Aspergillosis is a fungal infection that occurs most commonly within the lung
Aspergillosis results in a range of diseases either directly from the infection, or from an allergic response. It can occur in a variety of organs, though the most common infection site is within the respiratory system.
The incidence of pulmonary fungal disease has increased substantially over the past two decades; Aspergillus species being the most common of these. Invasive pulmonary aspergillosis is associated with a high mortality and morbidity rate in immuno‑compromised patients including those undergoing hematological stem cell or solid organ transplantation, (particularly lung transplants) and some patients in critical care, including those with COVID-19-associated pulmonary aspergillus. Aspergillus infection also plays an important role in severe asthma and cystic fibrosis and has been correlated with poorer clinical outcome in patients with chronic obstructive pulmonary disease. Chronic lung infections with Aspergillus can leave patients with extensive and permanent lung damage, requiring lifetime antifungal treatment.
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Aspergillosis is a fungal infection that occurs in immunocompromised patients
Aspergillosis results in a range of diseases either directly from the infection, or from an allergic response. It can occur in a variety of organs, though the most common infection site is within the respiratory system.
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.
The most common 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 and drug interactions. An opportunity exists to identify a new generation of potent inhaled therapies that have been optimized for lung administration.
Acute invasive aspergillosis
Invasive infection is a life-threatening infection caused by Aspergillus in patients with prolonged neutropenia or immunosuppression. Immuno-compromised patients, such as those undergoing stem cell or solid-organ transplantation, or those undergoing intensive treatment for haematological cancer, are at particular risk.
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Bafadehl et al Eur Respir J 2014; 43: 64–71
http://www.em-consulte.com/rmr/article/146292/
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
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Denning et al. Clinical and Translational Allergy 2014, 4:14 Armstead, Plos 1 June 2014 | Volume 9 | Issue 6
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
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