Purpose of Review <p>Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity response to <i>Aspergillus</i> species. This review aims to analyze recent advances in ABPA and discuss the current evidence-based diagnostic and treatment protocols.</p> Recent Findings <p><i>Aspergillus fumigatus</i> is the most implicated fungus, although species other than <i>A. fumigatus</i> may occasionally be responsible. <i>A. fumigatus</i>-specific IgE is the preferred screening test. Reducing the total IgE cut-off from 1000 to 500 IU/mL enhances the diagnostic performance of the criteria. Detection of <i>A. fumigatus</i>-specific IgG using automated enzyme immunoassay or lateral-flow assay is superior to other conventional methods. Although glucocorticoid therapy is the mainstay, antifungal monotherapy or combination therapy may benefit a subset of patients. Biologics are effective in refractory cases.</p> Summary <p>Revised diagnostic criteria advocated by the International Society for Human and Animal Mycology-ABPA working group adopt the latest evidence and improve diagnostic accuracy. Future research is likely to further enhance diagnostic precision and devise safe, effective, personalised, and economical treatment options.</p>

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Allergic Bronchopulmonary Aspergillosis: What's New

  • Puneet Saxena

摘要

Purpose of Review

Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity response to Aspergillus species. This review aims to analyze recent advances in ABPA and discuss the current evidence-based diagnostic and treatment protocols.

Recent Findings

Aspergillus fumigatus is the most implicated fungus, although species other than A. fumigatus may occasionally be responsible. A. fumigatus-specific IgE is the preferred screening test. Reducing the total IgE cut-off from 1000 to 500 IU/mL enhances the diagnostic performance of the criteria. Detection of A. fumigatus-specific IgG using automated enzyme immunoassay or lateral-flow assay is superior to other conventional methods. Although glucocorticoid therapy is the mainstay, antifungal monotherapy or combination therapy may benefit a subset of patients. Biologics are effective in refractory cases.

Summary

Revised diagnostic criteria advocated by the International Society for Human and Animal Mycology-ABPA working group adopt the latest evidence and improve diagnostic accuracy. Future research is likely to further enhance diagnostic precision and devise safe, effective, personalised, and economical treatment options.