Allergy in severe asthma |
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| Authors: | S. R. Del Giacco A. Bakirtas E. Bel A. Custovic Z. Diamant E. Hamelmann E. Heffler Ö. Kalayci S. Saglani S. Sergejeva S. Seys A. Simpson L. Bjermer |
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| Affiliation: | 1. Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy;2. Department of Pediatric Allergy and Asthma, School of Medicine, Gazi University, Ankara, Turkey;3. Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands;4. Department of Paediatrics, Imperial College London, London, UK;5. Department of General Practice and Department of Clinical Pharmacy & Pharmacology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands;6. Department of Respiratory Medicine and Allergology, Lund University, Lund, Sweden;7. Klinik für Kinder and Jugendmedizin Kinderzentrum, Bethel Evangelisches Krankenhaus, Allergy Center, Ruhr University Bochum, Bielefeld, Germany;8. Respiratory Medicine and Allergology – Department of Experimental and Clinical Medicine, University of Catania, Catania, Italy;9. School of Medicine, Hacettepe University, Ankara, Turkey;10. National Heart & Lung Institute, Imperial College London, London, UK;11. Institute of Technology, University of Tartu, Tartu, Estonia;12. Department of Microbiology and Immunology, Laboratory of Clinical Immunology, KU Leuven, Belgium;13. Centre Lead for Respiratory Medicine and Allergy, University Hospital of South Manchester, Education and Research Centre, University of Manchester, Manchester, UK |
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| Abstract: | It is well recognized that atopic sensitization is an important risk factor for asthma, both in adults and in children. However, the role of allergy in severe asthma is still under debate. The term ‘Severe Asthma’ encompasses a highly heterogeneous group of patients who require treatment on steps 4–5 of GINA guidelines to prevent their asthma from becoming ‘uncontrolled’, or whose disease remains ‘uncontrolled’ despite this therapy. Epidemiological studies on emergency room visits and hospital admissions for asthma suggest the important role of allergy in asthma exacerbations. In addition, allergic asthma in childhood is often associated with severe asthma in adulthood. A strong association exists between asthma exacerbations and respiratory viral infections, and interaction between viruses and allergy further increases the risk of asthma exacerbations. Furthermore, fungal allergy has been shown to play an important role in severe asthma. Other contributing factors include smoking, pollution and work‐related exposures. The ‘Allergy and Asthma Severity’ EAACI Task Force examined the current evidence and produced this position document on the role of allergy in severe asthma. |
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| Keywords: | aetiology allergy asthma atopy severity |
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