utero BPA exposure may be associated with higher odds of asthma and wheeze among school-age girl
According the U.S. National Institute of Health, Bisphenol A (BPA) is a chemical produced in large quantities for use primarily in the production of polycarbonate plastics. It is found in various products including shatterproof windows, eyewear, water bottles, and epoxy resins that coat some metal food cans, bottle tops, and water supply pipes.
How does BPA get into the body?
The primary source of exposure to BPA for most people is through the diet. While air, dust, and water are other possible sources of exposure, BPA in food and beverages accounts for the majority of daily human exposure.
Bisphenol A can leach into food from the protective internal epoxy resin coatings of canned foods and from consumer products such as polycarbonate tableware, food storage containers, water bottles, and baby bottles. The degree to which BPA leaches from polycarbonate bottles into liquid may depend more on the temperature of the liquid or bottle, than the age of the container. BPA can also be found in breast milk.
Why are people concerned about BPA?
One reason people may be concerned about BPA is because human exposure to BPA is widespread. The 2003-2004 National Health and Nutrition Examination Survey (NHANES III) conducted by the Centers for Disease Control and Prevention (CDC) found detectable levels of BPA in 93% of 2517 urine samples from people six years and older. The CDC NHANES data are considered representative of exposures in the United States. Another reason for concern, especially for parents, may be because some animal studies report effects in fetuses and newborns exposed to BPA.
If I am concerned, what can I do to prevent exposure to BPA?
Some animal studies suggest that infants and children may be the most vulnerable to the effects of BPA. Parents and caregivers can make the personal choice to reduce exposures of their infants and children to BPA:
Don’t microwave polycarbonate plastic food containers. Polycarbonate is strong and durable, but over time it may break down from over use at high temperatures.
Plastic containers have recycle codes on the bottom. Some, but not all, plastics that are marked with recycle codes 3 or 7 may be made with BPA.
Reduce your use of canned foods.
When possible, opt for glass, porcelain or stainless steel containers, particularly for hot food or liquids.
Use baby bottles that are BPA free.
There is growing concern over the role of chemical pollutants on early life origins of respiratory diseases (Gascon et al., 2013, Vrijheid et al., 2016, Casas and Gascon, 2020, Abellan and Casas, 2021), specifically on bisphenols due to their large production worldwide (CHEMTrust, 2018) and its widespread exposure to human populations (Calafat et al., 2008, Haug et al., 2018). Bisphenol A (BPA) is the most commonly used bisphenol. It is present in polycarbonate plastics and epoxy resins, used in many consumer products, and diet is the main source of exposure (Liao and Kannan, 2013). In 2017, the European Chemical Agency considered BPA as a “substance of very high concern” (Calafat et al., 2008, Agency and Bisfenol, 2017). Consequently, BPA production is restricted in some countries, which has resulted in the emergence of substitutes such as bisphenol F (BPF) and bisphenol S (BPS), with suspected similar toxicity (Lehmler et al., 2018, Rochester and Bolden, 2015). Bisphenols can cross the placenta and are also found in breastmilk, which results in exposure to foetuses and newborns (Lee et al., 2018).
