Allergic bronchopulmonary aspergillosis in paediatric cystic fibrosis patients

Almeida, Marina Buarque de; Bussamra, Maria Helena F.; Rodrigues, Joaquim Carlos

doi:10.1016/j.prrv.2005.09.003

Cited by 62 publications

(37 citation statements)

References 58 publications

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“…66,86,87 In other studies involving CF, 31-59% of patients were sensitised to A. fumigates. 67,88 When considering CF and ABPA, although sensitisation to A. fumigatus is crucial to ABPA diagnosis, it is important to differentiate lung colonisation by Aspergillus (40%), 69 allergic sensitisation (20-60%), 66,85 and clinically proven ABPA, a sizeable minority ranging from 1 to 11%. 71,89 The evolution from simple sensitisation to ABPA constitutes a crucial phase which urges to be correctly diagnosed in order to prevent disease progression.…”

Section: Allergic Sensitisation and Clinical Relevancementioning

confidence: 90%

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Cystic fibrosis, atopy, asthma and ABPA

Antunes

Fernandes

Borrego

et al. 2010

Allergologia et Immunopathologia

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The role of atopy on cystic fibrosis (CF) progression remains unclear but evidence suggests that it may influence the appearance of co-morbid conditions such as CF asthma or allergic bronchopulmonary aspergillosis (ABPA). Recognising asthma in patients with CF is not always easy but the identification of atopic markers favours the diagnosis. Physicians should be aware of this fact in order to achieve a better control of respiratory symptoms in patients with CF. Bronchial mucosa inflammation and abnormal mucus predispose to mould colonisation. These patients are at higher risk of allergic sensitisation, especially when atopic susceptibility is present. In the particular case of A. fumigatus, allergic sensitisation precedes ABPA development, which occurs in up to 10% of CF patients. Progression of lung function deterioration is most strikingly pronounced in patients with ABPA. Therefore, sensitisation with A. fumigatus should be regularly tested in patients with CF, especially those at higher risk. Recombinant allergens constitute an important advance in differentiating Aspergillus sensitisation from ABPA itself.

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Section: Allergic Sensitisation and Clinical Relevancementioning

confidence: 90%

“…60,[64][65][66][67][68][69][70][71] ABPA is a lung disease caused by immediate hypersensitivity reaction against Aspergillus fumigatus. The most clinically relevant characteristics are impaired mucociliary clearance, mucoid impactions, wheezing, pulmonary infiltrates, bronchiectasis and fibrosis.…”

Section: Abpamentioning

confidence: 99%

Cystic fibrosis, atopy, asthma and ABPA

Antunes

Fernandes

Borrego

et al. 2010

Allergologia et Immunopathologia

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“…Allergic bronchopulmonary aspergillosis (ABPA) is recognized as a severe complication and characterized by an accelerated decline in lung function. ABPA in CF affects mainly older children and adults, with a prevalence rate of 6 to 25% (17,49). Aspergillus bronchitis is observed in CF patients not fulfilling the criteria for ABPA but with positive respiratory tract cultures, and clinical improvement occurs with appropriate antifungal treatment (28,46).…”

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confidence: 99%

Aspergillus Species and Other Molds in Respiratory Samples from Patients with Cystic Fibrosis: a Laboratory-Based Study with Focus on Aspergillus fumigatus Azole Resistance

et al. 2011

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Respiratory tract colonization by molds in patients with cystic fibrosis (CF) were analyzed, with particular focus on the frequency, genotype, and underlying mechanism of azole resistance among Aspergillus fumigatus isolates. Clinical and demographic data were also analyzed. A total of 3,336 respiratory samples from 287 CF patients were collected during two 6-month periods in 2007 and 2009. Azole resistance was detected using an itraconazole screening agar (4 mg/liter) and the EUCAST method. cyp51A gene sequencing and microsatellite genotyping were performed for isolates from patients harboring azole-resistant A. fumigatus. Aspergillus spp. were present in 145 patients (51%), of whom 63 (22%) were persistently colonized. Twelve patients (4%) harbored other molds. Persistently colonized patients were older, provided more samples, and more often had a chronic bacterial infection. Six of 133 patients (4.5%) harbored azole-nonsusceptible or -resistant A. fumigatus isolates, and five of those six patients had isolates with Cyp51A alterations (M220K, tandem repeat [TR]/L98H, TR/L98H-S297T-F495I, M220I-V101F, and Y431C). All six patients were previously exposed to azoles. Genotyping revealed (i) microevolution for A. fumigatus isolates received consecutively over the 2-year period, (ii) susceptible and resistant isolates (not involving TR/L98H isolates) with identical or very closely related genotypes (two patients), and (iii) two related susceptible isolates and a third unrelated resistant isolate with a unique genotype and the TR/L98H resistance combination (one patient). Aspergilli were frequently found in Danish CF patients, with 4

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“…The spores of A. fumigatus species nest the respiratory system of the patient and producing mycelium, which secretes protein allergens. Buarque de Almeida et al showed the role of Asp f1, Asp f2, Asp f4 and Asp f6 proteins for the development of allergic aspergillosis in CF patients [12]. During the development of the disease high concentration of allergens in the lungs stimulates immunological response of the host.…”

Section: Discussionmentioning

confidence: 99%

Fungal Infection of Cystic Fibrosis Patients—Single Center Experience

Garczewska¹,

Kuś²,

Skorupa³

et al. 2016

Advances in Respiratory Medicine

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Introduction: Cystic fibrosis (CF) is the most common monogenetic autosomal recessive disease in the human population. This systemic disease is characterized by changes in multiple organs, mainly in the lung tissue and digestive tract. More than 59% of CF patients become sensitized to fungal spores, mostly Aspergillus fumigatus. 5−15% of CF patients develop allergic bronchopulmonary aspergillosis. The aim of the study was to analyse the occurrence of yeast and filamentous fungi of the respiratory infections in CF patients and evaluation of drug resistance. Material and methods: Between 2006 and 2014, mycological evaluation of 42 patients hospitalized at the National Institute of Tuberculosis and Lung Diseases was carried out. Results: 217 specimens from pulmonary tract were collected from 42 patients with cystic fibrosis. 205 (68%) strains of yeast and 96 (32%) filamentous fungi strains were cultured. The most common mould strain was A. fumigatus -22,2% (67 species). All isolates of filamentous fungi were in vitro 100% susceptible to itraconazole, voriconazole, posaconazole and amphotericin B. Conclusions: A. fumigatus and C. albicans were the most common etiological agents of fungal respiratory pathogens associated with CF patients. A. fumigatus strains were in vitro 100% susceptible to azole and amphotericin B. Two strains of C. albicans and one strain of C.tropicalis were non-susceptible to azole (fluconazole, itraconazole and voriconazole). Scedosporium apiospermum

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Allergic bronchopulmonary aspergillosis in paediatric cystic fibrosis patients

Cited by 62 publications

References 58 publications

Cystic fibrosis, atopy, asthma and ABPA

Cystic fibrosis, atopy, asthma and ABPA

Aspergillus Species and Other Molds in Respiratory Samples from Patients with Cystic Fibrosis: a Laboratory-Based Study with Focus on Aspergillus fumigatus Azole Resistance

Fungal Infection of Cystic Fibrosis Patients—Single Center Experience

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