It is hoped that the study, by clinical researchers based at Manchester's Wythenshawe Hospital, will reduce steroid use and serious attacks requiring hospital intervention for asthma sufferers. It could also help those with cystic fibrosis and chronic sinusitis.
Severe asthma in adults affects 10 - 20% of the UK's 5m asthmatics, and skin tests indicate that up to 70% of these sufferers are allergic to one or more common fungi in the air.
Previous studies have shown the benefits of one antifungal drug [itraconazole or Sporonoxâ] for the asthma subgroup known as "allergic bronchopulmonary aspergillosis" or "ABPA". The University of Manchester researchers are studying the more common association between fungal allergy and those with severe asthma who do not have ABPA. Volunteers are screened and, if testing shows allergy to one or more fungi, allocated itraconazole capsules or matching dummy capsules for 8 months. So far 26 patients (25% of the total required) have been enrolled.
Allergy to fungi is relatively common, affecting asthmatics, those with cystic fibrosis and others with chronic sinusitis (usually with nasal polyps). Fungi commonly implicated include airborne molds, such as Aspergillus, Cladosporium, Alternaria and Penicillium, with airborne fungal spores outnumbering pollen grains in outside air almost 1000-fold. Inside the home fungi are also very common, particularly in bedrooms and cellars, and compost is particularly rich in fungi.
The clinical study is funded by the charity The Moulton Trust as a grant to the University of Manchester. Its lead investigator Dr Robert Niven, of the North West Lung Centre, Wythenshawe Hospital, said: "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. 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."
Four centers are currently enroling patients: The North West Lung Centre, Wythenshawe Hospital, Hope Hospital (Ronan O'Driscoll); North Manchester General Hospital (Dr J Miles) and Preston Hospital (Dr A Vyas). The study is expected to conclude in 2006 when the results will be analysed.
The importance of fungi to health will be highlighted at a conference in London on June 15th 2005 hosted by the Fungal Research Trust, a UK Charity devoted to education and research into fungal disease. The charity has supported research in Manchester and other UK centres. Further details are available on the website www.fungalresearchtrust.org
For more information contact Jo Nightingale on 0161 275 8156 or joanne.nightingale@manchester.ac.uk, or Aeron Haworth on 0161 275 8383 or aeron.haworth@manchester.ac.uk.
Note to Editors:
The Fungal Research Trust Conference will take place at the Medical Society of London, 11 Chandos Street, London W1H 0EB at 10am on Wednesday 15th June 2005. For further information please phone June Beedham on 0771 432 6527.
Further information:
www.aspergillus.man.ac.uk
www.asthma.org.uk
www.ginasthma.com
www.pollenuk.co.uk
The University of Manchester (www.manchester.ac.uk) was formed by the merger of The Victoria University of Manchester and UMIST in October 2004, and with 36,000 students expected in the coming academic year is the largest higher education institution in the country. Its Faculty of Medical & Human Sciences (www.mhs.manchester.ac.uk) is one of the largest faculties of clinical and health sciences in Europe, with a research income of over £37 million.
The School of Medicine (www.medicine.manchester.ac.uk) is the largest of the Faculty's five Schools, with 1300 staff, almost 2000 undergraduates and a £32M research income. The School encompasses five teaching hospitals, and is closely linked to a range of general hospitals and community practices across the North West of England.