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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]