Allergic Bronchopulmonary Aspergillosis/Mycosis: An Underdiagnosed Disease

Abstract

Allergic bronchopulmonary aspergillosis (ABPA) is an immune-allergic disease of the lung due to a hypersensitivity reaction to antigens of Aspergillus fumigatus after colonization into the airways. Predominantly, it affects patients with bronchial asthma and those having cystic fibrosis (CF). Despite being recognized as a distinct entity nearly 70 years ago, this disease remains underdiagnosed. This may be due to the diagnostic methods employed, lack of standardized tests, and diagnostic criteria. The mainstay treatment for ABPA is systemic steroid. Azole antifungal agents represent an alternative for the treatment of exacerbations and are preferential strategy for corticosteroids sparing. Biologic drugs are expected to play an important role in the treatment of ABPA based on their mechanism in inhibition of type 2 inflammation, regulation of eosinophils and IgE levels, and modulation of inflammatory cytokines. Therefore, other studies are necessary for a better understanding of this disease so that an early detection can be done as well as a correct management.