Allergic bronchopulmonary aspergillosis in patients with asthma: dynamics of immunological parameters during antimycotic therapy
| Autor: | O V Aak, A V Sobolev, Nikolay Klimko, L. V. Filippova, O A Shurpitskaya, A E Uchevatkina, Y I Kozlova, Elena V. Frolova |
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| Rok vydání: | 2016 |
| Předmět: | |
| Zdroj: | Russian Journal of Allergy. 13:37-42 |
| ISSN: | 2686-682X 1810-8830 |
| DOI: | 10.36691/rja360 |
| Popis: | Background. To determine the frequency of allergic bronchopulmonary aspergillosis in patients with asthma and to study the dynamics of immunological parameters in patients with allergic bronchopulmonary aspergillosis during antimycotic therapy. Methods. During investigation of 176 patients with asthma the group of patients with allergic bronchopulmonary aspergillosis was isolated. Allergological (skin tests with fungal allergens, serum total IgE, specific IgE to fungal allergens), immunological (IFN-γ, IL-10) and mycological (microscopy and culture of respiratory samples) examination was performed. Computer tomography of the chest was done when indicated. Results. In patients with asthma frequency of sensitization to Aspergillus spp. was 27%, with allergic bronchopulmonary aspergillosis - 4%. The increased activity of T-helper type 2 in patients with allergic bronchopulmonary aspergillosis (n=7) was revealed. After itraconazole treatment during 24 weeks serum total IgE reduced (p=0,04), spontaneous and induced production of IFN-γ ratio was normalized. The reduction of the absolute number of eosinophils in 4 (80%) patients, decreased production of sIgE to Aspergillus spp. in 3 (60%) patients were noted. Conclusion. All patients with severe asthma needed additional allergological and mycological examination for the detection of allergic bronchopulmonary aspergillosis. Itraconazole therapy was effective, reduced fungal burden, and resulted to restoring of Th2/Th1 imbalance in patients with allergic bronchopulmonary aspergillosis. |
| Databáze: | OpenAIRE |
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