Risk Factors for Allergic Bronchopulmonary Aspergillosis and Sensitisation to Aspergillus Fumigatus in Patients with Cystic Fibrosis

Overview

Journal Eur J Pediatr

Specialty Pediatrics

Date 2005 Jun 1

PMID 15926067

Citations 16

Authors

Nicole Ritz

Roland A Ammann

Carmen Casaulta Aebischer

Franziska Schoeni-Affolter

Martin H Schoeni

Affiliations

Soon will be listed here.

Abstract

Unlabelled: An increasing incidence of allergic bronchopulmonary aspergillosis (ABPA) as a complication in patients with cystic fibrosis (CF) is reported. The objective of this retrospective case-control study was to assess potential risk factors for ABPA and for Aspergillus fumigatus sensitisation (AFS). In a group of 160 CF patients, 11 (7%) fulfilled the diagnostic criteria for ABPA and 20 (13%) had evidence of AFS. They were compared to 62 control CF patients (25 for ABPA and 37 for AFS group) without evidence of ABPA or AFS using extended matching for sex, age and weight. AFS patients had received significantly higher cumulative doses of inhaled corticosteroids than their respective controls (OR 8.0; 95% CI 1.74-63). Bronchial colonisation with Stenotrophomonas maltophilia was strongly and independently associated with ABPA (OR 20; 95% CI 2.8- infinity). A longer duration of Pseudomonas aeruginosa colonisation was independently associated with AFS (OR per year 1.50; 95% CI 1.12- infinity).

Conclusion: Cystic fibrosis patients with allergic bronchopulmonary aspergillosis have a more frequent isolation of S. maltophilia in their sputum than their controls. Longer duration of colonisation with P. aeruginosa is a risk factor for Aspergillus fumigatus sensitisation. Higher cumulative doses of inhaled corticosteroids are associated with Aspergillus fumigatus sensitisation and their role as a risk factor needs to be clarified.

Citing Articles

Longitudinal Study on Clinical Predictors for Allergic Bronchopulmonary Aspergillosis in Children and Young People with Cystic Fibrosis Highlights the Impact of Infection with and and Ivacaftor Treatment.

Chesshyre E, Enderby B, Shore A, Warren F, Warris A J Fungi (Basel). 2025; 11(2).

PMID: 39997410 PMC: 11855986. DOI: 10.3390/jof11020116.

Clinical Impact of in Children with Cystic Fibrosis.

Fainardi V, Sodini C, Deolmi M, Ciuni A, Skenderaj K, Stabile M Microorganisms. 2022; 10(4).

PMID: 35456789 PMC: 9032721. DOI: 10.3390/microorganisms10040739.

Allergic bronchopulmonary Aspergillosis in children.

Atay O, Asilsoy S, Atakul G, Al S, Boyacioglu O, Uzuner N Turk J Med Sci. 2021; 51(5):2554-2563.

PMID: 34174797 PMC: 8742489. DOI: 10.3906/sag-2104-227.

Increased Incidence and Associated Risk Factors of Aspergillosis in Patients with Bronchiectasis.

Yang B, Kim T, Ryu J, Park H, Hwangbo B, Kong S J Pers Med. 2021; 11(5).

PMID: 34067607 PMC: 8155934. DOI: 10.3390/jpm11050422.

Clinical and microbiological characteristics of cystic fibrosis adults never colonized by Pseudomonas aeruginosa: Analysis of the French CF registry.

Vongthilath R, Richaud Thiriez B, Dehillotte C, Lemonnier L, Guillien A, Degano B PLoS One. 2019; 14(1):e0210201.

PMID: 30620748 PMC: 6324790. DOI: 10.1371/journal.pone.0210201.

References

Knutsen A, Hutcheson P, Slavin R, Kurup V . IgE antibody to Aspergillus fumigatus recombinant allergens in cystic fibrosis patients with allergic bronchopulmonary aspergillosis. Allergy. 2004; 59(2):198-203. DOI: 10.1046/j.1398-9995.2003.00310.x. View

Dezateux C, Walters S, Balfour-Lynn I . Inhaled corticosteroids for cystic fibrosis. Cochrane Database Syst Rev. 2000; (2):CD001915. DOI: 10.1002/14651858.CD001915. View

Nepomuceno I, Esrig S, Moss R . Allergic bronchopulmonary aspergillosis in cystic fibrosis: role of atopy and response to itraconazole. Chest. 1999; 115(2):364-70. DOI: 10.1378/chest.115.2.364. View

Knutsen A, Hutcheson P, Mueller K, Slavin R . Serum immunoglobulins E and G anti-Aspergillus fumigatus antibody in patients with cystic fibrosis who have allergic bronchopulmonary aspergillosis. J Lab Clin Med. 1990; 116(5):724-7. View

PRADER A, Largo R, Molinari L, Issler C . Physical growth of Swiss children from birth to 20 years of age. First Zurich longitudinal study of growth and development. Helv Paediatr Acta Suppl. 1989; 52:1-125. View

Hutcheson P, Knutsen A, Rejent A, Slavin R . A 12-year longitudinal study of Aspergillus sensitivity in patients with cystic fibrosis. Chest. 1996; 110(2):363-6. DOI: 10.1378/chest.110.2.363. View

Peterson M, Jacobs Jr D, Milla C . Longitudinal changes in growth parameters are correlated with changes in pulmonary function in children with cystic fibrosis. Pediatrics. 2003; 112(3 Pt 1):588-92. DOI: 10.1542/peds.112.3.588. View

Mastella G, Rainisio M, Harms H, Hodson M, Koch C, Navarro J . Allergic bronchopulmonary aspergillosis in cystic fibrosis. Eur Respir J. 2001; 17(5):1052-3. DOI: 10.1183/09031936.01.17510520. View

Zeaske R, BRUNS W, Fink J, Greenberger P, Colby H, Liotta J . Immune responses to Aspergillus in cystic fibrosis. J Allergy Clin Immunol. 1988; 82(1):73-7. DOI: 10.1016/0091-6749(88)90054-1. View

10.

Schonheyder H, Jensen T, Hoiby N, Koch C . Clinical and serological survey of pulmonary aspergillosis in patients with cystic fibrosis. Int Arch Allergy Appl Immunol. 1988; 85(4):472-7. DOI: 10.1159/000234554. View

11.

Marchant J, Warner J, Bush A . Rise in total IgE as an indicator of allergic bronchopulmonary aspergillosis in cystic fibrosis. Thorax. 1994; 49(10):1002-5. PMC: 475237. DOI: 10.1136/thx.49.10.1002. View

12.

Geller D, Kaplowitz H, Light M, Colin A . Allergic bronchopulmonary aspergillosis in cystic fibrosis: reported prevalence, regional distribution, and patient characteristics. Scientific Advisory Group, Investigators, and Coordinators of the Epidemiologic Study of Cystic Fibrosis. Chest. 1999; 116(3):639-46. DOI: 10.1378/chest.116.3.639. View

13.

Eaton T, Weiner Miller P, Garrett J, Cutting G . Cystic fibrosis transmembrane conductance regulator gene mutations: do they play a role in the aetiology of allergic bronchopulmonary aspergillosis?. Clin Exp Allergy. 2002; 32(5):756-61. DOI: 10.1046/j.1365-2222.2002.01361.x. View

14.

Stevens D, Moss R, Kurup V, Knutsen A, Greenberger P, Judson M . Allergic bronchopulmonary aspergillosis in cystic fibrosis--state of the art: Cystic Fibrosis Foundation Consensus Conference. Clin Infect Dis. 2003; 37 Suppl 3:S225-64. DOI: 10.1086/376525. View

15.

BECKER J, Burke W, McDonald G, Greenberger P, Henderson W, Aitken M . Prevalence of allergic bronchopulmonary aspergillosis and atopy in adult patients with cystic fibrosis. Chest. 1996; 109(6):1536-40. DOI: 10.1378/chest.109.6.1536. View

16.

Wojnarowski C, Eichler I, Gartner C, Gotz M, Renner S, Koller D . Sensitization to Aspergillus fumigatus and lung function in children with cystic fibrosis. Am J Respir Crit Care Med. 1997; 155(6):1902-7. DOI: 10.1164/ajrccm.155.6.9196093. View

17.

Nir M, Lanng S, Johansen H, Koch C . Long-term survival and nutritional data in patients with cystic fibrosis treated in a Danish centre. Thorax. 1996; 51(10):1023-7. PMC: 472653. DOI: 10.1136/thx.51.10.1023. View

18.

El-Dahr J, Fink R, SELDEN R, Arruda L, Platts-Mills T, Heymann P . Development of immune responses to Aspergillus at an early age in children with cystic fibrosis. Am J Respir Crit Care Med. 1994; 150(6 Pt 1):1513-8. DOI: 10.1164/ajrccm.150.6.7952609. View

19.

Graff G, Burns J . Factors affecting the incidence of Stenotrophomonas maltophilia isolation in cystic fibrosis. Chest. 2002; 121(6):1754-60. DOI: 10.1378/chest.121.6.1754. View

20.

Nikolaizik W, Crameri R, Blaser K, Schoni M . Skin test reactivity to recombinant Aspergillus fumigatus allergen I/a in patients with cystic fibrosis. Int Arch Allergy Immunol. 1996; 111(4):403-8. DOI: 10.1159/000237399. View