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CC BY-NC-ND 4.0 · Semin Respir Crit Care Med 2024; 45(01): 003-020
DOI: 10.1055/s-0043-1777259
Review Article

Aspergillus and the Lung

Iris Janssens
1   Department of Internal Medicine and Paediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
2   Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
3   VIB Center for Inflammation Research, Ghent, Belgium
,
Bart N. Lambrecht
1   Department of Internal Medicine and Paediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
2   Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
3   VIB Center for Inflammation Research, Ghent, Belgium
4   Department of Pulmonary Medicine, ErasmusMC; Rotterdam, The Netherlands
,
Eva Van Braeckel
1   Department of Internal Medicine and Paediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
2   Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
› Author Affiliations Funding I.J., B.N.L., and E.V.B. receive funding from an EOS consortium grant (G0H1222N) and the Forton Fund and Belgian Cystic Fibrosis Association through the King Baudouin Foundation.
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Abstract

The filamentous fungus Aspergillus causes a wide spectrum of diseases in the human lung, with Aspergillus fumigatus being the most pathogenic and allergenic subspecies. The broad range of clinical syndromes that can develop from the presence of Aspergillus in the respiratory tract is determined by the interaction between host and pathogen. In this review, an oversight of the different clinical entities of pulmonary aspergillosis is given, categorized by their main pathophysiological mechanisms. The underlying immune processes are discussed, and the main clinical, radiological, biochemical, microbiological, and histopathological findings are summarized.

Keywords

Aspergillus - Aspergillus fumigatus - immunology - pathophysiology


Publication History

Article published online:
29 January 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Patterson TF. Aspergillus Species. In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Elsevier; 2019
    Google Scholar
  • 2 Griffiths JS, Camilli G, Kotowicz NK, Ho J, Richardson JP, Naglik JR. Role for IL-1 family cytokines in fungal infections. Front Microbiol 2021; 12: 633047
    CrossrefPubMedGoogle Scholar
  • 3 Kosmidis C, Denning DW. The clinical spectrum of pulmonary aspergillosis. Thorax 2015; 70 (03) 270-277
    CrossrefPubMedGoogle Scholar
  • 4 Brown GD, Denning DW, Gow NAR, Levitz SM, Netea MG, White TC. Hidden killers: human fungal infections. Sci Transl Med 2012; 4 (165) 165rv13
    CrossrefPubMedGoogle Scholar
  • 5 Ainsworth GC. Introduction to the History of Mycology. Cambridge University Press;; 1976
    Google Scholar
  • 6 Balajee SA, Houbraken J, Verweij PE. et al. Aspergillus species identification in the clinical setting. Stud Mycol 2007; 59: 39-46
    CrossrefPubMedGoogle Scholar
  • 7 Index Fungorum [Database on the Internet]. Index Fungorum Partnership. Accessed September 11, 2023 at: Https://Www.Indexfungorum.Org. 2023
    PubMedGoogle Scholar
  • 8 Sugui JA, Kwon-Chung KJ, Juvvadi PR, Latgé JP, Steinbach WJ. Aspergillus fumigatus and related species. Cold Spring Harb Perspect Med 2014; 5 (02) a019786-a019786
    CrossrefPubMedGoogle Scholar
  • 9 Tekaia F, Latgé JP. Aspergillus fumigatus: saprophyte or pathogen?. Curr Opin Microbiol 2005; 8 (04) 385-392
    CrossrefPubMedGoogle Scholar
  • 10 Pini G, Faggi E, Donato R, Sacco C, Fanci R. Invasive pulmonary aspergillosis in neutropenic patients and the influence of hospital renovation. Mycoses 2008; 51 (02) 117-122
    CrossrefPubMedGoogle Scholar
  • 11 Abdel Hameed AA, Yasser IH, Khoder IM. Indoor air quality during renovation actions: a case study. J Environ Monit 2004; 6 (09) 740-744
    CrossrefPubMedGoogle Scholar
  • 12 Abad A, Fernández-Molina JV, Bikandi J. et al. What makes Aspergillus fumigatus a successful pathogen? Genes and molecules involved in invasive aspergillosis. Rev Iberoam Micol 2010; 27 (04) 155-182
    CrossrefPubMedGoogle Scholar
  • 13 Park SJ, Mehrad B. Innate immunity to Aspergillus species. Clin Microbiol Rev 2009; 22 (04) 535-551
    CrossrefPubMedGoogle Scholar
  • 14 Sutton DA, Fothergill AW, Rinaldi MG. Guide to Clinically Significant Fungi. 1st ed. Williams & Wilkins; 1998
    Google Scholar
  • 15 Gugnani HC. Ecology and taxonomy of pathogenic aspergilli. Front Biosci 2003; 8: s346-s357
    CrossrefPubMedGoogle Scholar
  • 16 Agarwal R, Sehgal IS, Dhooria S. et al. Allergic bronchopulmonary aspergillosis. Indian J Med Res 2020; 151 (06) 529-549
    CrossrefPubMedGoogle Scholar
  • 17 Carrion SdeJ, Leal Jr SM, Ghannoum MA, Aimanianda V, Latgé JP, Pearlman E. The RodA hydrophobin on Aspergillus fumigatus spores masks dectin-1- and dectin-2-dependent responses and enhances fungal survival in vivo. J Immunol 2013; 191 (05) 2581-2588
    CrossrefPubMedGoogle Scholar
  • 18 van de Veerdonk FL, Gresnigt MS, Romani L, Netea MG, Latgé JP. Aspergillus fumigatus morphology and dynamic host interactions. Nat Rev Microbiol 2017; 15 (11) 661-674
    CrossrefPubMedGoogle Scholar
  • 19 Beauvais A, Latgé JP. Aspergillus biofilm in vitro and in vivo. Microbiol Spectr 2015;3(04):
    PubMedGoogle Scholar
  • 20 de Vries RP, Visser J. Aspergillus enzymes involved in degradation of plant cell wall polysaccharides. Microbiol Mol Biol Rev 2001; 65 (04) 497-522
    CrossrefPubMedGoogle Scholar
  • 21 Moore MM. The crucial role of iron uptake in Aspergillus fumigatus virulence. Curr Opin Microbiol 2013; 16 (06) 692-699
    CrossrefPubMedGoogle Scholar
  • 22 Moreno MA, Ibrahim-Granet O, Vicentefranqueira R. et al. The regulation of zinc homeostasis by the ZafA transcriptional activator is essential for Aspergillus fumigatus virulence. Mol Microbiol 2007; 64 (05) 1182-1197
    CrossrefPubMedGoogle Scholar
  • 23 Rautemaa-Richardson R, Richardson MD. Systemic fungal infections. Medicine (Baltimore) 2021; 49 (12) 760-765
    CrossrefPubMedGoogle Scholar
  • 24 Romani L. Immunity to fungal infections. Nat Rev Immunol 2011; 11 (04) 275-288
    CrossrefPubMedGoogle Scholar
  • 25 Garlanda C, Hirsch E, Bozza S. et al. Non-redundant role of the long pentraxin PTX3 in anti-fungal innate immune response. Nature 2002; 420 (6912) 182-186
    CrossrefPubMedGoogle Scholar
  • 26 Cunha C, Aversa F, Lacerda JF. et al. Genetic PTX3 deficiency and aspergillosis in stem-cell transplantation. N Engl J Med 2014; 370 (05) 421-432
    CrossrefPubMedGoogle Scholar
  • 27 Idol RA, Bhattacharya S, Huang G. et al. Neutrophil and macrophage NADPH oxidase 2 differentially control responses to inflammation and to Aspergillus fumigatus in mice. J Immunol 2022; 209 (10) 1960-1972
    CrossrefPubMedGoogle Scholar
  • 28 Röhm M, Grimm MJ, D'Auria AC, Almyroudis NG, Segal BH, Urban CF. NADPH oxidase promotes neutrophil extracellular trap formation in pulmonary aspergillosis. Infect Immun 2014; 82 (05) 1766-1777
    CrossrefPubMedGoogle Scholar
  • 29 Branzk N, Lubojemska A, Hardison SE. et al. Neutrophils sense microbe size and selectively release neutrophil extracellular traps in response to large pathogens. Nat Immunol 2014; 15 (11) 1017-1025
    CrossrefPubMedGoogle Scholar
  • 30 Gazendam RP, van Hamme JL, Tool ATJ. et al. Human neutrophils use different mechanisms to kill aspergillus fumigatus conidia and hyphae: evidence from phagocyte defects. J Immunol 2016; 196 (03) 1272-1283
    CrossrefPubMedGoogle Scholar
  • 31 McCormick A, Heesemann L, Wagener J. et al. NETs formed by human neutrophils inhibit growth of the pathogenic mold Aspergillus fumigatus. Microbes Infect 2010; 12 (12-13): 928-936
    CrossrefPubMedGoogle Scholar
  • 32 Block H, Zarbock A. A fragile balance: does neutrophil extracellular trap formation drive pulmonary disease progression?. Cells 2021; 10 (08) 1932
    CrossrefPubMedGoogle Scholar
  • 33 Cenci E, Perito S, Enssle KH. et al. Th1 and Th2 cytokines in mice with invasive aspergillosis. Infect Immun 1997; 65 (02) 564-570
    CrossrefPubMedGoogle Scholar
  • 34 Knutsen AP. Lymphocytes in allergic bronchopulmonary aspergillosis. Front Biosci 2003; 8 (04) d589-d602
    CrossrefPubMedGoogle Scholar
  • 35 Moretti S, Renga G, Oikonomou V. et al. A mast cell-ILC2-Th9 pathway promotes lung inflammation in cystic fibrosis. Nat Commun 2017; 8: 14017
    CrossrefPubMedGoogle Scholar
  • 36 Salazar F, Bignell E, Brown GD, Cook PC, Warris A. Pathogenesis of respiratory viral and fungal coinfections. Clin Microbiol Rev 2022; 35 (01) e0009421
    CrossrefPubMedGoogle Scholar
  • 37 Schneider DS, Ayres JS. Two ways to survive infection: what resistance and tolerance can teach us about treating infectious diseases. Nat Rev Immunol 2008; 8 (11) 889-895
    CrossrefPubMedGoogle Scholar
  • 38 Patterson TF, Thompson III GR, Denning DW. et al. Practice guidelines for the diagnosis and management of Aspergillosis: 2016 update by the infectious diseases Society of America. Clin Infect Dis 2016; 63 (04) e1-e60
    CrossrefPubMedGoogle Scholar
  • 39 Segal BH. Aspergillosis. N Engl J Med 2009; 360 (18) 1870-1884
    CrossrefPubMedGoogle Scholar
  • 40 Colombo AL, de Almeida Júnior JN, Slavin MA, Chen SCA, Sorrell TC. Candida and invasive mould diseases in non-neutropenic critically ill patients and patients with haematological cancer. Lancet Infect Dis 2017; 17 (11) e344-e356
    CrossrefPubMedGoogle Scholar
  • 41 Herbrecht R, Denning DW, Patterson TF. et al. Invasive Fungal Infections Group of the European Organisation for Research and Treatment of Cancer and the Global Aspergillus Study Group. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N Engl J Med 2002; 347 (06) 408-415
    CrossrefPubMedGoogle Scholar
  • 42 Uyeki TM, Bernstein HH, Bradley JS. et al. Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenzaa. Clin Infect Dis 2019; 68 (06) 895-902
    CrossrefPubMedGoogle Scholar
  • 43 Lin SJ, Schranz J, Teutsch SM. Aspergillosis case-fatality rate: systematic review of the literature. Clin Infect Dis 2001; 32 (03) 358-366
    CrossrefPubMedGoogle Scholar
  • 44 Gerson SL, Talbot GH, Hurwitz S, Strom BL, Lusk EJ, Cassileth PA. Prolonged granulocytopenia: the major risk factor for invasive pulmonary aspergillosis in patients with acute leukemia. Ann Intern Med 1984; 100 (03) 345-351
    CrossrefPubMedGoogle Scholar
  • 45 Hope WW, Walsh TJ, Denning DW. The invasive and saprophytic syndromes due to Aspergillus spp. Med Mycol 2005; 43 (Suppl. 01) S207-S238
    CrossrefPubMedGoogle Scholar
  • 46 Kauffman CA, Freifeld AG, Andes DR. et al. Endemic fungal infections in solid organ and hematopoietic cell transplant recipients enrolled in the Transplant-Associated Infection Surveillance Network (TRANSNET). Transpl Infect Dis 2014; 16 (02) 213-224
    CrossrefPubMedGoogle Scholar
  • 47 Schauwvlieghe AFAD, Rijnders BJA, Philips N. et al; Dutch-Belgian Mycosis study group. Invasive aspergillosis in patients admitted to the intensive care unit with severe influenza: a retrospective cohort study. Lancet Respir Med 2018; 6 (10) 782-792
    CrossrefPubMedGoogle Scholar
  • 48 van Arkel ALE, Rijpstra TA, Belderbos HNA, van Wijngaarden P, Verweij PE, Bentvelsen RG. COVID-19-associated pulmonary aspergillosis. Am J Respir Crit Care Med 2020; 202 (01) 132-135
    CrossrefPubMedGoogle Scholar
  • 49 White PL, Dhillon R, Cordey A. et al. A national strategy to diagnose coronavirus disease 2019-associated invasive fungal disease in the intensive care unit. Clin Infect Dis 2021; 73 (07) e1634-e1644
    CrossrefPubMedGoogle Scholar
  • 50 Dewi IM, Janssen NA, Rosati D. et al. Invasive pulmonary aspergillosis associated with viral pneumonitis. Curr Opin Microbiol 2021; 62: 21-27
    CrossrefPubMedGoogle Scholar
  • 51 Balz K, Trassl L, Härtel V, Nelson PP, Skevaki C, Virus-Induced T. Virus-induced T cell-mediated heterologous immunity and vaccine development. Front Immunol 2020; 11: 513
    CrossrefPubMedGoogle Scholar
  • 52 Krenke R, Grabczak EM. Tracheobronchial manifestations of Aspergillus infections. ScientificWorldJournal 2011; 11: 2310-2329
    CrossrefPubMedGoogle Scholar
  • 53 Nishiyama KH, Falcão Ede AA, Kay FU, Teles GBS, Bernardi FdelC, Funari Mde G. Acute tracheobronchitis caused by Aspergillus: case report and imaging findings. Radiol Bras 2014; 47 (05) 317-319
    PubMedGoogle Scholar
  • 54 Samanta P, Clancy CJ, Nguyen MH. Fungal infections in lung transplantation. J Thorac Dis 2021; 13 (11) 6695-6707
    CrossrefPubMedGoogle Scholar
  • 55 Kemper CA, Hostetler JS, Follansbee SE. et al. Ulcerative and plaque-like tracheobronchitis due to infection with Aspergillus in patients with AIDS. Clin Infect Dis 1993; 17 (03) 344-352 d
    CrossrefPubMedGoogle Scholar
  • 56 Singh N, Husain S. Aspergillus infections after lung transplantation: clinical differences in type of transplant and implications for management. J Heart Lung Transplant 2003; 22 (03) 258-266
    CrossrefPubMedGoogle Scholar
  • 57 Denning DW. Commentary: unusual manifestations of aspergillosis. Thorax 1995; 50 (07) 812-813
    CrossrefPubMedGoogle Scholar
  • 58 Kramer MR, Denning DW, Marshall SE. et al. Ulcerative tracheobronchitis after lung transplantation. A new form of invasive aspergillosis. Am Rev Respir Dis 1991; 144 (3 Pt 1): 552-556
    CrossrefPubMedGoogle Scholar
  • 59 Denning DW, Cadranel J, Beigelman-Aubry C. et al; European Society for Clinical Microbiology and Infectious Diseases and European Respiratory Society. Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management. Eur Respir J 2016; 47 (01) 45-68
    CrossrefPubMedGoogle Scholar
  • 60 Denning DW, Pleuvry A, Cole DC. Global burden of chronic pulmonary aspergillosis as a sequel to pulmonary tuberculosis. Bull World Health Organ 2011; 89 (12) 864-872
    CrossrefPubMedGoogle Scholar
  • 61 Laursen CB, Davidsen JR, Van Acker L. et al. CPAnet Registry—An International Chronic Pulmonary Aspergillosis Registry. J Fungi (Basel) 2020; 6 (03) 96
    CrossrefPubMedGoogle Scholar
  • 62 Salzer HJF, Heyckendorf J, Kalsdorf B, Rolling T, Lange C. Characterization of patients with chronic pulmonary aspergillosis according to the new ESCMID/ERS/ECMM and IDSA guidelines. Mycoses 2017; 60 (02) 136-142
    CrossrefPubMedGoogle Scholar
  • 63 Denning DW, Riniotis K, Dobrashian R, Sambatakou H. Chronic cavitary and fibrosing pulmonary and pleural aspergillosis: case series, proposed nomenclature change, and review. Clin Infect Dis 2003; 37 (Suppl. 03) S265-S280
    CrossrefPubMedGoogle Scholar
  • 64 Salzer HJF, Reimann M, Oertel C. et al; CPAnet. Aspergillus-specific IgG antibodies for diagnosing chronic pulmonary aspergillosis compared to the reference standard. Clin Microbiol Infect 2023; S1198-743X (23)00416-0
    PubMedGoogle Scholar
  • 65 Bongomin F, Harris C, Foden P, Kosmidis C, Denning DW. Innate and Adaptive Immune Defects In Chronic Pulmonary Aspergillosis. J Fungi (Basel) 2017; 3 (02) 26
    CrossrefPubMedGoogle Scholar
  • 66 Colombo SAP, Hashad R, Denning DW. et al. Defective interferon-gamma production is common in chronic pulmonary aspergillosis. J Infect Dis 2022; 225 (10) 1822-1831
    CrossrefPubMedGoogle Scholar
  • 67 Watanabe S, Suzuki J, Suzukawa M. et al. Serum total IgE may be a biomarker among chronic pulmonary aspergillosis patients with elevated serum total IgE levels: a cohort study with pathological evaluations. Med Mycol 2022; 60 (03) myac006
    CrossrefPubMedGoogle Scholar
  • 68 Sehgal IS, Dhooria S, Muthu V. et al. Identification of distinct immunophenotypes in chronic pulmonary aspergillosis using cluster analysis. Mycoses 2023; 66 (04) 299-303
    CrossrefPubMedGoogle Scholar
  • 69 Ito Y, Takazono T, Obase Y. et al. Serum cytokines usefulness for understanding the pathology in allergic bronchopulmonary aspergillosis and chronic pulmonary aspergillosis. J Fungi (Basel) 2022; 8 (05) 436
    CrossrefPubMedGoogle Scholar
  • 70 Khosravi AR, Shokri H, Hassan Al-Heidary S, Ghafarifar F. Evaluation of murine lung epithelial cells (TC-1 JHU-1) line to develop Th2-promoting cytokines IL-25/IL-33/TSLP and genes Tlr2/Tlr4 in response to Aspergillus fumigatus . J Mycol Med 2018; 28 (02) 349-354
    CrossrefPubMedGoogle Scholar
  • 71 Garth JM, Reeder KM, Godwin MS. et al. IL-33 signaling regulates innate IL-17A and IL-22 production via suppression of prostaglandin E2 during Lung Fungal Infection. J Immunol 2017; 199 (06) 2140-2148
    CrossrefPubMedGoogle Scholar
  • 72 Düesberg U, Wosniok J, Naehrlich L, Eschenhagen P, Schwarz C. Risk factors for respiratory Aspergillus fumigatus in German Cystic Fibrosis patients and impact on lung function. Sci Rep 2020; 10 (01) 18999
    CrossrefPubMedGoogle Scholar
  • 73 Brandt C, Roehmel J, Rickerts V, Melichar V, Niemann N, Schwarz C. Aspergillus bronchitis in patients with cystic fibrosis. Mycopathologia 2018; 183 (01) 61-69
    CrossrefPubMedGoogle Scholar
  • 74 Armstead J, Morris J, Denning DW. Multi-country estimate of different manifestations of aspergillosis in cystic fibrosis. PLoS One 2014; 9 (06) e98502
    CrossrefPubMedGoogle Scholar
  • 75 European Cystic Fibrosis Society. . Accessed September 26, 2023 at: Https://www.Ecfs.Eu/Projects/Ecfs-Patient-Registry/Annual-Reports; 2023
    PubMed
  • 76 Schwarz C. Clinical relevance of fungi in cystic fibrosis. Semin Respir Crit Care Med 2023; 44 (02) 252-259
    Article in Thieme ConnectPubMedGoogle Scholar
  • 77 Chrdle A, Mustakim S, Bright-Thomas RJ, Baxter CG, Felton T, Denning DW. Aspergillus bronchitis without significant immunocompromise. Ann N Y Acad Sci 2012; 1272: 73-85
    CrossrefPubMedGoogle Scholar
  • 78 Accessed September 14, 2023 at: https://www.allergome.org
    PubMed
  • 79 Denning DW, Pfavayi LT. Poorly controlled asthma—-easy wins and future prospects for addressing fungal allergy. Allergol Int 2023; 72 (04) 493-506
    CrossrefPubMedGoogle Scholar
  • 80 Knutsen AP, Bush RK, Demain JG. et al. Fungi and allergic lower respiratory tract diseases. J Allergy Clin Immunol 2012; 129 (02) 280-291 , quiz 292–293
    CrossrefPubMedGoogle Scholar
  • 81 Pavord ID, Beasley R, Agusti A. et al. After asthma: redefining airways diseases. Lancet 2018; 391 (10118): 350-400
    CrossrefPubMedGoogle Scholar
  • 82 Wardlaw AJ, Rick EM, Pur Ozyigit L, Scadding A, Gaillard EA, Pashley CH. New perspectives in the diagnosis and management of allergic fungal airway disease. J Asthma Allergy 2021; 14: 557-573
    CrossrefPubMedGoogle Scholar
  • 83 O'Driscoll BR, Hopkinson LC, Denning DW. Mold sensitization is common amongst patients with severe asthma requiring multiple hospital admissions. BMC Pulm Med 2005; 5: 4
    CrossrefPubMedGoogle Scholar
  • 84 Brusselle GG, Koppelman GH. Biologic therapies for severe asthma. N Engl J Med 2022; 386 (02) 157-171
    CrossrefPubMedGoogle Scholar
  • 85 Ray A, Oriss TB, Wenzel SE. Emerging molecular phenotypes of asthma. Am J Physiol Lung Cell Mol Physiol 2015; 308 (02) L130-L140
    CrossrefPubMedGoogle Scholar
  • 86 Lambrecht BN, Hammad H, Fahy JV. The cytokines of asthma. Immunity 2019; 50 (04) 975-991
    CrossrefPubMedGoogle Scholar
  • 87 Wiesner DL, Klein BS. Lung epithelium: barrier immunity to inhaled fungi and driver of fungal-associated allergic asthma. Curr Opin Microbiol 2017; 40: 8-13
    CrossrefPubMedGoogle Scholar
  • 88 Balenga NA, Klichinsky M, Xie Z. et al. A fungal protease allergen provokes airway hyper-responsiveness in asthma. Nat Commun 2015; 6: 6763
    CrossrefPubMedGoogle Scholar
  • 89 Wiesner DL, Merkhofer RM, Ober C. et al. Club cell TRPV4 serves as a damage sensor driving lung allergic inflammation. Cell Host Microbe 2020; 27 (04) 614-628.e6
    CrossrefPubMedGoogle Scholar
  • 90 Cayrol C, Duval A, Schmitt P. et al. Environmental allergens induce allergic inflammation through proteolytic maturation of IL-33. Nat Immunol 2018; 19 (04) 375-385
    CrossrefPubMedGoogle Scholar
  • 91 Janahi IA, Rehman A, Al-Naimi AR. Allergic bronchopulmonary aspergillosis in patients with cystic fibrosis. Ann Thorac Med 2017; 12 (02) 74-82
    CrossrefPubMedGoogle Scholar
  • 92 Maturu VN, Agarwal R. Prevalence of Aspergillus sensitization and allergic bronchopulmonary aspergillosis in cystic fibrosis: systematic review and meta-analysis. Clin Exp Allergy 2015; 45 (12) 1765-1778
    CrossrefPubMedGoogle Scholar
  • 93 De Baets F, De Keyzer L, Van Daele S. et al. Risk factors and impact of allergic bronchopulmonary aspergillosis in Pseudomonas aeruginosa-negative CF patients. Pediatr Allergy Immunol 2018; 29 (07) 726-731
    CrossrefPubMedGoogle Scholar
  • 94 Stevens DA, Moss RB, Kurup VP. et al; Participants in the Cystic Fibrosis Foundation Consensus Conference. Allergic bronchopulmonary aspergillosis in cystic fibrosis–state of the art: Cystic Fibrosis Foundation Consensus Conference. Clin Infect Dis 2003; 37 (Suppl. 03) S225-S264
    CrossrefPubMedGoogle Scholar
  • 95 Agarwal R, Sehgal IS, Dhooria S, Aggarwal AN. Developments in the diagnosis and treatment of allergic bronchopulmonary aspergillosis. Expert Rev Respir Med 2016; 10 (12) 1317-1334
    CrossrefPubMedGoogle Scholar
  • 96 Steels S, Proesmans M, Bossuyt X, Dupont L, Frans G. Laboratory biomarkers in the diagnosis and follow-up of treatment of allergic bronchopulmonary aspergillosis in cystic fibrosis. Crit Rev Clin Lab Sci 2023; 60 (01) 1-24
    CrossrefPubMedGoogle Scholar
  • 97 Ohn M, Robinson P, Selvadurai H, Fitzgerald DA. Question 11: how should allergic bronchopulmonary aspergillosis [ABPA] be managed in cystic fibrosis?. Paediatr Respir Rev 2017; 24: 35-38
    PubMedGoogle Scholar
  • 98 Castellani C, Duff AJA, Bell SC. et al. ECFS best practice guidelines: the 2018 revision. J Cyst Fibros 2018; 17 (02) 153-178
    CrossrefPubMedGoogle Scholar
  • 99 Knutsen AP, Slavin RG. Allergic bronchopulmonary aspergillosis in asthma and cystic fibrosis. Clin Dev Immunol 2011; 2011: 843763
    CrossrefPubMedGoogle Scholar
  • 100 Knutsen AP, Hutchinson PS, Albers GM, Consolino J, Smick J, Kurup VP. Increased sensitivity to IL-4 in cystic fibrosis patients with allergic bronchopulmonary aspergillosis. Allergy 2004; 59 (01) 81-87
    CrossrefPubMedGoogle Scholar
  • 101 Lameire S, Hammad H. Lung epithelial cells: upstream targets in type 2-high asthma. Eur J Immunol 2023; e2250106
    CrossrefPubMedGoogle Scholar
  • 102 Jelihovsky T. The structure of bronchial plugs in mucoid impaction, bronchocentric granulomatosis and asthma. Histopathology 1983; 7 (02) 153-167
    CrossrefPubMedGoogle Scholar
  • 103 Katzenstein AL, Liebow AA, Friedman PJ. Bronchocentric granulomatosis, mucoid impaction, and hypersensitivity reactions to fungi. Am Rev Respir Dis 1975; 111 (04) 497-537
    PubMedGoogle Scholar
  • 104 Persson EK, Verstraete K, Heyndrickx I. et al. Protein crystallization promotes type 2 immunity and is reversible by antibody treatment. Science 2019; 364 (6442) eaaw4295
    CrossrefPubMedGoogle Scholar
  • 105 Fahy JV, Locksley RM. Making asthma crystal clear. N Engl J Med 2019; 381 (09) 882-884
    CrossrefPubMedGoogle Scholar
  • 106 Gevaert E, Delemarre T, De Volder J. et al. Charcot-Leyden crystals promote neutrophilic inflammation in patients with nasal polyposis. J Allergy Clin Immunol 2020; 145 (01) 427-430.e4
    CrossrefPubMedGoogle Scholar
  • 107 Kousha M, Tadi R, Soubani AO. Pulmonary aspergillosis: a clinical review. Eur Respir Rev 2011; 20 (121) 156-174
    CrossrefPubMedGoogle Scholar
  • 108 Raghu G, Remy-Jardin M, Ryerson CJ. et al. Diagnosis of hypersensitivity pneumonitis in adults. An Official ATS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med 2020; 202 (03) e36-e69
    CrossrefPubMedGoogle Scholar
  • 109 Meeker DP, Gephardt GN, Cordasco Jr EM, Wiedemann HP. Hypersensitivity pneumonitis versus invasive pulmonary aspergillosis: two cases with unusual pathologic findings and review of the literature. Am Rev Respir Dis 1991; 143 (02) 431-436
    CrossrefPubMedGoogle Scholar
  • 110 Gerfaud-Valentin M, Reboux G, Traclet J, Thivolet-Béjui F, Cordier JF, Cottin V. Occupational hypersensitivity pneumonitis in a baker: a new cause. Chest 2014; 145 (04) 856-858
    CrossrefPubMedGoogle Scholar
  • 111 Reich JM. Chirping rales in bird-fancier's lung. Chest 1993; 104 (01) 326-327
    CrossrefPubMedGoogle Scholar
  • 112 Denning DW, Follansbee SE, Scolaro M, Norris S, Edelstein H, Stevens DA. Pulmonary aspergillosis in the acquired immunodeficiency syndrome. N Engl J Med 1991; 324 (10) 654-662
    CrossrefPubMedGoogle Scholar
  • 113 Mistry H, Ajsivinac Soberanis HM, Kyyaly MA. et al. The clinical implications of Aspergillus fumigatus sensitization in difficult-to-treat asthma patients. J Allergy Clin Immunol Pract 2021; 9 (12) 4254-4267.e10
    CrossrefPubMedGoogle Scholar
  • 114 Selman M, Pardo A, King Jr TE. Hypersensitivity pneumonitis: insights in diagnosis and pathobiology. Am J Respir Crit Care Med 2012; 186 (04) 314-324
    CrossrefPubMedGoogle Scholar
  • 115 Garg A, Bhalla AS, Naranje P, Vyas S, Garg M. Decoding the guidelines of invasive pulmonary aspergillosis in critical care setting: imaging perspective. Indian J Radiol Imaging 2023; 33 (03) 382-391
    Article in Thieme ConnectPubMedGoogle Scholar
  • 116 Greene R. The radiological spectrum of pulmonary aspergillosis. Med Mycol 2005; 43 (Suppl. 01) S147-S154
    CrossrefPubMedGoogle Scholar
  • 117 Bercusson A, Jarvis G, Shah A. CF fungal disease in the age of CFTR Modulators. Mycopathologia 2021; 186 (05) 655-664
    CrossrefPubMedGoogle Scholar
  • 118 Agarwal R. High attenuation mucoid impaction in allergic bronchopulmonary aspergillosis. World J Radiol 2010; 2 (01) 41-43
    CrossrefPubMedGoogle Scholar
  • 119 Fenoglio CM, Reboux G, Sudre B. et al. Diagnostic value of serum precipitins to mould antigens in active hypersensitivity pneumonitis. Eur Respir J 2007; 29 (04) 706-712
    CrossrefPubMedGoogle Scholar