Abstract
For decades, fungi have been recognized as associated with asthma and other reactive airway diseases. In contrast to type I-mediated allergies caused by pollen, fungi cause a large number of allergic diseases such as allergic bronchopulmonary mycoses, rhinitis, allergic sinusitis and hypersensitivity pneumonitis. Amongst the fungi, Aspergillus fumigatus is the most prevalent cause of severe pulmonary allergic disease, including allergic bronchopulmonary aspergillosis (ABPA), known to be associated with chronic lung injury and deterioration in pulmonary function in people with chronic asthma and cystic fibrosis (CF). The goal of this review is to discuss new understandings of host-pathogen interactions in the genesis of allergic airway diseases caused by A. fumigatus. Host and pathogen related factors that participate in triggering the inflammatory cycle leading to pulmonary exacerbations in ABPA are discussed.
Highlights
Fungi have been recognized as associated with asthma and other reactive airway diseases
We focus on the role of filamentous fungi in respiratory allergic diseases, and discuss how fungi mediate T helper (Th) 2 -mediated allergic diseases as a result of host-pathogen interactions that lead in ineffective clearance of spores, and how predisposing factors like host genetics determine outcomes for respiratory diseases
This study suggested that tolerance against A. fumigatus antigens in cystic fibrosis (CF)-allergic bronchopulmonary aspergillosis (ABPA) patients is defective and correlated to vitamin-D deficiency
Summary
Fungi have been recognized as associated with asthma and other reactive airway diseases. Aspergillus fumigatus is the most prevalent cause of severe pulmonary allergic disease, including allergic bronchopulmonary aspergillosis (ABPA), known to be associated with chronic lung injury and deterioration in pulmonary function in people with chronic asthma and cystic fibrosis (CF). The major respiratory manifestations caused by fungi include allergic bronchopulmonary mycoses (ABPM), severe asthma with fungal sensitization (SAFS), hypersensitivity pneumonitis, fungal sinusitis and allergic rhinitis [1]. It is thought that ineffective clearance of spores results largely from structural abnormalities in the airway epithelium, as observed in patients with allergic asthma or other causes of chronic lung disease, allowing for germination of spores into vegetative cells (hyphae) [4,25,26,27,28,29]
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