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Semin Respir Crit Care Med 2006; 27(2): 185-191
DOI: 10.1055/s-2006-939521
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Allergic Bronchopulmonary Aspergillosis

Peter G. Gibson1 , 2
  • 1Department of Respiratory and Sleep Medicine, Hunter Medical Research Institute, University of Newcastle
  • 2John Hunter Hospital, Newcastle, NSW, Australia
Further Information

Publication History

Publication Date:
13 April 2006 (online)

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ABSTRACT

Allergic bronchopulmonary aspergillosis is an uncommon but serious respiratory condition characterized by chronic airway inflammation and airway damage resulting from persistent colonization by and sensitization to the fungus Aspergillus fumigatus. The immunopathogenesis of allergic bronchopulmonary aspergillosis involves several pathways. Aspergillus allergens stimulate an interleukin 5-mediated Th2 pathway responsible for the eosinophilic infiltrate, whereas aspergillus proteases promote epithelial activation and a potent chemokine response that induces neutrophilic airway inflammation. The resulting airway inflammation is intense, involves tissue damage and remodeling, and is linked with the severity of bronchiectasis. Treatment involves corticosteroids and antifungal therapy with oral azoles. Additional management seeks to monitor and control the other disease components of severe asthma, bronchiectasis, and disease exacerbations.

KEYWORDS

Allergic aspergillosis - asthma - induced sputum - eosinophil

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Peter G GibsonM.B. B.S. F.R.A.C.P. 

Department of Respiratory and Sleep Medicine, Hunter Medical Research Institute, University of Newcastle, and John Hunter Hospital

Locked Bag 1, Hunter Region Mail Centre, Newcastle, NSW, 2310 Australia

Email: Peter.Gibson@hnehealth.nsw.gov.au

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