ASSOCIATION BETWEEN FUNGAL DETECTION IN THE AIRWAYS AND MODERATE TO
SEVERE ASTHMA IN HORSES: A CLINICAL STUDY
Abstract
Background: Fungi are ubiquitous in horses’ environment. Their
contribution to the pathophysiology of severe asthma (SA) is
acknowledged, while controversies remain for mild-moderate asthma (MA).
Objectives: We hypothesized that fungi were a risk factor for
asthma. Our objective was to compare different combinations of
analytical methods (cytology, culture) and sampling sites (tracheal wash
(TW), bronchoalveolar lavage fluid (BALF)) in relation to clinical
status (control, MA, SA). Study design: Prospective
cross-sectional study. Methods: The study population included
asymptomatic racing horses in the field and horses referred to the
hospital for respiratory investigations. Fungi were detected by cytology
and identified by mycology on TW and pooled BALF. Chi-square tests were
used for prevalence comparison between groups and association with
clinical investigations. Results: A total of 155 horses (85 MA,
35 SA and 35 controls) were included in the study. The overall
proportions of fungal detection in TW ranged from 45.7% to 89.4% among
groups. The prevalence of fungal detection in BALF was significantly
lower by cytology for SA (5.7%) than MA horses (23.6%) and
significantly higher by culture for MA horses (31.8%) than controls
(8.6%). Fungal detection by culture in BALF was significantly
associated with high tracheal mucus score, high neutrophil proportions
in BALF and diagnosis of MA. Main limitations: Mycology was
only performed in pooled BALF, and environment was not sampled.
Conclusion and clinical importance: Fungi were significantly
more prevalent in the airways of MA horses than SA and/or controls.
Fungal detection on TW, either by cytology or culture, was uninformative
in a clinical context. Fungal detection by culture (but not cytology) in
BALF represents a risk factor for MA.