Sensitization to Bjerkandera adusta enhances severity of cough symptom in patients with fungus-associated chronic cough (FACC).

OBJECTIVE The aim of the present study was to clarify the influence of sensitization to Bjerkandera adusta (B. adusta) on the clinical manifestation in patients with fungus-associated chronic cough (FACC). METHODS Seventeen patients with FACC who underwent bronchoprovocation tests using an antigenic solution of B. adusta were selected from among 21 FACC patients. We compared the allergological findings and clinical characteristics of the FACC patients who showed a positive reaction to the bronchoprovocation test (Allergic fungal cough sensitized to B. adusta; AFC-Bj) with the remaining FACC patients (non AFC-Bj) retrospectively. RESULTS The eleven patients with AFC-Bj had a median age of 52 (range, 22-70) years, and 45.5% were female. The respective values for six patients with non AFC-Bj were 47.5 (range, 36-60) years of age, and 33.3% were female. The positive ratios for an immediate cutaneous reaction (45.5%; p<0.05) and the lymphocyte stimulation test (63.6%; p<0.05) to B. adusta were found to be significantly higher in the AFC-Bj group than in the non AFC-Bj group. The total time required for complete remission of cough symptoms was longer (median 20, range 12-43 weeks; p=0.0009), and the recurrence ratio of coughing was more frequent in the AFC-Bj group in comparison to those in non AFC-Bj group (2, range 1-3 times and 0.5, range 0-1 times, respectively). CONCLUSIONS This study demonstrated that B. adusta, a basidiomycetous is an environmental fungus attracting attention because of its possible role in enhancing the cough severity of FACC patients via the sensitization to this fungus.