Mycogenic sensitization and allergic bronchopulmonary aspergillosis in cystic fibrosis patients: results of prospective study


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Abstract

The article presents the results of evaluation of the mycogenic sensitization and incidence of allergic bronchopulmonary aspergillosis (ABPA) in patients with cystic fibrosis (CF). An open prospective study included 181 patients with CF aged 1 to 37 years. All patients underwent allergologic (skin tests with fungal allergens, total immunoglobulin E - IgE - levels, and fungal-specific IgE levels) and mycological (microscopic and cultural studies of respiratory biosubstrates) examinations. Computed tomography scans of the chest were performed when indicated. The modern diagnostic criteria for ABPA in CF patients are described. The study revealed a high frequency of mycogenic sensitization in these patients, and identified the main fungal allergens. The need for antifungal drugs in the treatment of ABPA in CF patients is discussed. The efficiency of the use of azoles to reduce fungal load and restore immunological disorders is demonstrated.

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About the authors

Ya. I Kozlova

FSBEI HE "North-Western State Medical University n.a. I.I. Mechnikov"

Email: kozlova510@mail.ru
PhD, Associate Professor at the Department of Clinical Mycology, Allergology and Immunology

A. V Sobolev

FSBEI HE "North-Western State Medical University n.a. I.I. Mechnikov"

Yu. V Borzova

FSBEI HE "North-Western State Medical University n.a. I.I. Mechnikov"

I. E Suslova

FSBEI HE "North-Western State Medical University n.a. I.I. Mechnikov"

O. V Aak

FSBEI HE "North-Western State Medical University n.a. I.I. Mechnikov"

S. M Ignatyeva

FSBEI HE "North-Western State Medical University n.a. I.I. Mechnikov"

T. S Bogomolova

FSBEI HE "North-Western State Medical University n.a. I.I. Mechnikov"

T. A Stepanenko

City Multi-field Hospital № 2, St. Petersburg

A. V Orlov

St. Olga City Children's Hospital № 4

N. N Klimko

FSBEI HE "North-Western State Medical University n.a. I.I. Mechnikov"

References

  1. Farrell P.M., White T.B., Ren C.L., Hempstead S.E., Accurso F., Derichs N., Howenstine M., McColley S.A., Rock M., Rosenfeld M., Sermet-Gaudelus I., Southern K.W., Marshall B.C., Sosnay P.R. Diagnosis of Cystic Fibrosis: Consensus Guidelines from the Cystic Fibrosis Foundation. J. Pediatr. 2017;181:4-15.
  2. Красовский С.А., Самойленко В.А., Амелина Е.Л. Муковисцидоз: диагностика, клиника, основные принципы терапии. Пульмонол. и аллергол. 2013;1:42-6.
  3. Регистр больных муковисцидозом в Российской Федерации. 2014 г. М., 2015. 64 с.
  4. Agarwai R. Allergic bronchopulmonary aspergillosis. Chest. 2009;135:805-26.
  5. Moss R.B. Allergic bronchopulmonary aspergillosis and Aspergillus infection in cystic fibrosis. Curr. Opin. Pulm. Med. 2010; 16:598-603.
  6. Agarwal R., Chakrabarti A., Shah A., Gupta D., Meis J.F., Guleria R., Moss R., Denning D.W. ABPA complicating asthma ISHAM working group. Allergic bronchopulmonary aspergillosis: review of literature and proposal of new diagnostic and classification criteria. Clinical & Experimental Allergy. 2013; 43:850- 73.
  7. Климко Н.Н., Козлова Я.И., Хостелиди С.Н. Распространенность тяжелых и хронических микотических заболеваний в Российской Федерации по модели LIFE program. Проблемы мед. микологии. 2014;1:3-9.
  8. Denning D.W., Pleuvry A., Cole D.C. Global burden of allergic bronchopulmonary aspergillosis with asthma and its complication chronic pulmonary aspergillosis in adults. Med. Mycol. 2013;51:361-70.
  9. Taniguchi H., Abo H., Miyazawa H., Noto H., Izumi S. Case of allergic bronchopulmonary aspergillosis triggered by moving house. Nihon Kokyuki GakkaiZasshi. 2005;43(2):108-11.
  10. Stevens D.A., Moss R.B., Kurup V.P., Knutsen A.P., Greenberger P., Judson M.A., Denning D.W., Crameri R., Brody A.S., Light M., Skov M., Maish W., Mastella G. Allergic bronchopulmonary aspergillosis in cystic fibrosis-state of the art: Cystic Fibrosis Foundation Consensus Conference. Clin, infect. Dis. 2003;37:225-64.
  11. Hubert D., Simmonds N. Living longer with Cystic Fibrosis. European Cystic Fibrosis Society. 2015. 143 p.
  12. Anderson M., Gregory R., Thompson S., Souza D.W., Paul S., Mulligan R.C., Smith A.E., Welsh M.J. Demonstration that CFTR is chloride channel by selectivity. Science. 1991;253:202-5.
  13. Cohen-Cymberknoh M., Shoseyov D., Kerem E. Managing Cystic Fibrosis Strategies That increase Life Expectancy and improve Quality of Life. Concise Clinical Review. Am. J. Respir. Crit. Care Med.2011;183:1463-71.
  14. Knutsen A., Slavin R. Allergic Bronchopulmonary Aspergillosis in Asthma and Cystic Fibrosis. Clinical and Developmental immunology. 2011. 13 p.
  15. Knutsen A. Genetic and respiratory tract risk factors for aspergillosis: ABPA and asthma with fungal sensitization. Medical Mycology. 2006;44:61-70.
  16. Maturu V.N., Agarwal, R. Prevalence of Aspergillus sensitization and allergic bronchopulmonary aspergillosis in cystic fibrosis: Systematic review and meta-analysis. Clin. Exp. Allergy 2015;45;1765-78.
  17. Kraemer R., Delosea N., Ballinari P., Gallati S., Crameri R. Effect of allergic bronchopulmonary aspergillosis on lung function in children with cystic fibrosis. Am. J. Respir. Crit. Care Med. 2006;174:1211-20.
  18. Agarwal R., Gupta D., Aggarwal A.N., Saxena A.K., Chakrabarti A., Jindal S.K. Clinical significance of hyperattenuating mucoid impaction in allergic bronchopulmonary aspergillosis: an analysis of 155 patients. Chest. 2007;132:1183-90.
  19. Guazzelli L.S., Xavier M.O., Oliveira F.D., et al. Chronic cavitary pulmonary aspergillosis and fungal balls. Springer, 2009. P. 585-620.
  20. Denning D.W., Park S., Lass-Florl C., Fraczek M.G., Kirwan M., Gore R., Smith J., Bueid A., Moore C.B., Bowyer P., Perlin D.S. High-frequency triazole resistance found in nonculturable Aspergillus fumigatus from lungs of patients with chronic fungal disease. Clin. infect. Dis. 2011;52(9):1123-29.
  21. Agarwal R., Gupta D., Aggarwal A.N., Saxena A.K., Saikia B., Chakrabarti A., Jindal S.K. Clinical significance of decline in serum igE levels in allergic bronchopulmonary aspergillosis. Respir. Med. 2010;104:204-10.
  22. Agarwal R., Gupta D., Aggarwal A.N., Behera D., Jindal S.K. Allergic bronchopulmonary aspergillo sis: lessons from 126 patients attending a chest clinic in north India. Chest. 2006; 130:442-48.
  23. Moss R.B. Critique of trials in allergic bronchopulmonary aspergillosis and fungal allergy. Med. Mycol. 2006;44:269-72.
  24. Burgel P.R., Baixench M.T., Amsellem M., Audureau E., Chaperone J., Kanaan R., Honoré i., Dupouy-Camet J., Dusser D., Klaassen C.H., Meis J.F, Hubert D., Paugam A. High prevalence of azoleresistant Aspergillus fumigatus in adults with cystic fibrosis exposed to itraconazole. Antimicrob. Agents Chemother. 2012; 56:869-74.
  25. Stevens D.A., Schwartz H.J., Lee J.Y., Moskovitz B.L., Jerome D.C., Catanzaro A., Bamberger D.M., Weinmann A.J., Tuazon C.U., Judson M.A., Platts-Mills T.A., DeG raff A.C. Jr. A randomized trial of itraconazole in allergic bronchopulmonary aspergillosis. New Eng. J. Med. 2000;342:756-62.
  26. Godet C., Meurice J.C., Roblot F., Kauffmann-Lacroix C., Verdaguer M., Frat J.P., Cadranel J. Efficacy of nebulised liposomal amphotericin B in the attack and maintenance treatment of ABPA. Eur. Respir. J. 2012 39:1261-63.

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