The use of aggressive and intensive chemotherapeutic regimens, bone marrow and solid-organ transplantations, and the use of immunosuppressive regimens for treatment of autoimmune diseases, has led to significant increases in the prevalence of invasive fungal infections.
Disseminated candidiasis, pulmonary aspergillosis, and emerging opportunistic fungi are the most common agents producing life-threatening invasive mycoses it has been estimated that 200,000 immunocompromised patients develop invasive aspergillosis (IA) annually.
The commonest fungal genus to cause pulmonary-associated fungal infections is Aspergillus Fumigatus, with a wide spectrum of syndromes spanning allergic disease, saprophytic invasion (fungal bronchitis), and invasive aspergillosis.
Despite wide availability of antifungal therapies for invasive aspergillosis, mortality rates remain extremely high. Diagnosis is difficult and conventional therapies have dose-limiting toxicities. Experimental studies using inhaled Voriconazole and Amphotericin in small patient populations have provided promising data for the inhaled concept. An opportunity exists to identify a new generation of potent inhaled therapies that have been optimized for lung administration.
Chronic Pulmonary Aspergillosis
Chronic forms of pulmonary aspergillosis consist of simple aspergilloma, chronic cavitary pulmonary aspergillosis (CCPA), and chronic necrotizing pulmonary aspergillosis (CNPA) are estimated to affect ~1M patients worldwide
Allergic bronchopulmonary aspergillosis (ABPA)
ABPA is a pulmonary disorder caused by hypersensitivity to Aspergillus Fumigatus. Allergic fungal airways disease (AFAD) includes patients in which IgE sensitization and associated airway colonization with A. fumigatus, associated with poor disease control. AFAD is estimated to occur in 50% of patients with severe asthma.
Armstead J, Morris J, Denning DW (2014) Multi-Country Estimate of Different Manifestations of Aspergillosis in Cystic Fibrosis. PLoS ONE 9(6): e98502
Denning et al. Clinical and Translational Allergy 2014, 4:14 Armstead, Plos 1 June 2014 | Volume 9 | Issue 6