Antunes J, Fernandes A, Borrego L Miguel, Leiria-Pinto P, Cavaco J
Serviço de Imunoalergologia, Hospital Dona Estefânia, Lisboa, Portugal.
Allergol Immunopathol (Madr). 2010 Sep-Oct;38(5):278-84. doi: 10.1016/j.aller.2010.06.002. Epub 2010 Aug 2.
The role of atopy on cystic fibrosis (CF) progression remains unclear but evidence suggests that it may influence the appearance of co-morbid conditions such as CF asthma or allergic bronchopulmonary aspergillosis (ABPA). Recognising asthma in patients with CF is not always easy but the identification of atopic markers favours the diagnosis. Physicians should be aware of this fact in order to achieve a better control of respiratory symptoms in patients with CF. Bronchial mucosa inflammation and abnormal mucus predispose to mould colonisation. These patients are at higher risk of allergic sensitisation, especially when atopic susceptibility is present. In the particular case of A. fumigatus, allergic sensitisation precedes ABPA development, which occurs in up to 10% of CF patients. Progression of lung function deterioration is most strikingly pronounced in patients with ABPA. Therefore, sensitisation with A. fumigatus should be regularly tested in patients with CF, especially those at higher risk. Recombinant allergens constitute an important advance in differentiating Aspergillus sensitisation from ABPA itself.
特应性在囊性纤维化（CF）进展中的作用尚不清楚，但有证据表明，它可能会影响诸如CF哮喘或变应性支气管肺曲霉病（ABPA）等合并症的出现。识别CF患者的哮喘并不总是容易的，但特应性标志物的识别有助于诊断。医生应该了解这一事实，以便更好地控制CF患者的呼吸道症状。支气管黏膜炎症和异常黏液易导致霉菌定植。这些患者发生过敏致敏的风险更高，尤其是存在特应性易感性时。在烟曲霉的特定病例中，过敏致敏先于ABPA的发生，ABPA发生在高达10%的CF患者中。ABPA患者的肺功能恶化进展最为明显。因此，应定期对CF患者，尤其是高危患者进行烟曲霉致敏检测。重组变应原在区分曲霉致敏与ABPA本身方面是一项重要进展。
