Allergic Bronchopulmonary Aspergillosis: What's New
摘要
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 FindingsAspergillus 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.
SummaryRevised 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.