Greenberger Paul A
Division of Allergy-Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
J Allergy Clin Immunol. 2002 Nov;110(5):685-92. doi: 10.1067/mai.2002.130179.
Allergic bronchopulmonary aspergillosis (ABPA) complicates asthma and cystic fibrosis. The survival factors in Aspergillus fumigatus that support saprophytic growth in bronchial mucus are not understood. Prednisone remains the most definitive treatment but need not be administered indefinitely. MHC II -restricted CD4(+) T( H)2 clones have been derived from patients with ABPA. The total serum IgE concentration is elevated sharply but is "nonspecific. " IgE serum isotypic antibodies to A fumigatus are useful in diagnosis; this is in contrast to the situation for patients with asthma without ABPA. High-resolution computed tomography of the chest demonstrates multiple areas of bronchiectasis in most patients with ABPA and is a useful radiologic tool. Some asthma control patients might have a few bronchiectatic airways, but not to the extent seen in or of the same character as those in ABPA. This review discusses clinical, radiologic, investigational, pathogenetic, and treatment issues of ABPA.
变应性支气管肺曲霉病（ABPA）可使哮喘和囊性纤维化病情复杂化。支持烟曲霉在支气管黏液中腐生生长的生存因子尚不清楚。泼尼松仍然是最有效的治疗药物，但无需长期使用。已从ABPA患者中分离出MHC II类限制性CD4(+) T(H)2克隆。血清总IgE浓度急剧升高，但“不具有特异性”。针对烟曲霉的IgE血清同种型抗体对诊断有用；这与无ABPA的哮喘患者情况不同。胸部高分辨率计算机断层扫描显示，大多数ABPA患者有多个支气管扩张区域，是一种有用的影像学工具。一些哮喘得到控制的患者可能有少数支气管扩张气道，但程度不及ABPA患者所见，特征也不同。本文综述了ABPA的临床、影像学、研究、发病机制及治疗问题。
