Oguma Tsuyoshi, Ishiguro Takashi, Kamei Katsuhiko, Tanaka Jun, Suzuki Junko, Hebisawa Akira, Obase Yasushi, Mukae Hiroshi, Tanosaki Takae, Furusho Shiho, Kurokawa Koji, Watai Kentaro, Matsuse Hiroto, Harada Norihiro, Nakamura Ai, Shibayama Takuo, Baba Rie, Fukunaga Kentaro, Matsumoto Hisako, Ohba Hisano, Sakamoto Susumu, Suzuki Shinko, Tanaka Shintetsu, Yamada Takahiro, Yamasaki Akira, Fukutomi Yuma, Shiraishi Yoshiki, Toyotome Takahito, Fukunaga Koichi, Shimoda Terufumi, Konno Satoshi, Taniguchi Masami, Tomomatsu Katsuyoshi, Okada Naoki, Asano Koichiro
Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Saitama, Japan.
Clin Transl Allergy. 2024 Jan;14(1):e12327. doi: 10.1002/clt2.12327.
Allergic bronchopulmonary mycosis (ABPM) is an allergic disease caused by type I and type III hypersensitivity to environmental fungi. Schizophyllum commune, a basidiomycete fungus, is one of the most common fungi that causes non-Aspergillus ABPM.
Herein, we attempted to clarify the clinical characteristics of ABPM caused by S. commune (ABPM-Sc) compared with those of allergic bronchopulmonary aspergillosis (ABPA).
Patients with ABPM-Sc or ABPA were recruited from a nationwide survey in Japan, a multicenter cohort, and a fungal database at the Medical Mycology Research Center of Chiba University. The definition of culture-positive ABPM-Sc/ABPA is as follows: (1) fulfills five or more of the 10 diagnostic criteria for ABPM proposed by Asano et al., and (2) positive culture of S. commune/Aspergillus spp. in sputum, bronchial lavage fluid, or mucus plugs in the bronchi.
Thirty patients with ABPM-Sc and 46 with ABPA were recruited. Patients with ABPM-Sc exhibited less severe asthma and presented with better pulmonary function than those with ABPA (p = 0.008-0.03). Central bronchiectasis was more common in ABPM-Sc than that in ABPA, whereas peripheral lung lesions, including infiltrates/ground-glass opacities or fibrotic/cystic changes, were less frequent in ABPM-Sc. Aspergillus fumigatus-specific immunoglobulin (Ig)E was negative in 10 patients (34%) with ABPM-Sc, who demonstrated a lower prevalence of asthma and levels of total serum IgE than those with ABPM-Sc positive for A. fumigatus-specific IgE or ABPA.
Clinical characteristics of ABPM-Sc, especially those negative for A. fumigatus-specific IgE, differed from those of ABPA.
变应性支气管肺真菌病（ABPM）是一种由对环境真菌的I型和III型超敏反应引起的过敏性疾病。裂褶菌，一种担子菌纲真菌，是引起非曲霉菌性ABPM最常见的真菌之一。
在此，我们试图阐明与变应性支气管肺曲霉病（ABPA）相比，由裂褶菌引起的ABPM（ABPM-Sc）的临床特征。
从日本全国性调查、多中心队列以及千叶大学医学真菌研究中心的真菌数据库中招募ABPM-Sc或ABPA患者。培养阳性的ABPM-Sc/ABPA的定义如下：（1）符合浅野等人提出的ABPM的10项诊断标准中的5项或更多项，以及（2）痰、支气管灌洗液或支气管黏液栓中裂褶菌/曲霉属菌种培养阳性。
招募了30例ABPM-Sc患者和46例ABPA患者。与ABPA患者相比，ABPM-Sc患者哮喘症状较轻，肺功能较好（p = 0.008 - 0.03）。ABPM-Sc患者中央型支气管扩张比ABPA患者更常见，而包括浸润/磨玻璃影或纤维化/囊性改变在内的外周肺病变在ABPM-Sc患者中较少见。10例（34%）ABPM-Sc患者烟曲霉特异性免疫球蛋白（Ig）E呈阴性，这些患者哮喘患病率和血清总IgE水平低于烟曲霉特异性IgE阳性的ABPM-Sc患者或ABPA患者。
ABPM-Sc的临床特征，尤其是烟曲霉特异性IgE阴性的患者，与ABPA不同。
