Question 11: How should Allergic Bronchopulmonary Aspergillosis [ABPA] be managed in Cystic Fibrosis?

Ohn, Mon; Robinson, Paul D.; Selvadurai, Hiran; Fitzgerald, Dominic A.

doi:10.1016/j.prrv.2016.10.001

Cited by 4 publications

(4 citation statements)

References 30 publications

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“…or galactomannan in serum or bronchoalveolar lavage has been proposed as a microbiological criterion for probable invasive aspergillosis in immunocompetent patients with lung diseases, like Chronic obstructive pulmonary disease (COPD) and bronchiectasis, who also fulfil other clinical criteria, such as pulmonary deterioration, frequent exacerbations after antibiotic treatment, or high doses of steroids. These algorithms have only been applied to critical patients, however, further studies are required to validate the detection of galactomannan in immunocompetent patients who do not need to be admitted to an intensive care unit [ 32 , 33 , 34 ].…”

Section: Filamentous Fungimentioning

confidence: 99%

Fungi in Bronchiectasis: A Concise Review

Máiz

Nieto

Cantón

et al. 2018

IJMS

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Although the spectrum of fungal pathology has been studied extensively in immunosuppressed patients, little is known about the epidemiology, risk factors, and management of fungal infections in chronic pulmonary diseases like bronchiectasis. In bronchiectasis patients, deteriorated mucociliary clearance—generally due to prior colonization by bacterial pathogens—and thick mucosity propitiate, the persistence of fungal spores in the respiratory tract. The most prevalent fungi in these patients are Candida albicans and Aspergillus fumigatus; these are almost always isolated with bacterial pathogens like Haemophillus influenzae and Pseudomonas aeruginosa, making very difficult to define their clinical significance. Analysis of the mycobiome enables us to detect a greater diversity of microorganisms than with conventional cultures. The results have shown a reduced fungal diversity in most chronic respiratory diseases, and that this finding correlates with poorer lung function. Increased knowledge of both the mycobiome and the complex interactions between the fungal, viral, and bacterial microbiota, including mycobacteria, will further our understanding of the mycobiome’s relationship with the pathogeny of bronchiectasis and the development of innovative therapies to combat it.

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Section: Filamentous Fungimentioning

confidence: 99%

Fungi in Bronchiectasis: A Concise Review

Máiz

Nieto

Cantón

et al. 2018

IJMS

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“…The disease is the most common life-limiting congenital disorder in white people. Disruptions in the function of cystic fibrosis transmembrane conductance regulator, as a primary defect, leads to a wide range of symptoms and complications [1]. Cystic fibrosis is the most common cause of chronic pulmonary disease in children and is the leading cause of exocrine pancreatic insufficiency in early life.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Quality of Life in Terms of Sinonasal Symptoms in Children with Cystic Fibrosis

Hassanzad

Derakhshan

Ghaffaripour

et al. 2019

Biomolecular Concepts

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ObjectiveSinusitis is a common complaint in children with cystic fibrosis. However, the actual prevalence of chronic rhinosinusitis and its effect on the quality of life of children have not been well considered. Therefore, the objective of this study was to determine the effect of sinonasal quality of life in children with cystic fibrosis.Materials and methodsThis study was a diagnostic study performed on 80 children with cystic fibrosis ranging from 2 to 20 years old, who were referred to the cystic fibrosis clinic of Masih Daneshvari Hospital from 2017–2018. The questionnaires used in this study were chronic rhinosinusitis screening questionnaire based on the European task force and the evaluation of the sinonasal quality of life was based on the SN-5 survey.ResultsOf the 80 patients with fibrosis from 2 to 20 years old who were recruited in the study, 41 patients were female (51.3%) and 39 were male (48.8%). In 61 cases (76.3%), there was no chronic rhinosinusitis and 19 cases (23.8%) had chronic rhinosinusitis. The mean SN-5 score in 19 patients with chronic rhinosinusitis was 3.4105 and the mean score of patients without rhinosinusitis was 1.8426, with a P-value of 0.000. The mean SN-5 score was significant between the two groups. In patients with nasal congestion, there was a significant difference in quality of life factors such as sinus infection, nasal obstruction, and allergy symptoms (P<0.001). In patients with facial pain, there was a significant difference in quality of life factors such as sinus infection, nasal obstruction, allergic symptoms, and physical activity limitation (P <0.001). There was also a significant difference in the quality of life factors such as sinus infection, nasal obstruction, and allergy symptoms in patients with postnasal drip (P <0.001).ConclusionIn children with cystic fibrosis, the quality of life of sinonasal has a significant relationship with absence of chronic rhinosinusitis. This study showed that children with chronic renosinusitis have significantly lower quality of sinonasal life than children with chronic rhinosinusitis. The results demonstrated that quality of life scores in sinus infections, nasal obstruction, and allergy symptoms were significantly higher in patients with chronic rhinosinusitis than in those without chronic rhinosinusitis. The findings of this study are important for improving children’s health related quality of life, as it leads to promoting communication between the patient and the health care provider, identifying overlooked problems, monitoring the progress of the disease and the burden of treatment, and promoting interventions in the daily life of patients.

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“…92 Both the European CF Society and the United States CFF recommend annual screening for Aspergillus sensitization and ABPA. 97 98…”

Section: Allergic Manifestations: Misdirected Acquired Immunity Towar...mentioning

confidence: 99%

Aspergillus and the Lung

Janssens,

Lambrecht,

Van Braeckel

2024

Semin Respir Crit Care Med

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The filamentous fungus Aspergillus causes a wide spectrum of diseases in the human lung, with Aspergillus fumigatus being the most pathogenic and allergenic subspecies. The broad range of clinical syndromes that can develop from the presence of Aspergillus in the respiratory tract is determined by the interaction between host and pathogen. In this review, an oversight of the different clinical entities of pulmonary aspergillosis is given, categorized by their main pathophysiological mechanisms. The underlying immune processes are discussed, and the main clinical, radiological, biochemical, microbiological, and histopathological findings are summarized.

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Question 11: How should Allergic Bronchopulmonary Aspergillosis [ABPA] be managed in Cystic Fibrosis?

Cited by 4 publications

References 30 publications

Fungi in Bronchiectasis: A Concise Review

Fungi in Bronchiectasis: A Concise Review

Evaluation of Quality of Life in Terms of Sinonasal Symptoms in Children with Cystic Fibrosis

Aspergillus and the Lung

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