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Assessment of Aspergillus sensitization or persistent carriage as a factor in lung function impairment in cystic

Judith Fillaux1, François Brémont, Marléne Murris

  • 1Service de Parasitologie-Mycologie, CHU Rangueil, Toulouse, France. fillaux.j@chu-toulouse.fr

Scandinavian Journal of Infectious Diseases
|July 27, 2012
PubMed
Abstract

Insights

Cystic fibrosis patients with Aspergillus fumigatus sensitization or persistent carriage experience worse lung function decline. This impact is significant even without allergic bronchopulmonary aspergillosis (ABPA).

Area of Science:

  • Pulmonary Medicine
  • Infectious Diseases
  • Genetics

Background:

  • Cystic fibrosis (CF) patients with Aspergillus fumigatus carriage or sensitization are often treated with antifungals.
  • Fungal presence is believed to impair lung function in CF, even without allergic bronchopulmonary aspergillosis (ABPA).
  • This study investigates the impact of Aspergillus-related status on CF lung function.

Purpose of the Study:

  • To assess how Aspergillus-related status influences forced expiratory volume in 1 second (FEV₁) in CF patients.
  • To determine if sensitization or persistent carriage of Aspergillus fumigatus affects lung function independently of ABPA.

Main Methods:

  • Evaluated 251 CF patients from 1995-2007, recording demographics, CFTR mutations, BMI, and FEV₁.
  • Assessed A. fumigatus and Pseudomonas aeruginosa in sputum, and levels of A. fumigatus precipitin, total IgE, and specific anti-A. fumigatus IgE.
  • Categorized patients into ABPA, sensitization, persistent carriage, and control groups for multivariate analysis of FEV₁.

Main Results:

  • ABPA, sensitization, and persistent carriage were significantly associated with greater FEV₁ decline (ORs 15.9, 14.9, 10.7, respectively) compared to controls.
  • These associations remained significant and independent of other factors like P. aeruginosa detection, age, BMI, and baseline FEV₁.
  • The findings highlight a substantial negative impact of Aspergillus fumigatus on lung function in CF.

Conclusions:

  • Aspergillus fumigatus sensitization and persistent carriage significantly impact pulmonary function in cystic fibrosis patients.
  • These conditions, alongside ABPA, contribute to lung function decline in CF.
  • Further research and clinical attention are warranted for these Aspergillus-related conditions in CF management.

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