ArticleThe European respiratory journal2020
Environmental fungal sensitisation associates with poorer clinical outcomes in COPD.
Article in The European respiratory journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
49 citing papers in PubMed, 2 syntheses or guidelines pooled it, 79 citations in OpenAlex.
- Pooled it
- The global impact of Aspergillus infection on COPD.BMC pulmonary medicine · 2020Pooled it
- Suspected allergic bronchopulmonary candidiasis in a patient with concurrent multidrug-resistant bacterial pneumonia: A case report.Medicine · 2026Article
- Fungal Sensitization and the Manifestation of Asthmatic Features in Chronic Obstructive Pulmonary Disease.Internal medicine (Tokyo, Japan) · 2026Article
- Article
- Fungal-Associated Endotypes as a Treatable Trait in Bronchiectasis.Pulmonary therapy · 2026Review
- Climate change and respiratory health: implications for respiratory clinicians in primary and specialist care.NPJ primary care respiratory medicine · 2026Review
- Chronic Obstructive Pulmonary Disease in Singapore: Current Perspectives on Prevalence, Disease Burden, and Treatment.International journal of chronic obstructive pulmonary disease · 2026Review
- Association between environmental mold exposure and mild cognitive impairment in older adults: a case-control study.Frontiers in public health · 2026Article
- The airway mycobiome in chronic respiratory diseases: current advances and future frontiers.Journal of translational medicine · 2025Review
- Allergic bronchopulmonary aspergillosis in patients with chronic obstructive pulmonary disease: a case series and literature review.BMC pulmonary medicine · 2025Review
- Type 2 inflammation in chronic obstructive pulmonary disease: A promising treatable trait and practice recommendations.Chinese medical journal pulmonary and critical care medicine · 2025Article
- Aspergillus sensitisation & allergic bronchopulmonary aspergillosis in chronic obstructive pulmonary disease: Redefining a treatable trait.The Indian journal of medical research · 2025Article
- Immunosuppressive and antiinfectious regimens in vascular composite allograft recipients-a systematic review.Frontiers in transplantation · 2025Review
- Insights into human respiratory microbiome under dysbiosis and its analysis tool.Frontiers in microbiomes · 2025Review
- Characteristics of pathogenic microorganisms in COPD-related infections: prognostic correlations and implications.Frontiers in cellular and infection microbiology · 2025Observational
- Correlation ofInternational journal of chronic obstructive pulmonary disease · 2025Article
- Residential exposure toThe European respiratory journal · 2024Article
- Fungal lung disease.The European respiratory journal · 2024Review
- Infection and the microbiome in bronchiectasis.European respiratory review : an official journal of the European Respiratory Society · 2024Review
Corrections and comments
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Authors and funding
21 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAllergic sensitisation to fungi such as
methodsPatients with stable COPD (n=446) and nondiseased controls (n=51) were prospectively recruited across three countries (Singapore, Malaysia and Hong Kong) and screened against a comprehensive allergen panel including house dust mites, pollens, cockroach and fungi. For the first time, using a metagenomics approach, we assessed outdoor and indoor environmental allergen exposure in COPD. We identified key fungi in outdoor air and developed specific-IgE assays against the top culturable fungi, linking sensitisation responses to COPD outcomes. Indoor air and surface allergens were prospectively evaluated by metagenomics in the homes of 11 COPD patients and linked to clinical outcome.
resultsHigh frequencies of sensitisation to a broad range of allergens occur in COPD. Fungal sensitisation associates with frequent exacerbations, and unsupervised clustering reveals a "highly sensitised fungal predominant" subgroup demonstrating significant symptomatology, frequent exacerbations and poor lung function. Outdoor and indoor environments serve as important reservoirs of fungal allergen exposure in COPD and promote a sensitisation response to outdoor air fungi. Indoor (home) environments with high fungal allergens associate with greater COPD symptoms and poorer lung function, illustrating the importance of environmental exposures on clinical outcomes in COPD.
conclusionFungal sensitisation is prevalent in COPD and associates with frequent exacerbations representing a potential treatable trait. Outdoor and indoor (home) environments represent a key source of fungal allergen exposure, amenable to intervention, in "sensitised" COPD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.