Allergic Bronchopulmonary Aspergillosis

Tracy, Michael C.; Okorie, Caroline U. A.; Foley, Elizabeth A.; Moss, Richard B.

doi:10.3390/jof2020017

Cited by 74 publications

(95 citation statements)

References 119 publications

(161 reference statements)

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“…Allergic disease associated with fungal antigens, including the best characterized such syndrome, ABPA, is beyond the scope of this review. ABPA in CF, present in up to 20% of CF patients, carries significant morbidity, and is considered in detail elsewhere . National cystic fibrosis registry data in the USA is limited by a lack of standardization in protocols for collecting and analyzing samples.…”

Section: Epidemiologymentioning

confidence: 99%

“…ABPA in CF, present in up to 20% of CF patients, carries significant morbidity, and is considered in detail elsewhere. [1][2][3] National cystic fibrosis registry data in the USA is limited by a lack of standardization in protocols for collecting and analyzing samples. The most commonly described fungi in registry data are yeasts, specifically Candida spp., and the filamentous fungus Aspergillus.…”

Section: Epidemiologymentioning

confidence: 99%

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The myriad challenges of respiratory fungal infection in cystic fibrosis

Tracy

Moss

2018

Pediatric Pulmonology

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Fungal infection in cystic fibrosis (CF) is a recognized challenge, with many areas requiring further investigation. Consensus definitions exist for allergic bronchopulmonary aspergillus in CF, but the full scope of clinically relevant non-allergic fungal disease in CF-asymptomatic colonization, transient or chronic infection localized to endobronchial mucus plugs or airway tissue, and invasive disease-is yet to be clearly defined. Recent advances in mycological culture and non-culture identification have expanded the list of both potential pathogens and community commensals in the lower respiratory tract. Here we aim to outline the current understanding of fungal presence in the CF respiratory tract, risk factors for acquiring fungi, host-pathogen interactions that influence the role of fungi from bystander to pathogen, advances in the diagnostic approaches to isolating and identifying fungi in CF respiratory samples, challenges of classifying clinical phenotypes of CF patients with fungi, and current treatment approaches. Development and validation of biomarkers characteristic of different fungal clinical phenotypes, and controlled trials of antifungal agents in well-characterized target populations, remain central challenges to surmount and goals to be achieved.

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Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

The myriad challenges of respiratory fungal infection in cystic fibrosis

Tracy

Moss

2018

Pediatric Pulmonology

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“…These abnormalities allow persistence of A. fumigatus in the airways allowing them to germinate into hyphae. 3 In susceptible individuals, colonisation is followed by Aspergillus sensitisation, which is defined as immune-mediated response to A. fumigatus, without evidence of inflammation or tissue damage. 4 Aspergillus sensitisation is currently believed to be the first step in the pathogenesis of ABPA.…”

Section: Introductionmentioning

confidence: 99%

Aspergillus sensitisation in bidi smokers with and without chronic obstructive lung disease

Agarwal

Bhogal

Choudhary

et al. 2017

Mycoses

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Recent studies have described fungal sensitisation in patients with chronic obstructive pulmonary disease (COPD). However, no study has evaluated fungal sensitisation specifically in bidi smokers. Herein, we evaluate the prevalence of Aspergillus sensitisation in bidi smokers. Bidi smokers with and without COPD underwent chest radiography, spirometry, Aspergillus skin test, A. fumigatus precipitins, A. fumigatus-specific IgE and total IgE. Aspergillus sensitisation was defined as the presence of either immediate cutaneous hyperreactivity to Aspergillus antigen or raised A. fumigatus-specific IgE level >0.35 kUA/L. Bidis were obtained from a subset of cases and controls and cultured for the growth of any fungus. Two hundred subjects with COPD and 72 chronic bidi smokers without COPD were included in the study (258 men; mean age, 56.8 years). Aspergillus sensitisation was found to be significantly higher in bidi smokers without COPD (27.8%) compared to the COPD cases (16%). Age, COPD, lung function, severity of smoking and current smoking were not associated with Aspergillus sensitisation, on a multivariate logistic regression analysis. We found a high prevalence of Aspergillus sensitisation in bidi-smoking subjects. More studies are required to confirm the findings of our study.

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“…The role of omalizumab in ABPA management is being increasingly appreciated. 9 A review of 102 published cases of ABPA treated with omalizumab concluded that the drug helped mitigate symptoms, improve PFTs, and decrease corticosteroid requirements. 10 With the increasing use of omalizumab in refractory ABPA, there is interest in developing monoclonal antibodies that target other portions of ABPA's inflammatory cascade.…”

Section: Discussionmentioning

confidence: 99%