Assessing prevalence and clinical and allergological characteristics of fungal sensitization in Samara City

Molds Alternaria spp., Cladosporium spp., Aspergillus spp., and Penicillium spp. play a major role in populational sensitization. Fungal spores may become a predisposing factor in developing bronchial asthma (BA), allergic rhinitis (AR) and atopic dermatitis (AD). The aim of our study was to investigate prevalence and clinical manifestation of fungal sensitization in the City of Samara. 2016 – 2019 general clinical and allergological examination of 855 patients of different age suspected for respiratory allergy was performed. All patients were tested for measuring serum level of total IgE and IgE specific to most common respiratory and food allergens, including fungal allergens derived from Alternaria spp., Cladosporium spp., Aspergillus spp., Penicillium spp., (RIDA Allergyscreen, R-Biopharm, Germany). 26 patients previously diagnosed positive to native Alternaria extracts and 50 patients with symptoms of exacerbated allergic rhinitis during summer and autumn were tested for serum level of IgE specific to recombinant molecular Alternaria component (rAlt a l, Phadia ImmunoCAP). It was found that 28.4% pediatric and 18.2 % adult patients (р = 0.0322). 25% of patients appeared to be sensitized to fungal allergens. Sensitization to various mold-derived allergens was distributed as follows: Alternaria allergens – in 23% all patients examined, (27% children and 14% adults); Cladosporium – in 11% patients (10% children and 8% adults); Aspergillus – in 5% patients (6% children and 2% adults); Penicillum – in 2% patients (1% children and 3% adults). Moreover, sensitization to Alternaria allergens prevailed in more than 90% patients with fungal sensitization that was more common in young individuals (up to 18% in 7-17-year-old group), but profoundly declined in subjects over 50 years of age (p = 0.00001, χ² = 61.31). True sensitization to Alternaria (Alt a 1) was detected in more than half (63%) of patients with confirmed sensitization to native Alternaria extracts, whereas 66% and 25% patients with fungal sensitization suffered from allergic rhinitis and asthma, respectively. Sensitization to Alternaria is a risk factor of developing asthma in childhood (OR = 2.415). The data obtained evidence about prevalence of fungal sensitization and associated allergic diseases in the Samara region.