Genetic susceptibility to severe asthma with fungal sensitization
N. L. Overton
Division of Infection Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University Hospital of South Manchester NHS Foundation Trust, The University of Manchester, Manchester, UK
Manchester Fungal Infection Group (MFIG), The University of Manchester, Manchester, UK
Search for more papers by this authorA. Simpson
Division of Infection Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University Hospital of South Manchester NHS Foundation Trust, The University of Manchester, Manchester, UK
Search for more papers by this authorP. Bowyer
Division of Infection Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University Hospital of South Manchester NHS Foundation Trust, The University of Manchester, Manchester, UK
Manchester Fungal Infection Group (MFIG), The University of Manchester, Manchester, UK
Search for more papers by this authorCorresponding Author
D. W. Denning
Division of Infection Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University Hospital of South Manchester NHS Foundation Trust, The University of Manchester, Manchester, UK
Manchester Fungal Infection Group (MFIG), The University of Manchester, Manchester, UK
Correspondence
D. W. Denning, The University of Manchester, Education and Research Centre, Wythenshawe Hospital, Manchester, UK.
Email: [email protected]
Search for more papers by this authorN. L. Overton
Division of Infection Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University Hospital of South Manchester NHS Foundation Trust, The University of Manchester, Manchester, UK
Manchester Fungal Infection Group (MFIG), The University of Manchester, Manchester, UK
Search for more papers by this authorA. Simpson
Division of Infection Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University Hospital of South Manchester NHS Foundation Trust, The University of Manchester, Manchester, UK
Search for more papers by this authorP. Bowyer
Division of Infection Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University Hospital of South Manchester NHS Foundation Trust, The University of Manchester, Manchester, UK
Manchester Fungal Infection Group (MFIG), The University of Manchester, Manchester, UK
Search for more papers by this authorCorresponding Author
D. W. Denning
Division of Infection Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University Hospital of South Manchester NHS Foundation Trust, The University of Manchester, Manchester, UK
Manchester Fungal Infection Group (MFIG), The University of Manchester, Manchester, UK
Correspondence
D. W. Denning, The University of Manchester, Education and Research Centre, Wythenshawe Hospital, Manchester, UK.
Email: [email protected]
Search for more papers by this authorFunding information
The research leading to these results has received funding from the European Union's Seventh Framework Programme [FP7/2007-2013] under grant agreement no HEALTH-2010-260338 (ALLFUN). Funding was also provided by the National Aspergillosis Centre, Medical Research Council (grant number MR/M02010X/1), Fungal Infection Trust, and JP Moulton Charitable Foundation and the North West Lung Centre Charity. This report is independent research supported by the National Institute for Health Research Clinical Research Facility at University Hospital of South Manchester NHS Foundation Trust. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.
Summary
Severe asthma is problematic and its pathogenesis poorly understood. Fungal sensitization is common, and many patients with severe asthma with fungal sensitization (SAFS), used to denote this subgroup of asthma, respond to antifungal therapy. We have investigated 325 haplotype-tagging SNPs in 22 candidate genes previously associated with aspergillosis in patients with SAFS, with comparisons in atopic asthmatics and healthy control patients, of whom 47 SAFS, 279 healthy and 152 atopic asthmatic subjects were genotyped successfully. Significant associations with SAFS compared with atopic asthma included Toll-like receptor 3 (TLR3) (p = .009), TLR9 (p = .025), C-type lectin domain family seven member A (dectin-1) (p = .043), interleukin-10 (IL-10) (p = .0010), mannose-binding lectin (MBL2) (p = .007), CC-chemokine ligand 2 (CCL2) (2 SNPs, p = .025 and .041), CCL17 (p = .002), plasminogen (p = .049) and adenosine A2a receptor (p = .024). These associations differ from those found in ABPA in asthma, indicative of contrasting disease processes. Additional and broader genetic association studies in SAFS, combined with experimental work, are likely to contribute to our understanding of different phenotypes of problematic asthma.
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