Agarwal Ritesh, Bansal Sandeep, Chakrabarti Arunaloke
Department of Pulmonary Medicine, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India
Department of Otorhinolaryngology, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India.
Med Mycol. 2017 Jan 1;55(1):87-95. doi: 10.1093/mmy/myw071. Epub 2016 Sep 6.
Aspergillus fumigatus can cause several allergic disorders including Aspergillus-sensitized asthma, allergic bronchopulmonary aspergillosis (ABPA), and allergic fungal rhinosinusitis (AFRS). ABPA is an immunological pulmonary disorder caused by allergic reactions mounted against antigens of A. fumigatus colonizing the airways of patients with asthma (and cystic fibrosis). Allergic bronchopulmonary mycosis is an allergic fungal airway disease caused by thermotolerant fungi other than A. fumigatus On the other hand, AFRS is a type of chronic rhinosinusitis that is also a result of hypersensitivity reactions to the presence of fungi that become resident in the sinuses. The pathogenesis of ABPA and AFRS share several common features, and in fact, AFRS can be considered as the upper airway counterpart of ABPA. Despite sharing similar immunopathogenetic features, the simultaneous occurrence of the two disorders is uncommon. Due to the lacuna in understanding of the causative mechanisms, and deficiencies in the diagnosis and treatment, these disorders unfortunately are lifelong illnesses. This review provides an overview of the pathogenesis, diagnosis, and long-term outcomes of both these disorders.
烟曲霉可引发多种过敏性疾病，包括烟曲霉致敏性哮喘、变应性支气管肺曲霉病（ABPA）和变应性真菌性鼻-鼻窦炎（AFRS）。ABPA是一种免疫性肺部疾病，由针对定植于哮喘（和囊性纤维化）患者气道中的烟曲霉抗原的过敏反应引起。变应性支气管肺真菌病是一种由除烟曲霉之外的耐热真菌引起的变应性真菌气道疾病。另一方面，AFRS是一种慢性鼻窦炎，也是对鼻窦中定植真菌的超敏反应的结果。ABPA和AFRS的发病机制有几个共同特征，事实上，AFRS可被视为ABPA在上气道的对应病症。尽管具有相似的免疫发病机制特征，但这两种疾病同时发生的情况并不常见。由于对致病机制的认识不足以及诊断和治疗方面的缺陷，这些疾病不幸地会伴随患者一生。本综述概述了这两种疾病的发病机制、诊断和长期预后。
