Allergic Bronchopulmonary Mycosis

Chapter

Abstract

Allergic bronchopulmonary aspergillosis (ABPA) is a common manifestation in chronic allergic asthma and cystic fibrosis (CF) patients. The role of epithelial cell dysfunctions and of the Th2 immune response (“Interleukin-4 (IL-4) hypersensitivity”), seems to be essential for developing an ABPA. Genetic factors associated with the occurrence of ABPA are identified. Different phenotypes of ABPA are described: the sero-positive ABPA, and the bronchiectasis ABPA. Sero-positive ABPA and bronchiectasis ABPA may be the illustration of two stages of the disease, time leading to an inevitable bronchial destruction. It may also be illustrate different expression of the disease. Genetic factors may favor one or the other of these two phenotypes. When clinical, radiological and biological criteria for ABPA appear in combination and the diagnosis is made, then the treatment would need to include both systemic corticosteroids and the antifungal agent itraconazole. However, treatment regimens for this antifungal therapy have yet to be definitively established, although many experts report the benefit of prolonged antifungal treatment.

Keywords

Aspergillus Allergic bronchopulmonary aspergillosis Itraconazole IgE Asthma Severe asthma 

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© Springer-Verlag London 2015

Authors and Affiliations

  1. 1.Pulmonary DepartmentUniversity Hospital, INSERM U1019, Institut Pasteur de Lille, University of Lille 2LilleFrance
  2. 2.Pulmonary DepartmentMedical University of Lille, Centre de compétences des maladies orphelines pulmonaires, Hôpital CalmetteLilleFrance
  3. 3.Pulmonary DepartmentUniversity Hospital, INSERM U1019, Institut Pasteur de LilleLilleFrance
  4. 4.Paediatric Pulmonology and Allergology UnitUniversity Hospital Jeanne de Flandre, INSERM U1019, Institut Pasteur de LilleLilleFrance
  5. 5.Unité de pneumopédiatrie, Centre de compétence des maladies respiratoires raresUniversité Lille 2 et CHRU, Hôpital Jeanne de FlandreLilleFrance

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