The Journal is included in Russian and International Library and Abstract Databases
Russain Science Index (Russia)
EBSCO
DOI Registration Agency (USA)

Aspergillus species and chronic lung diseases

DOI: https://doi.org/10.29296/25877305-2020-11-03
Issue: 
11
Year: 
2020

Ya. Kozlova, Candidate of Medical Sciences, Associate Professor; V. Kuznetsov; Professor N.
Klimko, MD North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg

Among microscopic fungi that can infect the respiratory tract, Aspergillus spp. plays a leading role. Currently, chronic lung diseases are recognized as an important risk factor for various types of aspergillosis. In patients with asthma due to an allergic reaction to the Aspergillus spp. antigen severe asthma with fungal sensitization (SAFS) or allergic bronchopulmonary aspergillosis (ABPA) may develop. Long colonization of the lower respiratory tract by mold fungi in patients with chronic pulmonary cavities (tuberculosis, cystic fibrosis, bronchiectasis) can lead to the development of chronic pulmonary aspergillosis (CPA). In addition, in patients with COPD, risk factors for aspergillosis are long-term use of systemic or inhaled glucocorticosteroids in combination with repeated courses of antibacterial drugs in exacerbations of the underlying disease. Thus Aspergillus spp. they can act as both infectious agents and sources of allergens and significantly worsen the clinical course and outcomes of the underlying disease. Timely detection of Aspergillus-associated diseases in immunocompetent pulmonological patients helps to determine the optimal therapeutic tactics and prevent the development of complications.

Keywords: 
pulmonology
chronic lung diseases
Aspergillus spp.
allergic bronchopulmonary aspergillosis
chronic pulmonary aspergillosis



References: 
  1. Henderson A., English M., Vecht R. Pulmonary aspergillosis. A survey of its occurrence in patients with chronic lung disease and a discussion of the significance of diagnostic tests. Thorax. 1968; 23 (5): 513–8. DOI: 10.1136/thx.23.5.513
  2. Lass-Florl C. The changing face of epidemiology of invasive fungal disease in Europe. Mycoses. 2009; 52 (3): 197–205. DOI: 10.1111/j.1439-0507.2009.01691.x
  3. Rick E., Woolnough K., Pashley C. et al. Allergic Fungal Airway Disease. J Investig Allergol Clin Immunol. 2016; 26 (6): 344–54. DOI: 10.18176/jiaci.0122
  4. van de Veerdonk F., Gresnigt M., Romani L. et al. Aspergillus fumigatus morphology and dynamic host interactions. Nat Rev Microbiol. 2017; 15 (11): 661–74. DOI: 10.1038/nrmicro.2017.90
  5. Kosmidis C., Denning D. The clinical spectrum of pulmonary aspergillosis. Thorax. 2015; 70 (3): 270–7. DOI: 10.1136/thoraxjnl-2014-206291
  6. Ca Yii A., Koh M., Lapperre T. et al. The emergence of Aspergillus species in chronic respiratory disease. Front Biosci (Schol. Ed). 2017; 9: 127–38. DOI: 10.2741/s477
  7. Agarwal R. Severe asthma with fungal sensitization. J Fungi. 2016; 2: 13–8.
  8. Denning D., O’Driscoll B., Hogaboam C. et al. The link between fungi and asthma: A summary of the evidence. Eur Respir J. 2006; 27: 615–26. DOI: 10.1183/09031936.06.00074705
  9. Agarwal R., Aggarwal A., Gupta D. et al. Aspergillus hypersensitivity and allergic bronchopulmonary aspergillosis in patients with bronchial asthma: systematic review and meta-analysis. Int J Tuberc Lung Dis. 2009; 13 (8): 936–44.
  10. Agarwal R., Nath A., Aggarwal A. et al. Aspergillus hypersensitivity and allergic bronchopulmonary aspergillosis in patients with acute severe asthma in a respiratory intensive care unit in North India. Mycoses. 2010; 53 (2): 138–43. DOI: 10.1111/j.1439-0507.2008.01680.x
  11. Fairs A., Agbetile J., Hargadon B. et al. IgE sensitization to Aspergillus fumigatus is associated with reduced lung function in asthma. Am J Respir Crit Care Med. 2010; 182 (11): 1362–8. DOI: 10.1164/rccm.201001-0087OC
  12. Goh K., Ang Yii A., Lapperre T. et al. Sensitization to Aspergillus species is associated with frequent exacerbations in severe asthma. J Asthma Allergy. 2017; 10: 131–140. DOI: 10.2147/JAA.S130459
  13. Menzies D., Holmes L., McCumesky G. et al. Aspergillus sensitization is associated with airflow limitation and bronchiectasis in severe asthma. Allergy. Eur J Allergy Clin Immunol. 2011; 66 (5): 679–85. DOI: 10.1111/j.1398-9995.2010.02542.x
  14. Denning D., O’Driscoll B., Powell G. et al. Randomized controlled trial of oral antifungal treatment for severe asthma with fungal sensitization: The Fungal Asthma Sensitization Trial (FAST) study. Am J Respir Crit Care Med. 2009; 179 (1): 11–8. DOI: 10.1164/rccm.200805-737OC
  15. Agbetile J., Bourne M., Fairs A. et al. Effectiveness of voriconazole in the treatment of Aspergillus fumigatus associated asthma (EVITA3 study). J Allergy Clin Immunol. 2014; 134 (1) : 33–9. DOI: 10.1016/j.jaci.2013.09.050
  16. Di Stefano F., Cinti B., Antonicelli L. Efficacy of omalizumab in severe asthma with fungal sensitisation: a case report. Eur Ann Allergy Clin Immunol. 2014; 46 (1): 56–9.
  17. Knutsen A., Bush R., Demain J. et al. Fungi and allergic lower respiratory tract diseases. J Allergy Clin Immunol. 2012; 129 (2): 280–91. DOI: 10.1016/j.jaci.2011.12.970
  18. Agarwal R., Chakrabarti A., Shah A. et al. For the ABPA complicating asthma ISHAM working group 2013. Allergic bronchopulmonary aspergillosis: review of literature and proposal of new diagnostic and classification criteria. Clin Exp Allergy. 2013; 43 (8): 850–73. DOI: 10.1111/cea.12141
  19. Wark P., Hensley M., Saltos N. et al. Antiinflammatory effect of itraconazole in stable allergic bronchopulmonary aspergillosis: a randomized controlled trial. J Allergy Clin Immunol. 2003; 111 (5): 952–7. DOI: 10.1067/mai.2003.1388
  20. Chishimba L., Niven R., Cooley J. et al. Voriconazole and posaconazole improve asthma severity in allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitization. J Asthma. 2012; 49 (4): 423–33. DOI: 10.3109/02770903.2012.662568
  21. Ram B., Aggarwal A., Dhooria S. et al. A pilot randomized trial of nebulized amphotericin in patients with allergic bronchopulmonary aspergillosis. J Asthma. 2016; 53 (5): 517–24. DOI: 10.3109/02770903.2015.1127935
  22. Fairs A., Agbetile J., Hargadon B. et al. IgE sensitization to Aspergillus fumigatus is associated with reduced lung function in asthma. Am J Respir Crit Care Med. 2010; 182 (11): 1362–8. DOI: 10.1164/rccm.201001-0087OC
  23. Huerta A., Soler N., Esperatti M. et al. Importance of Aspergillus spp. isolation in Acute exacerbations of severe COPD: prevalence, factors and follow-up: the FUNGI-COPD study. Respir Res. 2014; 15 (1): 17. DOI: 10.1186/1465-9921-15-17
  24. Garnacho-Montero J., Amaya-Villar R., Ortiz-Leyba C. et al. Isolation of Aspergillus spp. from the respiratory tract in critically ill patients: risk factors, clinical presentation and outcome. Crit Care. 2005; 9 (3): 191–9. DOI: 10.1186/cc3488
  25. Agarwal R., Hazarika B., Gupta D. et al. Aspergillus hypersensitivity in patients with chronic obstructive pulmonary disease: COPD as a risk factor for ABPA? Med Mycol. 2010; 48 (7): 988–94. DOI: 10.3109/13693781003743148
  26. Samarakoon P., Soubani A. Invasive pulmonary aspergillosis in patients with COPD: a report of five cases and systematic review of the literature. Chron Respir Dis. 2008; 5 (1): 19–27. DOI: 10.1177/1479972307085637
  27. Lin S., Schranz J., Teutsch S. Aspergillosis case-fatality rate: systematic review of the literature. Clin Infect Dis. 2001; 32 (3): 358–66. DOI: 10.1086/318483
  28. Tutar N., Metan G., Koc A. et al. Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease. Multidiscip Respir Med. 2013; 8 (1): 59. DOI: 10.1186/2049-6958-8-59
  29. Bulpa P., Dive A., Sibille Y. Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease. Eur Respir J. 2007; 30 (4): 782–800. DOI: 10.1183/09031936.00062206
  30. Herbrecht R., Denning D., Patterson T. et al. Invasive Fungal Infections Group of the European Organisation for, C. Treatment of and G. the Global Aspergillus Study: Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N Engl J Med. 2002; 347 (6): 408–15. DOI: 10.1056/NEJMoa020191
  31. Agarwal R., Khan A., Aggarwal A. et al. Link between CFTR mutations and ABPA: a systematic review and meta-analysis. Mycoses. 2012; 55 (4): 357–65. DOI: 10.1111/j.1439-0507.2011.02130.x
  32. Maturu V., Agarwal R. Prevalence of Aspergillus sensitization and allergic bronchopulmonary aspergillosis in cystic fibrosis: Systematic review and meta-analysis. Clin Exp Allergy. 2015; 45 (12): 1765–78. DOI: 10.1111/cea.12595
  33. Hutcheson P., Knutsen A., Rejent A. et al. A 12-year longitudinal study of Aspergillus sensitivity in patients with cystic fibrosis. Chest. 1996; 110 (2): 363–6. DOI: 10.1378/chest.110.2.363
  34. Baxter C., Dunn G., Jones A. et al. Novel immunologic classification of aspergillosis in adult cystic fibrosis. J Allergy Clin Immunol. 2013; 132 (3): 560–6. DOI: 10.1016/j.jaci.2013.04.007
  35. Klimko N.N. Mikozy: diagnostika i lechenie. Rukovodstvo dlja vrachej. 3-e izd. pererab. i dop. (uchebnoe posobie). M.: Farmtek, 2017; 272 s. [Klimko N. Mycoses: diagnosis and treatment. A guide for physicians. 3rd ed. (tutorial). Moscow: Farmtek, 2017; 272 p. (in Russ.)].
  36. Aspergillus in persistent lung cavities after tuberculosis. A report from the Research Committee of the British Tuberculosis Association. Tubercle. 1968; 49 (1): 1–11.
  37. Hedayati M., Azimi Y., Droudinia A. et al. Prevalence of chronic pulmonary aspergillosis in patients with tuberculosis from Iran. Eur J Clin Microbiol Infect Dis. 2015; 34 (9): 1759–65. DOI: 10.1007/s10096-015-2409-7
  38. Kuznetsov V.D., Kozlova Ja.I., Borzova Ju.V. i dr. Sochetanie allergicheskogo bronholegochnogo aspergilleza (A. terrus) i hronicheskogo aspergilleza legkih (A. fumigatus): Opisanie klinicheskogo sluchaja i obzor literatury. Problemy meditsinskoj mikologii. 2020; 22 (1): 28–35. [Kuznetsov V., Kozlova Y., Borzova Y. et al. Aspergillosis (A. terreus) and chronic pulmonary aspergillosis (A. fumigatus). Clinical case and review of literature. Problems In Medical Mycology. 2020; 22 (1): 28–35 (in Russ.)].
  39. Denning D., Cadranel J., Beigelman-Aubry C. et al. Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management. Eur Respir J. 2016; 47 (1): 45–68. DOI: 10.1183/13993003.00583-2015
  40. Limper A., Knox K., Sarosi G. et al. An official American Thoracic Society statement: Treatment of fungal infections in adult pulmonary and critical care patients. Am J Respir Crit Care Med. 2011; 183 (1): 96–128. DOI: 10.1164/rccm.2008-740ST