Prevalence of <scp>A</scp>spergillus sensitization and allergic bronchopulmonary aspergillosis in cystic fibrosis: systematic review and meta‐analysis

Maturu, Venkata Nagarjuna; Agarwal, Ritesh

doi:10.1111/cea.12595

Cited by 142 publications

(125 citation statements)

References 79 publications

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“…A majority of ABPA patients have symptoms of asthma, a common disease, so the rate of misdiagnosis could be 3.7–11.1% [4]. The overall prevalence of ABPA in patients with cystic fibrosis has been estimated at nearly 9% [5]. In 2013, the recommended diagnostic guidelines for ABPA were put forward by the ABPA expert group of the International Society for Human and Animal Mycology (ISHAM).…”

Section: Introductionmentioning

confidence: 99%

Role of Aspergillus fumigatus-Specific IgE in the Diagnosis of Allergic Bronchopulmonary Aspergillosis

Liu

Xu²,

Yang

et al. 2019

Int Arch Allergy Immunol

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Introduction: Allergic bronchopulmonary aspergillosis (ABPA) has been regarded as a rare disease in China due to the lack of quantitative detection of Aspergillus fumigatus-specific IgE (sIgE). We compared the diagnostic rate of ABPA among asthma patients with or without A. fumigatus-sIgE screening tests to evaluate the benefit of the tests in diagnosing ABPA. Methods: We reviewed the detection rate of A. fumigatus-sIgE and the diagnostic rate of ABPA in 1842 asthma patients in the First Affiliated Hospital of Zhejiang University from 2014 to 2016. Additionally, we collected 144 asthma cases from November 2016 to March 2017 to detect the total serum IgE, A. fumigatus-sIgE and sIgE against mixed mold extract, the ABPA diagnostic rate of these patients was then compared with the total cohort. Total serum IgE, A. fumigatus-sIgE and sIgE against mixed mold extract were also tested in 30 patients identified with Aspergillus-positive sputum culture to analyze the incidence of ABPA. Results: Among the 1,842 asthma cases, 566 were inspected for total IgE; 308 (55.40%) were total IgE-positive and 58 (10.43%) had total IgE > 1,000 IU/mL. In contrast, only 126 cases were tested for A. fumigatus-sIgE (6.84%), and 28 had A. fumigatus-sIgE > 0.35 kUA/L (22.22%). Eleven patients were finally diagnosed with ABPA. Of 1,842 asthma patients, only 0.6% were diagnosed with ABPA if the A. fumigatus-sIgE was not detected at first. Moreover, among the 144 asthma cases that were selected for total IgE, A. fumigatus-sIgE, and sIgE against mixed mold extract screening tests, 12 had total IgE > 1,000 IU/mL (8.33%), 11 had A. fumigatus-sIgE > 0.35 kUA/L (7.64%), and 14 had sIgE against mixed mold extract > 0.35 (9.72%); 7 of these patients were confirmed as having ABPA according to the ISHAM guidelines (4.86%) but only 2 without A. fumigatus-sIgE screening test were diagnosed with ABPA (1.39%) (p = 0.000). Of the 30 Aspergillus-positive sputum culture cases, 4 had A. fumigatus-sIgE > 0.35 kUA/L (13.33%), but none was diagnosed with ABPA. Conclusions: Routine A. fumigatus-sIgE screening for asthma patients can significantly improve the diagnostic rate of ABPA.

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Section: Introductionmentioning

confidence: 99%

Role of Aspergillus fumigatus-Specific IgE in the Diagnosis of Allergic Bronchopulmonary Aspergillosis

Liu

Xu²,

Yang

et al. 2019

Int Arch Allergy Immunol

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“…There are an estimated 3 million individuals with chronic PA and 4.5 million with allergic bronchopulmonary aspergillosis globally (10,11). Af has also been implicated in the pathogenesis of asthma, chronic obstructive airways disease, and bronchiectasis (11)(12)(13). Treatment options remain limited, and high mortality rates persist (14).…”

mentioning

confidence: 99%

Calcineurin Orchestrates Lateral Transfer of Aspergillus fumigatus during Macrophage Cell Death

Shah

Kannambath

Herbst

et al. 2016

Am J Respir Crit Care Med

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Rationale: Pulmonary aspergillosis is a lethal mold infection in the immunocompromised host. Understanding initial control of infection and how this is altered in the immunocompromised host are key goals for comprehension of the pathogenesis of pulmonary aspergillosis.Objectives: To characterize the outcome of human macrophage infection with Aspergillus fumigatus and how this is altered in transplant recipients on calcineurin inhibitor immunosuppressants. Methods:We defined the outcome of human macrophage infection with A. fumigatus, as well as the impact of calcineurin inhibitors, through a combination of single-cell fluorescence imaging, transcriptomics, proteomics, and in vivo studies.Measurements and Main Results: Macrophage phagocytosis of A. fumigatus enabled control of 90% of fungal germination. However, fungal germination in the late phagosome led to macrophage necrosis. During programmed necroptosis, we observed frequent cell-cell transfer of A. fumigatus between macrophages, which assists subsequent control of germination in recipient macrophages. Lateral transfer occurred through actin-dependent exocytosis of the late endosome in a vasodilator-stimulated phosphoprotein envelope. Its relevance to the control of fungal germination was also shown by direct visualization in our zebrafish aspergillosis model in vivo. The calcineurin inhibitor FK506 (tacrolimus) reduced cell death and lateral transfer in vitro by 50%. This resulted in uncontrolled fungal germination in macrophages and also resulted in hyphal escape.Conclusions: These observations identify programmed, necrosisdependent lateral transfer of A. fumigatus between macrophages as an important host strategy for controlling fungal germination. This process is critically dependent on calcineurin. Our studies provide fundamental insights into the pathogenesis of pulmonary aspergillosis in the immunocompromised host.

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“…Recently, differences have been identified that might enable a relatively simple differentiation between ABPA and AS based on the determination of CDC203c basophils concentration, galactomannan antigen in lower respiratory tract samples and pecific IgG in serum. In contrast with ABPA patients, patients with AS have a lower plasma concentration of CDC203c basophils, a negative galactomannan test (< 0.5) and a positive A.fumigatus-specific serum IgG (< 75µg/ mL) (13,16,27).…”

Section: Fungi Of the Genus Aspergillusmentioning

confidence: 98%

“…This term is used to describe hypersensitity reactions which do not meet all of the criteria necessary for making a diagnosis of ABPA (17). AS supposedly affects between 20 and 65 % of CF patients (16). The problems of establishing the prevalence of AS lie in its overlapping clinical features with ABPA and the use of different diagnostic microbiological methods.…”

Section: Fungi Of the Genus Aspergillusmentioning

confidence: 99%

“…The problems of establishing the prevalence of AS lie in its overlapping clinical features with ABPA and the use of different diagnostic microbiological methods. Another problem is poor comparability of commercially available tests and in-house tests (16). Recently, differences have been identified that might enable a relatively simple differentiation between ABPA and AS based on the determination of CDC203c basophils concentration, galactomannan antigen in lower respiratory tract samples and pecific IgG in serum.…”

Section: Fungi Of the Genus Aspergillusmentioning

confidence: 99%

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Glivne okužbe pri bolnikih s cistično fibrozo

Tomazin

Matos

2017

SlovMedJour

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In the last two decades prevalence of fungal infections is increasing for various reasons. One of them is the advance of medical science and the associated longer life expectancy in some patient groups. This includes cystic fibrosis patients who encounter fungal diseases already in their childhood. Fungal pathogens isolated in high frequencies from the respiratory tract include Aspergillus fumigatus, Candida albicans and Scedosporium apiospermum. In the case of cystic fibrosis, these organisms normaly colonise the respiratory and intestinal mucosae and can cause hipersensitivity reactions and invasive diseases. The fungus-patient interactions are complex and depend on several different factors which determine what course will the colonisation/infection take. IzvlečekV zadnjem času se pojavnost glivnih okužb povečuje iz različnih razlogov. Eden od njih je napredek v medicinski znanosti in z njim povezana daljša pričakovana življenjska doba določenih skupin bolnikov. Sem spadajo tudi bolniki s cistično fibrozo, ki se s problematiko glivnih patogenov srečujejo že v otroštvu. Največjo vlogo imajo glive Aspergillus fumigatus, Candida albicans in Scedosporium apiospermum. Pri cistični fibrozi so ti organizmi kolonizatorji dihal in prebavil, povzročitelji preobčutljivostnih reakcij in v redkih primerih povzročitelji invazivnih okužb. Do kakšnega poteka bo prišlo, je odvisno od značilnosti posameznega bolnika, glive in okolja ter izredno kompleksnih interakcij med njimi.

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Prevalence of Aspergillus sensitization and allergic bronchopulmonary aspergillosis in cystic fibrosis: systematic review and meta‐analysis

Abstract: There is a high prevalence of AS and ABPA in patients with CF. Despite six decades of research, there is still a need to adopt uniform methodology and criteria for the diagnosis of AS/ABPA.

Cited by 142 publications

References 79 publications

Role of <b><i>Aspergillus fumigatus-</i></b>Specific IgE in the Diagnosis of Allergic Bronchopulmonary Aspergillosis

Role of <b><i>Aspergillus fumigatus-</i></b>Specific IgE in the Diagnosis of Allergic Bronchopulmonary Aspergillosis

Calcineurin Orchestrates Lateral Transfer of Aspergillus fumigatus during Macrophage Cell Death

Glivne okužbe pri bolnikih s cistično fibrozo

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