Asthma effects about 8.2% of the US population, with about 10% of asthmatics having severe asthma. Several earlier studies have reported that higher levels of airborne fungi (molds) are associated with significantly higher rates of asthma symptoms, asthma related emergency room visits and hospitalizations, and asthma related deaths.
Patients who experience severe asthma when exposed to fungi are now termed Severe Asthma with Fungal Sensitization (SAFS). Allergic Bronchopulmonary Aspergillosis (ABPA) is a common form of severe asthma in which the patient has hypersensitivity to Aspergillus fungi.
Fungi produce hundreds of allergens and mycotoxins which can worsen asthma and allergies. Some fungi like Aspergillus can also grow in the lungs and cause invasive infections.
A number of studies have reported that reducing airborne fungal exposures are often helpful to patients with SAFS and ABPA. Antifungal drugs may also be useful for SAFS and ABPA patients. Two recent trials reported that the use of itraconazole (Sporonox ®) was associated with significantly improved quality of life in SAFS patients, while another study reported that voriconazole (Vfend ®) treatment was not useful in reducing severe asthma exacerbations in Aspergillus fumigatus sensitized asthma patients. Several published studies with ABPA patients have also reported that itraconazole treatment was associated with significantly fewer asthma symptoms and significantly better quality of life and lung function as compared to placebo treated ABPA patients.
Much more research is needed on the use of antifungal drugs to treat severe asthma.