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Obstructive lung diseases and allergic bronchopulmonary aspergillosis

Valliappan Muthu1, Kuruswamy T Prasad, Inderpaul S Sehgal

  • 1Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Current Opinion in Pulmonary Medicine
|January 4, 2021
PubMed
Abstract

Insights

Allergic bronchopulmonary aspergillosis (ABPA) complicates asthma and cystic fibrosis, and is increasingly seen in other obstructive lung diseases (OLDs). Recent advances aid diagnosis and treatment, but more research is needed.

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.

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