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Updated: Feb 15, 2026
Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis
Published on: March 9, 2018
Allergic Bronchopulmonary Aspergillosis
Michael C Tracy1, Caroline U A Okorie2, Elizabeth A Foley3
1Center for Excellence in Pulmonary Biology, Department of Pediatrics, Stanford University School of Medicine, 770 Welch Road suite 350, Palo Alto, CA 94304, USA. mtracy@stanford.edu.
Abstract:
Allergic bronchopulmonary aspergillosis (ABPA), a progressive fungal allergic lung disease, is a common complication of asthma or cystic fibrosis. Although ABPA has been recognized since the 1950s, recent research has underscored the importance of Th2 immune deviation and granulocyte activation in its pathogenesis. There is also strong evidence of widespread under-diagnosis due to the complexity and lack of standardization of diagnostic criteria. Treatment has long focused on downregulation of the inflammatory response with prolonged courses of oral glucocorticosteroids, but more recently concerns with steroid toxicity and availability of new treatment modalities has led to trials of oral azoles, inhaled amphotericin, pulse intravenous steroids, and subcutaneously-injected anti-IgE monoclonal antibody omalizumab, all of which show evidence of efficacy and reduced toxicity.
Insights
Allergic bronchopulmonary aspergillosis (ABPA) is a fungal lung disease often underdiagnosed. New treatments show promise for managing ABPA with reduced toxicity compared to long-term steroids.
Area of Science:
- Pulmonology
- Immunology
- Mycology
Background:
- Allergic bronchopulmonary aspergillosis (ABPA) is a progressive fungal allergic lung disease complicating asthma and cystic fibrosis.
- Pathogenesis involves Th2 immune deviation and granulocyte activation.
- Under-diagnosis is common due to complex and non-standardized diagnostic criteria.
Purpose of the Study:
- To review the current understanding of ABPA pathogenesis.
- To highlight diagnostic challenges.
- To discuss emerging and alternative treatment strategies.
Main Methods:
- Literature review of ABPA pathogenesis, diagnosis, and treatment.
- Analysis of recent clinical trials and therapeutic approaches.
Main Results:
- ABPA involves Th2 immunity and granulocyte activation.
- Diagnostic criteria lack standardization, leading to under-diagnosis.
- Newer treatments like oral azoles, inhaled amphotericin, and omalizumab show efficacy and reduced toxicity.
Conclusions:
- ABPA requires better diagnostic standardization.
- Novel therapeutic options offer alternatives to prolonged oral glucocorticosteroids.
- Emerging treatments improve ABPA management with enhanced safety profiles.
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