Allergic bronchopulmonary aspergillosis

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What is Allergic bronchopulmonary aspergillosis?

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Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity disease, hence called 'allergic'. This happens in patients with asthma when the bronchi (large windpipe leading to the lungs) is infected with a fungus called Aspergillus. Depending of individuals, there is mounting of an immune response towards these fungi, leading to recurrent symptoms like a typical asthma attack. This is a disease of the airways, ie. the windpipe leading to the lungs.

Who gets Allergic bronchopulmonary aspergillosis?

ABPA was first reported in England in 1952. After that, a number of cases have been diagnosed from many countries. A recent study suggested that the ABPA in patients with chronic bronchial asthma is as high as 16%.

Predisposing Factors

Asthma is a criterion for diagnosing this condition. This disease only occurs in asthmatics. Otherwise, aspergillosis affects all races, gender, and age equally. There is also no geographical differences around the world.

Progression

The mechanism of ABPA remains incompletely understood. However it involves allergic reaction to the fungus Aspergillus sp. Chronic lung conditions such as asthma and cystic fibrosis may trap Aspergillus fumigatus in the persistent, thick secretions. The body responds by mounting an immune reaction towards Aspergillus. It is interesting to note that despite vigorous immune responses towards Aspergillus, the fungus is still able to colonise the airway and cause recurrent symptoms. Chronic colonisation by Aspergillus eventually leads to enzymes and toxin release by the fungi. Added with chronic inflammation, this can lead to airway destruction and dilatation, called bronchiectasis. This disease is characterised by remissions and relapses. This means the disease comes and goes.

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