Allergic Bronchopulmonary Mycosis

Allergic bronchopulmonary aspergillosis (ABPA) is a common manifestation in chronic allergic asthma and cystic fibrosis (CF) patients. The role of epithelial cell dysfunctions and of the Th2 immune response (“Interleukin-4 (IL-4) hypersensitivity”), seems to be essential for developing an ABPA. Genetic factors associated with the occurrence of ABPA are identified. Different phenotypes of ABPA are described: the sero-positive ABPA, and the bronchiectasis ABPA. Sero-positive ABPA and bronchiectasis ABPA may be the illustration of two stages of the disease, time leading to an inevitable bronchial destruction. It may also be illustrate different expression of the disease. Genetic factors may favor one or the other of these two phenotypes. When clinical, radiological and biological criteria for ABPA appear in combination and the diagnosis is made, then the treatment would need to include both systemic corticosteroids and the antifungal agent itraconazole. However, treatment regimens for this antifungal therapy have yet to be definitively established, although many experts report the benefit of prolonged antifungal treatment.