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Allergic Bronchopulmonary Aspergillosis in Asthma and Cystic Fibrosis

Authors :
Alan P. Knutsen
Raymond G. Slavin
Source :
Clinical and Developmental Immunology, Vol 2011 (2011), Clinical and Developmental Immunology
Publication Year :
2011
Publisher :
Hindawi Limited, 2011.

Abstract

Allergic bronchopulmonary aspergillosis (ABPA) is a Th2 hypersensitivity lung disease in response toAspergillus fumigatusthat affects asthmatic and cystic fibrosis (CF) patients. Sensitization toA. fumigatusis common in both atopic asthmatic and CF patients, yet only 1-2% of asthmatic and 7–9% of CF patients develop ABPA. ABPA is characterized by wheezing and pulmonary infiltrates which may lead to pulmonary fibrosis and/or bronchiectasis. The inflammatory response is characterized by Th2 responses toAspergillusallergens, increased serum IgE and eosinophilia. A number of genetic risks have recently been identified in the development of ABPA. These include HLA-DR and HLA-DQ, IL-4 receptor alpha chain (IL-4RA) polymorphisms, IL-10-1082GA promoter polymorphisms, surfactant protein A2 (SP-A2) polymorphisms, and cystic fibrosis transmembrane conductance regulator gene (CFTR) mutations. The studies indicate that ABPA patients are genetically at risk to develop skewed and heightened Th2 responses toA. fumigatusantigens. These genetic risk studies and their consequences of elevated biologic markers may aid in identifying asthmatic and CF patients who are at risk to the development of ABPA. Furthermore, these studies suggest that immune modulation with medications such as anti-IgE, anti-IL-4 and/or IL-13 monoclonal antibodies may be helpful in the treatment of ABPA.

Details

Language :
English
ISSN :
17402530 and 17402522
Volume :
2011
Database :
OpenAIRE
Journal :
Clinical and Developmental Immunology
Accession number :
edsair.doi.dedup.....e15be448c51e97414e401e8a93e03564