The following is a summary of “Fungal allergen sensitization: Prevalence, risk factors, and geographic variation in the United States,” published in the December 2023 issue of Allergy & Immunology by Kwong, et al.
Allergic diseases often involve various fungal species in their pathogenesis. However, many epidemiological studies focusing on IgE-mediated fungal sensitization have only examined a limited number of species. For a study, researchers sought to investigate the prevalence of fungal allergen sensitization, identify associated risk factors, and explore geographic variations in the United States.
Between 2014 and 2019, a US-wide clinical laboratory analyzed 7,912,504 serum-specific IgE (sIgE) test results for 17 fungal species in 1,651,203 patients aged 0-85 years. The study assessed fungal sensitization prevalence, patterns, and their correlation with demographic characteristics, clinical diagnoses, and geographic regions.
Of the patients tested, 22% exhibited positivity (sIgE > 0.10 kUA/L) to at least one fungal allergen, with 13.7% positive to more than two fungal allergens. Candida albicans (18.6%), Alternaria alternata (16.6%), Stemphylium herbarum (14.9%), and Aspergillus fumigatus (14.2%) had the highest species-specific positivity rates. Other commonly tested fungi had lower positivity rates (e.g., Cladosporium herbarum 11.1%, Penicillium chrysogenum 10.7%). Independent risk factors for test positivity across all fungal species included male sex, adolescence (particularly in those aged 10-19), atopic dermatitis, and asthma. Fungal sensitization tended to be higher in urban areas and ecoregions dominated by grasslands and prairies compared to woodlands and forests, although there was significant variation in sensitization risk to different fungi across different ecoregions.
The study identified several independent risk factors for fungal sensitization, including male sex, adolescence, atopic dermatitis, asthma, and ecoregion. The findings highlighted the importance of considering geographic and demographic factors in understanding fungal sensitization patterns and their associated risk factors.
Reference: jacionline.org/article/S0091-6749(23)01189-2/fulltext