Lewington-Gower Elisa, Chan Ley, Shah Anand
Department of Respiratory Medicine, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Department of Respiratory Medicine, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London SW3 6NP, UK.
Ther Adv Chronic Dis. 2021 Oct 23;12:20406223211047003. doi: 10.1177/20406223211047003. eCollection 2021.
Allergic bronchopulmonary aspergillosis is an allergic pulmonary condition caused by hypersensitivity to antigens of found most commonly in patients with underlying asthma or cystic fibrosis. Host factors which alter the innate and adaptive immune responses to this abundant airborne fungus contribute to the development of chronic airway inflammation, bronchiectasis, and fibrosis. Traditionally, treatment has focussed on reducing fungal burden and immune response to fungal antigens. However, a significant proportion of patients continue to suffer recurrent exacerbations with progressive lung damage, and the side effect burden of existing treatments is high. New treatments including novel antifungal agents, monoclonal antibodies against aspects of the adaptive immune response as well as targeted immunotherapies may be better tolerated and achieve improved outcomes but have not yet been studied in large-scale randomised control trials.
变应性支气管肺曲霉病是一种过敏性肺部疾病，由对曲霉菌抗原过敏引起，最常见于患有基础哮喘或囊性纤维化的患者。改变对这种常见空气传播真菌的固有免疫和适应性免疫反应的宿主因素会导致慢性气道炎症、支气管扩张和纤维化的发展。传统上，治疗重点在于减轻真菌负荷以及对真菌抗原的免疫反应。然而，相当一部分患者仍反复出现病情加重并伴有进行性肺损伤，且现有治疗的副作用负担较重。包括新型抗真菌药物、针对适应性免疫反应方面的单克隆抗体以及靶向免疫疗法在内的新治疗方法可能耐受性更好且疗效更佳，但尚未在大规模随机对照试验中进行研究。
