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PPT : Overview of Aspergillus lung disease
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Lung damage host defense mediated
* Atopic allergy to fungal spores
o 10% of asthmatics skin prick positive to aspergillus
* Asthma and positive IgG precipitins to aspergillus
* ABPA
* Aspergilloma
Lung damage mediated by the fungus’s digestive proteolytic enzymes and host defense
* Invasive aspergillosis
o Severe immunosuression
* Semi-invasive aspergillosis
o Low grade chronic invasion of aspergillus into airway walls and lung
o Mild immunosuppression – DM, steroid therapy, chronic lung disease, poor nutrition
Growing evidence from clinical data and genetic studies that there is dysregulated immune function in bronchiectasis
Altered susceptibility to specific pathogens
Self-reactivity
Non-tuberculous mycobacteria (NTM) in bronchiectasis
* NTM are ubiquitous environmental organisms
* Prevalence of NTM in patients with bronchiectasis is 2%
* Mycobacterium avium complex (MAC) is the most frequent NTM isolated in bronchiectasis
* Pseudomonas aeruginosa and Staphylococcus aureus are frequently co-cultured
* NTM may be associated with progressive lung damage
o HRCT thorax (progressive bronchiectasis, new nodules, new/progression of cavities, consolidation)
* A mutation in the interferon-gamma-receptor gene linked to susceptibility to mycobacterial infection
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Category : ImmunologySource : www.aspergillus.org.uk
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