Diagnostic markers for allergic bronchopulmonary aspergillosis in paediatric cystic fibrosis patientsConference abstracts
THE INFLUENCE OF THE CFTR MODULATOR IVACAFTOR ON ASPERGILLOSIS IN CYSTIC FIBROSISConference abstracts
Background: Aspergillus lung disease may be associated with either the development of, or complicate, non-cystic fibrosis bronchiectasis (NCFB). Whilst IgE to aspergillus may support a diagnosis of Allergic Bronchopulmonary Aspergillosis, the significance of IgG to aspergillus (IgG asp) in NCFB is unclear.Method: A retrospective case series reviewing 102 patients diagnosed with NCFB, seen in a specialist secondary care bronchiectasis clinic in 2015. 60.8% had a previous IgG asp performed. 16 (25.8%) patients had elevated (≥40mgA/L) IgG asp (high group) and 46 (74.2%) patients had normal (
Conclusion: Our study did not demonstrate a difference in the trend FEV1 Z score for patients with aspergillus treated for ABPA and those with aspergillus found on respiratory secretions who were not diagnosed or treated for ABPA.
Conclusions. The applied diagnostic criteria had no significant effect on the reported rate of ABPA prevalence.
PMID: 31702121 [PubMed – as supplied by publisher]
The clinical effects of Aspergillus fumigatus in the cystic fibrosis (CF) airway, with the exception of allergic bronchopulmonary aspergillosis, is unclear.
In conclusion, reliable identification of Aspergillus species is achieved by using molecular sequencing, especially for the emerging rare and cryptic species. They are mostly indistinguishable by conventional methods and might exhibit variable antifungal susceptibility profiles. Moreover, investigation of the antifungal susceptibility patterns is necessary for improved antifungal therapy against aspergillosis.
Nontuberculous mycobacteria (NTM) cause difficult-to-treat opportunistic infections, most frequently of the lungs. Patients with chronic obstructive pulmonary diseases, cystic fibrosis or bronchiectasis are prone to NTM pulmonary disease (PD) and other opportunistic infections, including by Aspergillus fumigatus. Co-infections are difficult to identify as diagnostic criteria for NTM-PD and chronic pulmonary aspergillosis (CPA) overlap [1, 2]. The literature suggests that NTM and Aspergillus co-infections are associated with higher mortality . Therefore, Aspergillus serology is part of NTM-PD diagnostic work up in our reference centre.
CONCLUSION: The use of multiple recombinant antigens may improve the diagnostic accuracy in CF complicated with ABPA or AB. Asp f1 reactivity may relate to the presence of actively growing Aspergillus spp., which might be a useful marker for guiding antifungal therapy in ABPA.
PMID: 31090534 [PubMed – as supplied by publisher]
Aspergillus is the causative agent of human diseases ranging from asthma to invasive infection. Genetic and environmental factors are crucial in regulating the interaction between the host and Aspergillus. The role played by the enzyme indoleamine 2,3-dioxygenase 1 (IDO1), which catalyzes the first and rate-limiting step of tryptophan catabolism along the kynurenine pathway, is increasingly being recognized, but whether and how genetic variation of IDO1 influences the risk of aspergillosis in susceptible patients is incompletely understood. In addition, whether the closely related protein IDO2 plays a similar role remains …