Department of Pulmonary Medicine, Postgraduate Institute of Medical Education & Research, Sector-12, Chandigarh-160012, India.
Future Microbiol. 2013 Nov;8(11):1463-74. doi: 10.2217/fmb.13.116.
Allergic bronchopulmonary aspergillosis (ABPA) is a complex pulmonary disorder caused by immunologic reactions to antigens released by Aspergillus fumigatus, a ubiquitous fungi colonizing the tracheobronchial tree of asthmatic patients. The clinical presentation is usually poorly controlled asthma, recurrent pulmonary opacities and bronchiectasis. The prevalence of ABPA in asthma clinics may be as high as 13% with a global burden of almost 5 million patients. A. fumigatus-specific IgE level is the most sensitive test in diagnosis of ABPA, and all asthmatic patients should be routinely screened with A. fumigatus-specific IgE levels for early diagnosis. The goals of managing ABPA include control of asthma, prevention and treatment of acute exacerbations, and preventing the development or progression of bronchiectasis. Glucocorticoids are the treatment of choice with itraconazole reserved for those with recurrent exacerbations and glucocorticoid-dependent disease. There is a dire need for newer treatment approaches including oral antifungal agents and immunomodulatory therapy.
变应性支气管肺曲霉病（ABPA）是一种由烟曲霉释放的抗原引起的免疫反应导致的复杂肺部疾病，烟曲霉是一种普遍存在的真菌，定植于哮喘患者的气管支气管树。其临床表现通常为控制不佳的哮喘、反复肺部阴影和支气管扩张。ABPA 在哮喘诊所的患病率可能高达 13%，全球患者人数接近 500 万。烟曲霉特异性 IgE 水平是诊断 ABPA 最敏感的检测方法，所有哮喘患者都应常规进行烟曲霉特异性 IgE 水平筛查，以便早期诊断。ABPA 的治疗目标包括控制哮喘、预防和治疗急性加重，以及预防支气管扩张的发生或进展。糖皮质激素是治疗的首选药物，对于反复发作和依赖糖皮质激素的疾病，伊曲康唑保留作为治疗选择。迫切需要新的治疗方法，包括口服抗真菌药物和免疫调节治疗。
