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Treatment options in severe fungal asthma and allergic bronchopulmonary aspergillosis.
[allergic bronchopulmonary aspergillosis]
Severe
asthma
with
fungal
sensitisation
and
allergic
bronchopulmonary
aspergillosis
encompass
two
closely
related
subgroups
of
patients
with
severe
allergic
asthma
.
Pulmonary
disease
is
due
to
pronounced
host
inflammatory
responses
to
noninvasive
subclinical
endobronchial
infection
with
filamentous
fungi
,
usually
Aspergillus
fumigatus
.
These
patients
usually
do
not
achieve
satisfactory
disease
control
with
conventional
treatment
of
severe
asthma
,
i
.
e
.
high
-dose
inhaled
corticosteroids
and
long
-acting
bronchodilators
.
Although
prolonged
systemic
corticosteroids
are
effective
,
they
carry
a
substantial
toxicity
profile
.
Supplementary
or
alternative
therapies
have
primarily
focused
on
use
of
antifungal
agents
including
oral
triazoles
and
inhaled
amphotericin
B
.
Immunomodulation
with
omalizumab
,
a
humanised
anti-
IgE
monoclonal
antibody
,
or
"
pulse
"
monthly
high
-dose
intravenous
corticosteroid
,
has
also
been
employed
.
This
article
considers
the
experience
with
these
approaches
,
with
emphasis
on
recent
clinical
trials
.
Diseases
Validation
Diseases presenting
"severe asthma"
symptom
22q11.2 deletion syndrome
allergic bronchopulmonary aspergillosis
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