Aspergillus-associated airway disease, inflammation, and the innate immune response.

[allergic bronchopulmonary aspergillosis]

Aspergillus moulds exist ubiquitously as spores that are inhaled in large numbers daily . Whilst most are removed by anatomical barriers , disease may occur in certain circumstances . Depending on the underlying state of the human immune system , clinical consequences can ensue ranging from an excessive immune response during allergic bronchopulmonary aspergillosis to the formation of an aspergilloma in the immunocompetent state . The severest infections occur in those who are immunocompromised where invasive pulmonary aspergillosis results in high mortality rates . The diagnosis of Aspergillus-associated pulmonary disease is based on clinical , radiological , and immunological testing . An understanding of the innate and inflammatory consequences of exposure to Aspergillus species is critical in accounting for disease manifestations and preventing sequelae . The major components of the innate immune system involved in recognition and removal of the fungus include phagocytosis , antimicrobial peptide production , and recognition by pattern recognition receptors . The cytokine response is also critical facilitating cell-to -cell communication and promoting the initiation , maintenance , and resolution of the host response . In the following review , we discuss the above areas with a focus on the innate and inflammatory response to airway Aspergillus exposure and how these responses may be modulated for therapeutic benefit .