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Background: House dust mite (HDM) is the most common sensitising allergen in asthma. Ethnic minority groups (EMGs) in the UK are more likely to live in deprived conditionings with a greater exposure to HDM and other aero‐allergens. Aim: To compare the ethnicity‐based patterns of sensitisation to aero‐allergens and the impact of ethnicity on clinical outcomes in patients with difficult‐to‐treat asthma (DTA). Methods: Data of patients with DTA were extracted from the registry of the Birmingham Regional Severe Asthma Service (BRSAS), which have a catchment population of 7.3million from Central England. Patients from White and EMG backgrounds were compared in terms of the prevalence of atopy, total serum immunoglobulin E (IgE), specific serum IgE (ssIgE) and asthma related clinical outcomes. Logistic regression analysis was conducted to explore ethnicity‐based risk factors for HDM sensitisation. Results: A total of 1272 patients [White 1016 (79.9%), EMG 256 (20.1%) EMG] with a median age of 51 years (range 16–97) were included in the analysis. Patients from EMG were more likely (64%) to reside in the worst scale of index of multiple deprivation (IMD) than the White patients (25.5%), p < 0.0001. Positive HDM sensitisation was more prevalent in the EMG than in the White group [142/216 (66%) versus 375/842 (45%), p < 0.0001]. The median HDM ssIgE level was higher in the EMG than in the White group [3.0 KUA/L (IQR 0.06, 11.5) versus 0.1 (0.01, 3.0), p < 0.000001]. The odds ratio for positive sensitisation to HDM conveyed by the EMG status was 2.61 (95%CI, 1.8–3.8), p < 0.0001. Compared to the White group, the EMG had higher median total serum IgE [326 KU/L (115, 971) versus 114 (29.8, 434.8), p < 0.000001], higher blood eosinophil count (0.36 × 109(0.18, 0.62) versus 0.23 (0.1,0.47), p < 0.000001), were marginally more atopic (79.2% vs. 75.6%, p = 0.098) and were less likely to being on maintenance oral corticosteroids (22% vs. 39.7%, p < 0.0001). Conclusion: In this DTA cohort, positive HDM sensitisation was greater amongst the EMG than the White patients. The EMG status was a significant risk factor for HDM sensitisation. [ABSTRACT FROM AUTHOR]

AFS in our study was characterized by earlier age of onset, higher IgE levels and lower FEV1 We suggest AFS is worth considering in uncontrolled asthma and those with moderate-severe asthma There is a need to assess anti-fungal drugs as an adjunct to standard therapy in AFS To the editor, The biological role of fungi in the pathophysiology of asthma has attracted renewed attention during the last decade. Assessment of sensitization to aero-allergens including fungal allergens was performed by the skin prick tests using allergen kits by Hollister Stier Allergy (Jubilant Pharma LLC, USA). Patients with multiple fungal sensitizations had poorer ACT scores in comparison to those with sensitization to a single fungal allergen ( I p i < 0.001), that is the median ACT scores in subjects with no fungal allergen was 23.0 (22.0-24.0); with sensitization to one fungal allergen was 21.0 (19.0-22.0) and with sensitization to >=2 fungal allergens was 18.0 (18.0-20.0) (Figure 1C). (C) Box plot illustrating the relationship between ACT scores and sensitization to none, 1 or >=2 fungal allergens: The plot illustrates that sensitization to >=2 fungal allergens was associated with poorer asthma control. [Extracted from the article]

Briefly, the questionnaire had 21 items, including core questions to assess the prevalence of rhinitis, asthma and eczema. Asthma insights and management in India: lessons learnt from the Asia pacific-asthma insights and management (AP-AIM) Study. In conclusion, the prevalence of asthma and rhinitis in this Bengaluru cohort is higher than the previously reported overall prevalence in India. [Extracted from the article]