Allergic bronchopulmonary aspergillosis in patients with asthma: Results of a prospective study


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Abstract

Aim. To estimate the frequency of fungal sensitization and the incidence of allergic bronchopulmonary aspergillosis (ABPA) in asthmatic patients. Subjects and methods. A total of 140 asthmatic patients were examined. They underwent allergologic (skin tests for fungal allergens, estimation of total and fungal allergen-specific IgE levels) and mycological (microscopy and inoculation of respiratory biosubstrates) examinations. Chest computed tomography, when indicated, was done. A group of patients with ABPA and that of patients with severe asthma and fungal sensitization were identified. Results. The frequency of fungal sensitization in asthmatic patients was 36%; the main allergenic fungi were Aspergillus and Alternaria. The incidence of ABPA was as high as 4% in the patients with asthma and 11% in those with severe asthma and fungal sensitization. Conclusion. The given current diagnostic criteria will assist practitioners to identify ABPA, to prevent its progression, and to initiate specific anti-inflammatory and antifungal therapy in due time.

About the authors

Ya I Kozlova

ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава России

Санкт-Петербург, Россия

E V Frolova

ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава России

Санкт-Петербург, Россия

L V Filippova

ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава России

Санкт-Петербург, Россия

A E Uchevatkina

ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава России

Санкт-Петербург, Россия

O V Aak

ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава России

Санкт-Петербург, Россия

N N Klimko

ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава России

Санкт-Петербург, Россия

References

  1. Knutsen AP, Bush RK, Demain JG, Denning DW, Dixit A, Fairs A, Greenberger PA, Kariuki B, Kita H, Kurup VP, Moss RB, Niven RM, Pashley CH, Slavin RG, Vijay HM, Wardlaw AJ. Fungi and allergic lower respiratory tract diseases. J Allergy Clin Immunol. 2012;129:280-291. https://doi.org/10.1016/j.jaci.2011.12.970
  2. Аллергология. Под ред. Федосеева Г.Б. СПб.: Нордмед-Издат; 2001:98-113.
  3. Пульмонология. Под ред. Чучалина А.Г. М.: ГЭОТАР-Медиа, 2009.
  4. Denning DW, Pashley C, Hartl D, Wardlaw A, Godet C, Del Giacco S, Delhaes L, Sergejeva S. Fungal allergy in asthma—state of the art and research needs. Clinical andTranslational Allergy. 2014;4:14. https://doi.org/10.1186/2045-7022-4-14
  5. Denning DW, O’Driscoll BR, Powell G, Chew F, Atherton GT, Vyas A, Miles J, Morris J, Niven RM. Randomized controlled trial of oral antifungal treatment for severe asthma with fungal sensitization: The Fungal Asthma Sensitization Trial (FAST) study. Am J Respir Crit Care Med. 2009;179:11-18. https://doi.org/10.1164/rccm.200805-737OC
  6. Hogan C, Denning DW. Allergic bronchopulmonary aspergillosis and related allergic syndromes. Semin Respir Crit Care Med. 2011;32:682-692. https://doi.org/10.1055/s-0031-1295716
  7. Agarwal R, Chakrabarti A, Shah A, Gupta D, Meis JF, Guleria R, Moss R, Denning DW; ABPA complicating asthma ISHAM working group. Allergic bronchopulmonary aspergillosis: review of literature and proposal of new diagnostic and classification criteria. Clinical & Experimental Allergy. 2013;43:850-873. https://doi.org/10.1111/cea.12141
  8. Agarwal R, Aggarwal AN, Gupta D, Jindal SK. Aspergillus hypersensitivity and allergic bronchopulmonary aspergillosis in patients with bronchial asthma: systematic review and metaanalysis. Int J Tuberc Lung Dis. 2009;13:936-944.
  9. Denning DW, Pleuvry A, Cole DC. Global burden of allergic bronchopulmonary aspergillosis with asthma and its complication chronic pulmonary aspergillosis in adults. Med Mycol. 2013; 51(4):361-370. https://doi.org/10.3109/13693786.2012.738312
  10. Климко Н.Н., Козлова Я.И., Хостелиди С.Н., Шадривова О.В., Борзова Ю.В., Васильева Н.В. Распространенность тяжелых и хронических микотических заболеваний в Российской Федерации по модели LIFE program. Проблемы медицинской микологии. 2014;1:3-9.
  11. Agarwal R, Chakrabarti A. Clinical manifestations and natural history of allergic bronchopulmonary aspergillosis. In: Pasqualotto AC, еds. Aspergillosis: from diagnosis to prevention. Springer. 2010:707-724.
  12. Agarwal R, Gupta D, Aggarwal AN, Saxena AK, Chakrabarti A, Jindal SK. Clinical significance of hyperattenuating mucoid impaction in allergic bronchopulmonary aspergillosis: an analysis of 155 patients. Chest. 2007;132:1183-1190. https://doi.org/10.1378/chest.07-0808
  13. Agarwal R, Singh N, Gupta D. Pulmonary hypertension as a presenting manifestation of allergic bronchopulmonary aspergillosis. Indian J Chest Dis Allied Sci. 2009;51:37-40.
  14. Agarwal R, Gupta D, Aggarwal AN Behera D, Jindal SK. Allergic bronchopulmonary aspergillosis: lessons from 126 patients attending a chest clinic in north India. Chest. 2006;130:442-448.
  15. Fairs A, Agbetile J, Hargadon B, Bourne M, Monteiro WR, Brightling CE, Bradding P, Green RH, Mutalithas K, Desai D, Pavord ID, Wardlaw AJ, Pashley CH. IgE sensitization to Aspergillus fumigatus is associated with reduced lung function in asthma. Am J Respir Crit Care Med. 2010;182:1362-1368.
  16. O’Driscoll BR, Powell G, Chew F, Niven RM, Miles JF, Vyas A, Denning DW. Comparison of skin prick tests with specific serum immunoglobulin E in the diagnosis of fungal sensitization in patients with severe asthma. Clin Exp Allergy. 2009;39:1677-1683. https://doi.org/10.1111/j.13652222.2009.03339.x
  17. Moss RB. Critique of trials in allergic bronchopulmonary aspergillosis and fungal allergy. Med Mycol. 2006; 44:267-272.
  18. Agarwal R. What is the current place of azoles in allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitization. Expert Rev Respir Med. 2012;6:363-371. https://doi.org/10.1586/ers.12.35
  19. Чучалин А.Г. Бронхиальная астма: новые перспективы в терапии. Терапевтический архив. 2012;84(3):5-11.

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