The Clinical Implications of Aspergillus Fumigatus Sensitization in Difficult-To-Treat Asthma Patients.

BACKGROUND: Fungal sensitivity has been associated with severe asthma outcomes. However, the clinical implication of Aspergillus fumigatus sensitization in difficult-to-treat (or difficult) asthma is unclear. OBJECTIVES: To characterize the clinical implications of A fumigatus sensitization in a large difficult asthma cohort. METHODS: Participants who underwent both skin prick and specific IgE testing to A fumigatus (n = 318) from the longitudinal real-life Wessex AsThma CoHort of difficult asthma, United Kingdom, were characterized by A fumigatus sensitization (either positive skin prick test result or specific IgE) and allergic bronchopulmonary aspergillosis status using clinical/pathophysiological disease measures. RESULTS: A fumigatus sensitization was found in 23.9% (76 of 318) of patients with difficult asthma. Compared with A fumigatus nonsensitized subjects, those with sensitization were significantly more often male (50% vs 31%), older (58 years) with longer asthma duration (33 years), higher maintenance oral corticosteroid (39.7%) and asthma biologic use (27.6%), raised current/maximum log10 total IgE+1 (2.43/2.72 IU/L), worse prebronchodilator airflow obstruction (FEV1 62.2% predicted, FEV1/forced vital capacity 61.2%, forced expiratory flow between 25% and 75% exhalation 30.9% predicted), and frequent radiological bronchiectasis (40%), but had less psychophysiologic comorbidities. Allergic bronchopulmonary aspergillosis diagnosis was associated with higher treatment needs and stronger eosinophilic signals. Factors independently associated with A fumigatus sensitization in difficult asthma included maintenance oral corticosteroid use (odds ratio [OR], 3.34) and maximum log10 total IgE+1 (OR, 4.30), whereas for allergic bronchopulmonary aspergillosis included maintenance oral corticosteroid use (OR, 6.98), maximum log10 total IgE+1 (OR, 4.65), and radiological bronchiectasis (OR, 4.08). CONCLUSIONS: A fumigatus sensitization in difficult asthma identifies a more severe form of airways disease associated with greater morbidity, treatment need, and airways dysfunction/damage, but fewer psychophysiologic comorbidities. Screening of A fumigatus status should be an early element in the comprehensive assessment of patients with difficult asthma.

Preparation of iron-enriched baker's yeast and its efficiency in recovery of rats from dietary iron deficiency.

OBJECTIVES: Iron is an important mineral, essential for the health and function of mammalian cells. Despite its key role, iron deficiency in humans is common worldwide, often leading to significant health issues within the population. The aim of this study was to evaluate the potential of using iron-enriched baker's yeast as a source of iron, especially for the protection and recovery from conditions related to anemia. METHODS: Iron-enriched yeast was prepared by cultivating cells on basal medium comprising different iron concentrations. The effects of iron supplementation on animal health were assessed by feeding anemic rats with a variety of diets containing either inorganic iron or iron-enriched yeast. Body weight, iron bioavailability, blood parameters, and the activity of iron-containing enzymes (catalase) were studied. RESULTS: Iron accumulation in yeast cells increased with iron concentration, reaching a maximum of 15 mg/g when 32 mM iron was applied. Rat groups fed iron-enriched yeast had the highest feed efficiency, iron bioavailability, and hemoglobin concentration. The source of iron supplementation influenced catalase activity in kidney tissues, increasing from 70 U/g tissue in anemic rats to 90 U/g tissue (inorganic iron salt), 110 U/g tissue (inorganic iron salt and non-enriched dry yeast), 145 U/g tissue (iron-enriched yeast 15 mg/g iron) and 115 U/g tissue (iron-enriched yeast 30 mg/g iron). The histologic study of tissues from liver, kidney, heart, and spleen of rats from different groups showed that the damage observed in tissues of anemic rats, was not observed after feeding with iron-enriched yeasts. CONCLUSION: The results demonstrated that ingestion of iron-enriched yeast is more efficient than inorganic treatment in recovery from iron deficiency, including tissue recovery in rats.