Allergic bronchopulmonary aspergillosis in cystic fibrosis

Hanley-Lopez, Jean; Clement, Loran T.

doi:10.1097/00063198-200011000-00014

Cited by 11 publications

(10 citation statements)

References 23 publications

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“…Among them, Aspergillus fumigatus has been reported with a prevalence ranging from 16 to 45.7% in CF patients (2,3,7,8,18). This fungus is well known to clinicians involved in the follow-up of these patients since it may cause various diseases, the most common being allergic bronchopulmonary aspergillosis (3,12,26,43). In addition, other Aspergillus species, including Aspergillus flavus and Aspergillus niger, may be present as transient colonizers of the airways, usually without any associated clinical signs (28,38).…”

mentioning

confidence: 99%

Development of an Oligonucleotide Array for Direct Detection of Fungi in Sputum Samples from Patients with Cystic Fibrosis

Bouchara

Hsieh

Croquefer³

et al. 2009

J Clin Microbiol

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Cystic fibrosis (CF) is the most common inherited genetic disease in Caucasian populations. Besides bacteria, many species of fungi may colonize the respiratory tract of these patients, sometimes leading to true respiratory infections. In this study, an oligonucleotide array capable of identifying 20 fungal species was developed to directly detect fungi in the sputum samples of CF patients. Species-specific oligonucleotide probes were designed from the internal transcribed spacer (ITS) regions of the rRNA operon and immobilized on a nylon membrane. The fungal ITS regions were amplified by PCR and hybridized to the array for species identification. The array was validated by testing 182 target strains (strains which we aimed to identify) and 141 nontarget strains (135 species), and a sensitivity of 100% and a specificity of 99.2% were obtained. The validated array was then used for direct detection of fungi in 57 sputum samples from 39 CF patients, and the results were compared to those obtained by culture. For 16 sputum samples, the results obtained by the array corresponded with those obtained by culture. For 33 samples, the array detected more fungal species than culture did, while the reverse was found for eight samples. The accuracy of the array for fungal detection in sputum samples was confirmed (or partially confirmed) in some samples by cloning and resequencing the amplified ITS fragments. The present array is a useful tool for both the simultaneous detection of multiple fungal species present in the sputa of CF patients and the identification of fungi isolated from these patients.

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mentioning

confidence: 99%

Development of an Oligonucleotide Array for Direct Detection of Fungi in Sputum Samples from Patients with Cystic Fibrosis

Bouchara

Hsieh

Croquefer³

et al. 2009

J Clin Microbiol

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“…In patients with baseline high IgE level, a 2-fold rise in IgE may antedate an ABPA flare. Reduction in IgE by 50% after high-dose systemic corticosteroid therapy also supports the diagnosis [5]. Recent work suggests that a limited panel of recombinant allergens, used either for skin tests or as the antigen in RAST testing, improve specificity for the detection of sensitization to A. fumigatus, as well as for the detection of ABPA [16,17].…”

Section: Clinical Features and Diagnostic Criteria For Abpa In Cfmentioning

confidence: 84%

“…Ideally corticosteroid therapy should be withdrawn in 2-3 months. If there is no improvement, the diagnosis of ABPA [5] should be questioned. If the patient relapses during the corticosteroid taper, corticosteroid dosages should be increased and/or itraconazole added.…”

Section: Treatment Of Abpa In Cf Patientsmentioning

confidence: 99%

“…In refractory cases, attempt should be made to search for and modify mould spore exposure (e.g. stables, rotting vegetation), and regular replacement of nebulizer tubing and filters is crucial to the prevention of mould growth [5].…”

Section: Treatment Of Abpa In Cf Patientsmentioning

confidence: 99%

“…Aspergillus spp. usually only colonize but can cause asthma, allergic bronchopulmonary aspergillosis (ABPA), aspergilloma and rarely infection with true tissue invasion [5]. The most common species include A. fumigatus and Aspergillus clavatus.…”

Section: Introductionmentioning

confidence: 99%

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Respiratory Fungal Infections and Allergic Bronchopulmonary Aspergillosis

Que¹,

Geddes²

2005

Cystic Fibrosis in the 21st Century

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Factors effecting impact of Aspergillus fumigatus sensitization in cystic fibrosis

Kanthan

Bush

Kemp

et al. 2007

Pediatric Pulmonology

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The clinical impact of Aspergillus fumigatus (Af) sensitization in cystic fibrosis (CF) is controversial. We examined the effect of Af sensitization (Afs) on pulmonary function and growth using a retrospective cohort analysis over two 5-year study periods: 1996-2000 (19 Afs cases and 19 controls) and 2001-2005 (24 Afs cases and 23 controls). Sensitization was defined as Af specific radioallergosorbent test (RAST) >or= 17.5 iu/ml and total serum IgE level >or=150 iu/ml. We examined the impact of changing treatment schedules over these periods. Afs cases had lower median FEV(1) %predicted (%PR) compared to matched controls 1996: 67 versus 80, P < 0.01; 2001: 78 versus 93, P < 0.01. Afs cases in the 2001 cohort had a higher FEV(1) %PR compared to Afs cases in the 1996 cohort: 78 versus 67, P < 0.01. For the 1996 Afs cohort FEV(1) %PR fell significantly over 5 years but not for the 2001 Afs cohort. Af RAST and total IgE reflected the changes in pulmonary function. Children in the 2001 Afs cohort were prescribed significantly more oral antifungal treatment (odds ratio 4.3, 95%CI 1.2-15.7, P = 0.03). Afs children continue to have poorer lung function compared to controls but this observational, hypothesis generating study, suggests that the use of antifungal treatment is associated with better lung function.

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Allergic bronchopulmonary aspergillosis in cystic fibrosis

Cited by 11 publications

References 23 publications

Development of an Oligonucleotide Array for Direct Detection of Fungi in Sputum Samples from Patients with Cystic Fibrosis

Development of an Oligonucleotide Array for Direct Detection of Fungi in Sputum Samples from Patients with Cystic Fibrosis

Respiratory Fungal Infections and Allergic Bronchopulmonary Aspergillosis

Factors effecting impact of Aspergillus fumigatus sensitization in cystic fibrosis

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