Frequent Pet Contact as Risk Factor for Allergic Bronchopulmonary Aspergillosis in Cystic Fibrosis

Grehn, Claudia; Eschenhagen, Patience; Temming, Svenja; Düesberg, Uta; Neumann, Konrad; Schwarz, C.

doi:10.3389/fcimb.2020.601821

Cited by 6 publications

(3 citation statements)

References 27 publications

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“…All these risk factors should be taken into account during exacerbations of the disease, especially when laboratory tests confirm colonization, and there is no response after administration of appropriate medications. 6,67,[73][74][75] Implementation of highly effective CFTR modulators during the last few years has been a breakthrough in CF care. However, the chronic inflammation and infection with bacteria and fungi in the CF airways are still outstanding challenges.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

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Pulmonary Aspergillosis in People with Cystic Fibrosis

Schwarz,

Eschenhagen,

Mainz

et al. 2024

Semin Respir Crit Care Med

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In the last decade, fungal respiratory diseases have been increasingly investigated for their impact on the clinical course of people with cystic fibrosis (CF), with a particular focus on infections caused by Aspergillus spp. The most common organisms from this genus detected from respiratory cultures are Aspergillus fumigatus and Aspergillus terreus, followed by Aspergillus flavus, Aspergillus niger, and Aspergillus nidulans. These species have been identified to be both chronic colonizers and sources of active infection and may negatively impact lung function in people with CF. This review article discusses definitions of aspergillosis, challenges in clinical practice, and current literature available for laboratory findings, clinical diagnosis, and treatment options for pulmonary diseases caused by Aspergillus spp. in people with CF.

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Section: Clinical Manifestationsmentioning

confidence: 99%

Section: Pathogenesis Of Aspergillus Spp Colonization...mentioning

confidence: 99%

Pulmonary Aspergillosis in People with Cystic Fibrosis

Schwarz,

Eschenhagen,

Mainz

et al. 2024

Semin Respir Crit Care Med

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“…Identification of potential environmental sources like pet-ownership, 54 asthma control, swift detection, treatment of exacerbations, and prevention of further lung damage are the main treatment goals. Pharmacological interventions include systemic corticosteroids, antifungal drugs, and anti-IgE antibodies.…”

Section: Treatment Of Allergic Bronchopulmonary Aspergillosismentioning

confidence: 99%

Clinical Relevance of Fungi in Cystic Fibrosis

Schwarz¹

2023

Semin Respir Crit Care Med

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In cystic fibrosis, a new era has started with the approval and use of highly effective cystic fibrosis transport regulator (CFTR) modulator therapy. As pulmonary function is increasing and exacerbation rate significantly decreases, the current meaning of fungal pulmonary diseases is questioned. During the past couple of decades, several studies have been conducted regarding fungal colonization and infection of the airways in people with cystic fibrosis. Although Aspergillus fumigatus for filamentous fungi and Candida albicans for yeasts remain by far the most common fungal species in patients with cystic fibrosis, the pattern of fungal species associated with cystic fibrosis has considerably diversified recently. Fungi such as Scedosporium apiospermum or Exophiala dermatitidis are recognized as pathogenic in cystic fibrosis and therefore need attention in clinical settings. In this article, current definitions are stated. Important diagnostic steps are described, and their usefulness discussed. Furthermore, clinical treatment strategies and recommendations are named and evaluated. In cystic fibrosis, fungal entities can be divided into different subgroups. Besides colonization, allergic bronchopulmonary aspergillosis, bronchitis, sensitization, pneumonia, and aspergilloma can occur as a fungal disease entity. For allergic bronchopulmonary aspergillosis, bronchitis, pneumonia, and aspergilloma, clear indications for therapy exist but this is not the case for sensitization or colonization. Different pulmonary fungal disease entities in people with cystic fibrosis will continue to occur also in an era of highly effective CFTR modulator therapy. Whether the percentage will decrease or not will be the task of future evaluations in studies and registry analysis. Using the established definition for different categories of fungal diseases is recommended and should be taken into account if patients are deteriorating without responding to antibiotic treatment. Drug–drug interactions, in particular when using azoles, should be recognized and therapies need to be adjusted accordingly.

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