Obstructive lung diseases and allergic bronchopulmonary aspergillosis

Area of Science:

• Pulmonology
• Allergy and Immunology
• Infectious Diseases

Background:

• Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus fumigatus.
• ABPA commonly complicates asthma and cystic fibrosis.
• ABPA is increasingly recognized in other obstructive lung diseases (OLDs).

Purpose of the Study:

• To summarize recent developments in ABPA complicating OLDs.
• To highlight advances in diagnosis and treatment.
• To identify unmet needs in ABPA research.

Main Methods:

• Review of recent literature on ABPA in OLDs.
• Analysis of clinical features, pathophysiology, and diagnostic criteria.
• Evaluation of treatment strategies and research gaps.

Main Results:

• New insights into ABPA pathophysiology, including eosinophil extracellular traps and mucus plugs.
• Established utility of recombinant fungal antigens for diagnosis.
• Proposed newer, more sensitive diagnostic criteria for ABPA.
• Aspergillus sensitization is more common in COPD and non-cystic fibrosis bronchiectasis, associated with higher exacerbation rates.

Conclusions:

• Advances in diagnosis and treatment of ABPA have occurred.
• Further research is needed on genetic predisposition, pathophysiology, and treatment.
• Patients with OLDs require evaluation for Aspergillus sensitization and ABPA.