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Allergic bronchopulmonary mycosis – pathophysiology, histology, diagnosis, and treatment

Allergic bronchopulmonary mycosis (ABPM) develops mainly in patients with asthma or cystic fibrosis via types I and III hypersensitivity reactions to filamentous fungi. Aspergillus spp., especially Aspergillus fumigatus, is the major causative fungus because of its small conidia, thermophilic hyphae...

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Autores principales: Asano, Koichiro, Kamei, Katsuhiko, Hebisawa, Akira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Asia Pacific Association of Allergy, Asthma and Clinical Immunology 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073182/
https://www.ncbi.nlm.nih.gov/pubmed/30079302
http://dx.doi.org/10.5415/apallergy.2018.8.e24
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author Asano, Koichiro
Kamei, Katsuhiko
Hebisawa, Akira
author_facet Asano, Koichiro
Kamei, Katsuhiko
Hebisawa, Akira
author_sort Asano, Koichiro
collection PubMed
description Allergic bronchopulmonary mycosis (ABPM) develops mainly in patients with asthma or cystic fibrosis via types I and III hypersensitivity reactions to filamentous fungi. Aspergillus spp., especially Aspergillus fumigatus, is the major causative fungus because of its small conidia, thermophilic hyphae, and ability to secrete serine proteases. The cardinal histological feature of ABPM is allergic (eosinophilic) mucin-harboring hyphae in the bronchi, for which the formation of extracellular DNA trap cell death (ETosis) of eosinophils induced by viable fungi is essential. Clinically, ABPM is characterized by peripheral blood eosinophilia, increased IgE levels in the serum, IgE and IgG antibodies specific for fungi, and characteristic radiographic findings; however, there are substantial differences in the clinical features of this disease between East and South Asian populations. Systemic corticosteroids and/or antifungal drugs effectively control acute diseases, but recurrences are quite common, and development of novel treatments are warranted to avoid adverse effects and emergence of drug-resistance due to prolonged treatment with corticosteroids and/or antifungal drugs.
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spelling pubmed-60731822018-08-03 Allergic bronchopulmonary mycosis – pathophysiology, histology, diagnosis, and treatment Asano, Koichiro Kamei, Katsuhiko Hebisawa, Akira Asia Pac Allergy Current Review Allergic bronchopulmonary mycosis (ABPM) develops mainly in patients with asthma or cystic fibrosis via types I and III hypersensitivity reactions to filamentous fungi. Aspergillus spp., especially Aspergillus fumigatus, is the major causative fungus because of its small conidia, thermophilic hyphae, and ability to secrete serine proteases. The cardinal histological feature of ABPM is allergic (eosinophilic) mucin-harboring hyphae in the bronchi, for which the formation of extracellular DNA trap cell death (ETosis) of eosinophils induced by viable fungi is essential. Clinically, ABPM is characterized by peripheral blood eosinophilia, increased IgE levels in the serum, IgE and IgG antibodies specific for fungi, and characteristic radiographic findings; however, there are substantial differences in the clinical features of this disease between East and South Asian populations. Systemic corticosteroids and/or antifungal drugs effectively control acute diseases, but recurrences are quite common, and development of novel treatments are warranted to avoid adverse effects and emergence of drug-resistance due to prolonged treatment with corticosteroids and/or antifungal drugs. Asia Pacific Association of Allergy, Asthma and Clinical Immunology 2018-07-16 /pmc/articles/PMC6073182/ /pubmed/30079302 http://dx.doi.org/10.5415/apallergy.2018.8.e24 Text en Copyright © 2018. Asia Pacific Association of Allergy, Asthma and Clinical Immunology. https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Current Review
Asano, Koichiro
Kamei, Katsuhiko
Hebisawa, Akira
Allergic bronchopulmonary mycosis – pathophysiology, histology, diagnosis, and treatment
title Allergic bronchopulmonary mycosis – pathophysiology, histology, diagnosis, and treatment
title_full Allergic bronchopulmonary mycosis – pathophysiology, histology, diagnosis, and treatment
title_fullStr Allergic bronchopulmonary mycosis – pathophysiology, histology, diagnosis, and treatment
title_full_unstemmed Allergic bronchopulmonary mycosis – pathophysiology, histology, diagnosis, and treatment
title_short Allergic bronchopulmonary mycosis – pathophysiology, histology, diagnosis, and treatment
title_sort allergic bronchopulmonary mycosis – pathophysiology, histology, diagnosis, and treatment
topic Current Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073182/
https://www.ncbi.nlm.nih.gov/pubmed/30079302
http://dx.doi.org/10.5415/apallergy.2018.8.e24
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