Spores for thought
20 June 2005

Researchers believe they are making good progress towards finding effective treatments for people whose asthma symptoms are triggered by fungal spores.

Up to 70% of the 1.1 million people who experience severe asthma symptoms are allergic to one or more common fungal spores (pictured) in the air, researchers at the University of Manchester have found.

Spores are minute particles that are dispersed through the air by fungi in order to reproduce. There are a thousand times more fungal spores than pollen grains in the air. In the garden, compost heaps are teeming with fungal spores and inside the home they are also very common, particularly in bedrooms and cellars.

A team from Wythenshawe Hospital, led by Dr Robert Niven, are studying the antifungal treatment of asthma. They aim to find treatments that will reduce steroid use and serious attacks for many people with severe asthma symptoms.

Antifungal drugs have been shown to benefit some people with asthma caused by a mould called Aspergillus - allergic bronchopulmonary aspergillosis (ABPA).

The Manchester researchers are hoping to find a more common association between fungal allergy and severe asthma symptoms. Volunteers, who have severe asthma and are allergic to one or more fungi, will be given the antifungal drug itraconazole or a placebo for eight months and the result analysed.

'We have few options for patients with severe asthma other than prescribing more steroids, and those we do have can have side effects worse than steroids themselves,' said Dr Niven.

'Antifungal treatment for those sensitized to fungi may be a useful additional strategy to improve the breathing and overall health of these patients. Certainly our limited treatment experience with itraconazole suggests fewer admissions to hospital for asthma and reduced numbers of steroid courses,' he added.

'We have known for some time that patients at the severe end of the spectrum of asthma, for example those who need mechanical ventilation during attacks of asthma, are far more likely to be hypersensitive to fungi than others with asthma,' commented Professor Martyn Partridge, Asthma UK's Chief Medical Adviser.

'Whether this is the reason for their asthma being more severe is unclear but a good trial of an appropriate antifungal treatment should answer that question.'

The picture of an aspergillus spore magnified is used courtesy of the Fungal Research Trust.