SummaryThe incidence and prevalence of fungal infections in Russia is unknown. We estimated the burden of fungal infections in Russia according to the methodology of the LIFE program (www.LIFE-worldwide.org). The total number of patients with serious and chronic mycoses in Russia in 2011 was three million. Most of these patients (2607 494) had superficial fungal infections (recurrent vulvovaginal candidiasis, oral and oesophageal candidiasis with HIV infection and tinea capitis). Invasive and chronic fungal infections (invasive candidiasis, invasive and chronic aspergillosis, cryptococcal meningitis, mucormycosis and Pneumocystis pneumonia) affected 69 331 patients. The total number of adults with allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitisation was 406 082.

Summary Introduction Allergic bronchopulmonary aspergillosis (ABPA) is a lung disease in patients with asthma or cystic fibrosis (CF) caused by chronic allergic inflammation to Aspergillus spp. antigens. The role of different immunological mediators in the formation of chronic allergic inflammation in patients with ABPA is not sufficiently explored. Objectives This study aimed to investigate serum levels of thymic stromal lymphopoietin (TSLP), thymus and activated chemokine (TARC) as well as IL‐8 in patients with ABPA, and to evaluate their diagnostic and monitoring value in the disease. Patients/methods Prospective study included 21 patients with ABPA, 25 patients with severe asthma with fungal sensitisation (SAFS), 37 patients with severe asthma without fungal sensitisation (SAwFS), and 16 healthy people. In patients with ABPA, the serum levels of biomarkers were determined at baseline and after 12 weeks of itraconazole therapy. Serum levels of total IgE, Aspergillus‐fumigatus‐specific IgE, TSLP, TARC, IL‐8 were analysed by enzyme‐linked immunosorbent assay. Results In patients with ABPA we established significantly higher serum levels of TARC, IL‐8, total IgE, Aspergillus‐fumigatus‐specific IgE and peripheral blood eosinophil counts, compared to patients with SAwFS. There were no differences in TSLP levels between the examined groups of patients. Serum TARC levels were positively correlated to serum total IgE levels, A fumigatus‐specific IgE levels and peripheral blood eosinophil counts and also negatively correlated to lung function (FEV1). Longitudinally, serum levels TARC, total IgE and peripheral blood eosinophil counts significant decreased after treatment of ABPA. Conclusion Thymus and activated chemokine is a useful test in diagnosing and monitoring response to the antifungal treatment of patients with ABPA.

Allergic bronchopulmonary aspergillosis (ABPA) is a caused by hypersensitivity to Aspergillus spp. antigens, is the lung disease, which occurs in patients with asthma or cystic fibrosis and is characterized by poor control of background disease and development of respiratory failure. According to experts opinion the number of patients with ABPA is about four million people in the world and 175 000 persons in Russian Federation. The clinical course improvement, prevention of progression and prophylaxis of bronchiectasis depend on timely and correct diagnosis of the disease. International Society of Human and Animal Mycology (ISHAM) formed a working group «ABPA in patients with asthma» for worldwide collaboration with physicians and researchers. The working group proposed new diagnostic criteria. This report presents a clinical case of ABPA in asthmatic patient. The diagnosis is established according criteria proposed by R. Agarwal et al., 2013.

ВведениеAspergillus spp. -это возбудители инвазивного аспергиллеза (ИА) и хронического аспергиллеза легких (ХАЛ), а также источники большого коли-чества аллергенов [1, 2]

The given current diagnostic criteria will assist practitioners to identify ABPA, to prevent its progression, and to initiate specific anti-inflammatory and antifungal therapy in due time.