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.

How Th17-high asthma is affected by IL-17 and what you can do about it

Hello and welcome to the World Asthma Foundation blog, where we share the latest news and insights on asthma research and treatment. We are a nonprofit organization dedicated to improving the lives of people with asthma and advancing the science of asthma prevention and cure. Our mission is to raise awareness, educate, and advocate for asthma patients and their families. Our vision is a world free of Asthma.

If you are a Severe Asthmatic, you may have a subtype of asthma called Th17-high asthma. This subtype is characterized by high levels of a molecule called IL-17 in your airways. IL-17 is produced by a type of immune cell called Th17 cell. Th17 cells are normally involved in protecting the body from certain bacteria and fungi. However, in some cases, they can become overactive and produce too much IL-17.

IL-17 is a powerful inflammatory molecule that can worsen your asthma symptoms by:

• Attracting other immune cells, such as neutrophils, to your airways

• Activating tissue cells to secrete mucus and contract airway smooth muscle

• Inducing the production of other inflammatory molecules that cause more damage

• Interfering with the action of steroids, which are the main drugs used to treat asthma

In this blog post, we will explain how IL-17 affects Th17-high asthma and what you can do about it.

How IL-17 affects Th17-high asthma
IL-17 plays a key role in driving neutrophilic inflammation in Th17-high asthma. Neutrophils are a type of white blood cell that fight infections and inflammation. However, in Th17-high asthma, they accumulate in the airways and cause damage to the lung tissue. This leads to more severe asthma symptoms and poor response to conventional treatments.

IL-17 can stimulate neutrophils to release harmful substances that can damage the airway lining and cause mucus production, airway narrowing, and airway remodeling.

IL-17 can also make asthma worse by interfering with the action of steroids. Steroids work by suppressing inflammation and reducing the activity of immune cells. However, IL-17 can make some immune cells resistant to steroids, which means that steroids may not work as well for some severe asthmatics.

What you can do about IL-17.

One possible strategy to treat Th17-high asthma is to block IL-17 or its receptor with drugs that can prevent IL-17 from binding to its targets and causing inflammation. Several such drugs have been developed and tested in clinical trials for various inflammatory diseases, such as psoriasis, rheumatoid arthritis, and Crohn’s disease. Some of these drugs have also been tested in Severe Asthmatics who have high levels of IL-17 or neutrophils in their airways.

The results of these trials have been mixed. Some studies have shown that blocking IL-17 can improve lung function, reduce exacerbations, and lower the need for oral steroids in severe asthmatics. Other studies have shown no benefit or even worse outcomes with IL-17 blockers. The reasons for these discrepancies are not clear yet, but may depend on factors such as the type of IL-17 blocker used, the dose and duration of treatment, the characteristics of the patients enrolled, and the endpoints measured.

Therefore, more research is needed to determine whether blocking IL-17 is a viable option for treating severe asthma. We also need to identify which patients are most likely to benefit from this approach and how to monitor their response and safety. We also need to explore other ways to modulate IL-17 production or function in severe asthmatics.

In addition to pharmacological interventions, there are also some lifestyle changes that may help reduce IL-17 levels and improve asthma control. These include:

• Avoiding or reducing exposure to triggers that may activate Th17 cells, such as allergens, infections and pollution

• Eating a balanced diet that contains anti-inflammatory foods, such as fruits, vegetables, nuts and fish

• Exercising regularly, but not too intensely, as moderate exercise can reduce inflammation and improve lung function

• Managing stress levels, as stress can increase inflammation and worsen asthma symptoms

If you have asthma, it is important to consult your doctor regularly and follow their advice on how to manage your condition. Your doctor may perform some tests to determine your asthma subtype and prescribe the best treatment for you.

By understanding how IL-17 affects your asthma and taking steps to reduce its impact, you may be able to breathe easier and enjoy a better quality of life.

We hope that this blog post has given you some insight into the role of IL-17 in severe asthma and the potential challenges and opportunities for targeting it. We will continue to update you on this topic as new findings emerge. In the meantime, if you have any questions or comments, please feel free to contact us or leave a comment below.

Thank you for reading and stay tuned for more blog posts from the World Asthma Foundation. Together we can defeat asthma.

How to Live Well with Asthma in the Post-COVID Era

The COVID-19 pandemic has been a tough time for everyone, especially for people with asthma. Asthma is a chronic condition that affects the airways and makes it hard to breathe. People with asthma may have more severe symptoms or complications if they get infected with COVID-19. That’s why it’s important to know how to manage your asthma and protect yourself from the virus.

But even as the pandemic seems to be winding down, the challenges are not over for people with asthma. Many people still live in fear of getting sick or infecting others. Many people still face stress, anxiety, depression, or isolation due to the pandemic. Many people still struggle with access to health care or vaccines.

That’s why we need to learn how to live well with asthma in the post-COVID era. In this blog post, we will share some insights from recent studies and some tips on how to cope with the physical and mental health challenges of asthma and COVID-19.

Summary

The COVID-19 pandemic has had a significant impact on the quality of life and treatment of asthma patients around the world. A recent study by Naglaa Youssef and colleagues surveyed 200 asthma patients in Egypt and found that 80% of them had uncontrolled asthma, meaning that their symptoms were frequent or severe and interfered with their daily activities. The most common factor that affected their quality of life was the limitation of activity, such as exercise, work, or socializing. Women reported a higher level of perceived threat from COVID-19 than men.

The study also found some positive changes in the patients’ health behaviors during the pandemic. More patients visited their clinician regularly and followed their treatment plan than before the pandemic. However, over 75% of the patients could not tell the difference between asthma and COVID-19 symptoms, which could lead to confusion or delay in seeking medical help.

The study concluded that the COVID-19 pandemic improved some aspects of asthma care, but also highlighted the need for better asthma control and education. Uncontrolled asthma is a major risk factor for poor quality of life and should be addressed by both patients and clinicians.

Another study by Valeria Saladino and colleagues explored the psychological and social effects of the pandemic on the population, mostly children, college students, and health professionals. They found that these groups were more likely to develop post-traumatic stress disorder, anxiety, depression, and other symptoms of distress due to the pandemic. They also found that social distancing and security measures affected the relationship among people and their perception of empathy toward others.

The study suggested that telepsychology and technological devices could be useful tools to decrease the negative effects of the pandemic and improve psychological treatment of patients online. Telepsychology is the delivery of psychological services using telecommunication technologies, such as phone calls, video calls, or online platforms. Telepsychology can offer benefits such as convenience, accessibility, affordability, and continuity of care.

Key takeaways

Here are some key takeaways on how to live well with asthma in the post-COVID era:

• Keep your asthma under control. Follow your asthma action plan, take your medications as prescribed, monitor your symptoms and peak flow, and avoid triggers that can worsen your asthma.

• Protect yourself from COVID-19. Follow the public health guidelines to prevent the spread of the virus. Wear a mask when you are in public places, wash your hands frequently, practice social distancing, and get vaccinated when it’s available for you.

• Seek medical help when needed. Don’t hesitate to contact your clinician if you have any questions or concerns about your asthma or COVID-19. If you have symptoms of COVID-19, such as fever, cough, shortness of breath, or loss of taste or smell, get tested and isolate yourself until you get the results.

• Stay active and healthy. Physical activity can improve your lung function and overall health. Choose activities that are suitable for your fitness level and don’t trigger your asthma. Eat a balanced diet, drink plenty of water, and get enough sleep.

• Seek support and information. Living with asthma can be stressful and isolating, especially during a pandemic. Reach out to your family, friends, or support groups for emotional support. You can also visit the World Asthma Foundation website to learn more about asthma and how to manage it during the pandemic.

• Practice empathy. Empathy is the ability to understand and share the feelings of another person. It can help you to care for others, cooperate with them, and support them in times of need. Empathy can also motivate you to follow public health guidelines and get vaccinated to prevent the spread of the virus.

• Use telepsychology. Telepsychology is a convenient and effective way to access psychological services online. It can help you cope with stress, anxiety, depression, or other mental health problems caused by the pandemic. It can also help you improve your relationship with yourself and others.

Conclusion

Asthma is a common chronic condition that can impair your quality of life if it’s not well controlled. The COVID-19 pandemic has added more challenges and risks for people with asthma. However, by following some simple steps, you can live well with asthma in the post-COVID era.

The World Asthma Foundation is a non-profit organization that aims to empower the world asthma community through education, collaboration, and advocacy. Our vision is to see a day where they can improve the quality of lifem for all asthmatics.
We do this by advocating for an improved understanding
of the causes, diagnostic tools, methodologies, precision therapies, prevention, sustainability in healthcare, and one day
a cure.

Together, we can makea difference for people living with asthma.

Food Dye and Inflamation

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.

Interventions To Help Asthma Clinical Adherence

Conditions:   Asthma/Drug Therapy;   Medication Adherence/Statistics & Numerical Data;   Reminder Systems;   Humans;   Hispanic Americans;   Communication Barriers;   Child
Interventions:   Device: SmartInhaler with reminder function turned on;   Device: SmartInhaler
Sponsors:   University of California, San Francisco;   Academic Pediatric Association
Not yet recruiting – verified December 2016

View full post on ClinicalTrials.gov: asthma | Studies received in the last 14 days

Cysteinyl Leukotrienes Pathway Genes, Atopic Asthma and Drug Response: From Population Isolates to Large Genome-Wide Association Studies.

Related Articles

Cysteinyl Leukotrienes Pathway Genes, Atopic Asthma and Drug Response: From Population Isolates to Large Genome-Wide Association Studies.

Front Pharmacol. 2016;7:299

Authors: Thompson MD, Capra V, Clunes MT, Rovati GE, Stankova J, Maj MC, Duffy DL

Abstract
Genetic variants associated with asthma pathogenesis and altered response to drug therapy are discussed. Many studies implicate polymorphisms in genes encoding the enzymes responsible for leukotriene synthesis and intracellular signaling through activation of seven transmembrane domain receptors, such as the cysteinyl leukotriene 1 (CYSLTR1) and 2 (CYSLTR2) receptors. The leukotrienes are polyunsaturated lipoxygenated eicosatetraenoic acids that exhibit a wide range of pharmacological and physiological actions. Of the three enzymes involved in the formation of the leukotrienes, arachidonate 5 lipoxygenase 5 (ALOX5), leukotriene C4 synthase (LTC4S), and leukotriene hydrolase (LTA4H) are all polymorphic. These polymorphisms often result in variable production of the CysLTs (LTC4, LTD4, and LTE4) and LTB4. Variable number tandem repeat sequences located in the Sp1-binding motif within the promotor region of the ALOX5 gene are associated with leukotriene burden and bronchoconstriction independent of asthma risk. A 444A > C SNP polymorphism in the LTC4S gene, encoding an enzyme required for the formation of a glutathione adduct at the C-6 position of the arachidonic acid backbone, is associated with severe asthma and altered response to the CYSLTR1 receptor antagonist zafirlukast. Genetic variability in the CysLT pathway may contribute additively or synergistically to altered drug responses. The 601 A > G variant of the CYSLTR2 gene, encoding the Met201Val CYSLTR2 receptor variant, is associated with atopic asthma in the general European population, where it is present at a frequency of ?2.6%. The variant was originally found in the founder population of Tristan da Cunha, a remote island in the South Atlantic, in which the prevalence of atopy is approximately 45% and the prevalence of asthma is 36%. In vitro work showed that the atopy-associated Met201Val variant was inactivating with respect to ligand binding, Ca(2+) flux and inositol phosphate generation. In addition, the CYSLTR1 gene, located at Xq13-21.1, has been associated with atopic asthma. The activating Gly300Ser CYSLTR1 variant is discussed. In addition to genetic loci, risk for asthma may be influenced by environmental factors such as smoking. The contribution of CysLT pathway gene sequence variants to atopic asthma is discussed in the context of other genes and environmental influences known to influence asthma.

PMID: 27990118 [PubMed – in process]

View full post on pubmed: asthma