An Overview of Allergic Bronchopulmonary Aspergillosis; Diagnostic and Therapeutic Aspects

Allergic Bronchopulmonary Aspergillosis (ABPA) is a hypersensitivity response to Aspergillus antigens in patients with asthma or cystic fibrosis (CF). The inhalation of spores from the environment is followed by growth of hyphae in the mucus of the bronchial tree and stimulates an immune response involving Th2 CD4 T cells and IgE and IgG antibodies. Although diagnostic procedure for ABPA is a big challenge, serological marker (measurement of IgE antibody) for the diagnosis of ABPA is chosen in clinical. However, cross-reactivity may also occur between crude fungal extracts. Therefore, combination of clinical, biological and radiological criteria with molecular-based allergy can solve this problem. Although, the mainstay of treatment for ABPA is corticosteroids followed by antifungal regimes, but treatment is dependent on the ABPA stage with asthma control, prevention and treatment of acute disease, and preventing the progression of bronchiectasis. The current review paper presents a comprehensive overview of the allergic bronchopulmonary aspergillosis based on diagnostic and therapeutic aspects.