Mold Allergy and Asthma

The connection between mold allergy and severe asthma

Patient consulting Doctor for breathing difficulties, Asthma
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Allergies to mold (or fungus) can result from exposure to airborne mold spores, which can lead to symptoms of allergic rhinitis and allergic asthma. Asthma can be worsened by exposure to mold spores in certain people in a number of ways.

Alternaria Allergy

While any airborne mold can worsen asthma, allergy to the mold Alternaria has been associated with severe asthma exacerbations. Alternaria is found almost everywhere, including in air and soil. It is mostly an outdoor mold, as opposed to Aspergillus and Penicillium, which tend to be indoor molds. Treatment of asthma from Alternaria allergy does not differ from the usual treatments for asthma.

Allergic Bronchopulmonary Aspergillosis

Allergic bronchopulmonary aspergillosis, or ABPA, is a disease characterized by severe asthma and allergy to the mold Aspergillus. ABPA causes a severe allergic reaction within the lung, which can lead to bronchiectasis.

People with ABPA have specific findings on blood tests that differentiate them from those who simply have an allergy to Aspergillus paired with asthma, which is far more common than actually having ABPA. Treatment for ABPA often requires oral corticosteroids along with other typical therapies for severe asthma.

Trichophyton Allergy

Trichophyton is a major cause of fungal skin infections, including athlete’s foot (tinea pedis) and jock itch (tinea cruris). While Trichophyton typically only results in mild fungal skin infections, asthmatics with an allergy to Trichophyton can have severe asthma symptoms when infected with this fungus. Treatment with oral anti-fungal medications, such as fluconazole, has been shown to improve asthma symptoms in people with Trichophyton allergy.

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Article Sources
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  1. Al-Ahmad M, Jusufovic E, Arifhodzic N, Rodriguez T, Nurkic J. Association of molds and metrological parameters to frequency of severe asthma exacerbation. Allergy, Asthma & Clinical Immunology. 2019;15(1). doi:10.1186/s13223-019-0323-8

  2. Knutsen A, Slavin R. Allergic Bronchopulmonary Aspergillosis in Asthma and Cystic Fibrosis. Clinical and Developmental Immunology. 2011;2011:1-13. doi:10.1155/2011/843763

  3. Denning D, Pashley C, Hartl D et al. Fungal allergy in asthma–state of the art and research needs. Clin Transl Allergy. 2014;4(1). doi:10.1186/2045-7022-4-14

Additional Reading
  • Bush RK, Portnoy JM. The Role And Abatement of Fungal Allergens In Allergic Disease. J Allergy Clin Immunol. 2001; 107:S430-40.
  • Eggleston PA, Bush RK. Environmental Allergen Avoidance: An Overview. J Allergy Clin Immunol. 2001; 107:S403-5.
  • Matsuoka H, Niimi A, Matsumoto H, et al. Specific IgE Response to Trichophyton and Asthma Severity. Chest. 2009; 135:898-903.