Gibson Peter G
Department of Respiratory and Sleep Medicine, Hunter Medical Research Institute, University of Newcastle, NSW, Australia.
Semin Respir Crit Care Med. 2006 Apr;27(2):185-91. doi: 10.1055/s-2006-939521.
Allergic bronchopulmonary aspergillosis is an uncommon but serious respiratory condition characterized by chronic airway inflammation and airway damage resulting from persistent colonization by and sensitization to the fungus Aspergillus fumigatus. The immunopathogenesis of allergic bronchopulmonary aspergillosis involves several pathways. Aspergillus allergens stimulate an interleukin 5-mediated Th2 pathway responsible for the eosinophilic infiltrate, whereas aspergillus proteases promote epithelial activation and a potent chemokine response that induces neutrophilic airway inflammation. The resulting airway inflammation is intense, involves tissue damage and remodeling, and is linked with the severity of bronchiectasis. Treatment involves corticosteroids and antifungal therapy with oral azoles. Additional management seeks to monitor and control the other disease components of severe asthma, bronchiectasis, and disease exacerbations.
变应性支气管肺曲霉病是一种罕见但严重的呼吸道疾病，其特征为慢性气道炎症和气道损伤，这是由烟曲霉持续定植并致敏所致。变应性支气管肺曲霉病的免疫发病机制涉及多条途径。曲霉过敏原刺激白介素5介导的Th2途径，该途径导致嗜酸性粒细胞浸润，而曲霉蛋白酶促进上皮细胞活化和强烈的趋化因子反应，从而诱导中性粒细胞气道炎症。由此产生的气道炎症强烈，涉及组织损伤和重塑，并与支气管扩张的严重程度相关。治疗包括使用皮质类固醇和口服唑类进行抗真菌治疗。进一步的管理旨在监测和控制重度哮喘、支气管扩张和疾病加重等其他疾病组成部分。
