Update on Respiratory Fungal Infections in Cystic Fibrosis Lung Disease and After Lung Transplantation

Overview

Journal J Fungi (Basel)

Date 2020 Dec 29

PMID 33371198

Citations 8

Authors

Sabine Renner

Edith Nachbaur

Peter Jaksch

Eleonora Dehlink

Affiliations

Soon will be listed here.

Abstract

Cystic fibrosis is the most common autosomal-recessive metabolic disease in the Western world. Impaired trans-membrane chloride transport via the cystic fibrosis transmembrane conductance regulator (CFTR) protein causes thickened body fluids. In the respiratory system, this leads to chronic suppurative cough and recurrent pulmonary infective exacerbations, resulting in progressive lung damage and respiratory failure. Whilst the impact of bacterial infections on CF lung disease has long been recognized, our understanding of pulmonary mycosis is less clear. The range and detection rates of fungal taxa isolated from CF airway samples are expanding, however, in the absence of consensus criteria and univocal treatment protocols for most respiratory fungal conditions, interpretation of laboratory reports and the decision to treat remain challenging. In this review, we give an overview on fungal airway infections in CF and CF-lung transplant recipients and focus on the most common fungal taxa detected in CF, , spp., , species, and , their clinical presentations, common treatments and prophylactic strategies, and clinical challenges from a physician's point of view.

Citing Articles

Airway Mycobiota-Microbiota During Pulmonary Exacerbation of Cystic Fibrosis Patients: A Culture and Targeted Sequencing Study.

Angebault C, Vandenborght L, Bassinet L, Wizla N, Ferroni A, Dessein R Mycoses. 2025; 68(1):e70024.

PMID: 39816006 PMC: 11736540. DOI: 10.1111/myc.70024.

Metagenomics Applied to the Respiratory Mycobiome in Cystic Fibrosis.

Angebault C, Botterel F Mycopathologia. 2024; 189(5):82.

PMID: 39264513 PMC: 11392981. DOI: 10.1007/s11046-024-00887-6.

A Lateral-Flow Device for the Rapid Detection of Species.

Davies G, Thornton C Diagnostics (Basel). 2024; 14(8).

PMID: 38667492 PMC: 11048963. DOI: 10.3390/diagnostics14080847.

Fungal Colonization of the Airways of Patients with Cystic Fibrosis: the Role of the Environmental Reservoirs.

Ravenel K, Guegan H, Gastebois A, Bouchara J, Gangneux J, Giraud S Mycopathologia. 2024; 189(2):19.

PMID: 38407729 DOI: 10.1007/s11046-023-00818-x.

Association between Cystic Fibrosis exacerbations, lung function, T2 inflammation and microbiological colonization.

Albon D, Zhang L, Patrie J, Jones M, Li Z, Noonan E Allergy Asthma Clin Immunol. 2023; 19(1):15.

PMID: 36849900 PMC: 9969710. DOI: 10.1186/s13223-023-00760-z.

References

Engel T, Tehupeiory-Kooreman M, Melchers W, Reijers M, Merkus P, Verweij P . Evaluation of a New Culture Protocol for Enhancing Fungal Detection Rates in Respiratory Samples of Cystic Fibrosis Patients. J Fungi (Basel). 2020; 6(2). PMC: 7345163. DOI: 10.3390/jof6020082. View

Iversen M, Burton C, Vand S, Skovfoged L, Carlsen J, Milman N . Aspergillus infection in lung transplant patients: incidence and prognosis. Eur J Clin Microbiol Infect Dis. 2007; 26(12):879-86. DOI: 10.1007/s10096-007-0376-3. View

Baxter C, Dunn G, Jones A, Webb K, Gore R, Richardson M . Novel immunologic classification of aspergillosis in adult cystic fibrosis. J Allergy Clin Immunol. 2013; 132(3):560-566.e10. DOI: 10.1016/j.jaci.2013.04.007. View

Verleden G, Glanville A, Lease E, Fisher A, Calabrese F, Corris P . Chronic lung allograft dysfunction: Definition, diagnostic criteria, and approaches to treatment-A consensus report from the Pulmonary Council of the ISHLT. J Heart Lung Transplant. 2019; 38(5):493-503. DOI: 10.1016/j.healun.2019.03.009. View

Voskamp A, Gillman A, Symons K, Sandrini A, Rolland J, OHehir R . Clinical efficacy and immunologic effects of omalizumab in allergic bronchopulmonary aspergillosis. J Allergy Clin Immunol Pract. 2015; 3(2):192-9. DOI: 10.1016/j.jaip.2014.12.008. View

Nihtinen A, Anttila V, Richardson M, Meri T, Volin L, Ruutu T . The utility of intensified environmental surveillance for pathogenic moulds in a stem cell transplantation ward during construction work to monitor the efficacy of HEPA filtration. Bone Marrow Transplant. 2007; 40(5):457-60. DOI: 10.1038/sj.bmt.1705749. View

Zhang L, Borish L, Smith A, Somerville L, Albon D . Use of mepolizumab in adult patients with cystic fibrosis and an eosinophilic phenotype: case series. Allergy Asthma Clin Immunol. 2020; 16:3. PMC: 6945791. DOI: 10.1186/s13223-019-0397-3. View

Schwarz C, Brandt C, Antweiler E, Krannich A, Staab D, Schmitt-Grohe S . Prospective multicenter German study on pulmonary colonization with Scedosporium /Lomentospora species in cystic fibrosis: Epidemiology and new association factors. PLoS One. 2017; 12(2):e0171485. PMC: 5298894. DOI: 10.1371/journal.pone.0171485. View

Nguyen L, Viscogliosi E, Delhaes L . The lung mycobiome: an emerging field of the human respiratory microbiome. Front Microbiol. 2015; 6:89. PMC: 4327734. DOI: 10.3389/fmicb.2015.00089. View

10.

Chen M, Kondori N, Deng S, Gerrits van den Ende A, Lackner M, Liao W . Direct detection of Exophiala and Scedosporium species in sputa of patients with cystic fibrosis. Med Mycol. 2017; 56(6):695-702. DOI: 10.1093/mmy/myx108. View

11.

Delhaes L, Touati K, Faure-Cognet O, Cornet M, Botterel F, Dannaoui E . Prevalence, geographic risk factor, and development of a standardized protocol for fungal isolation in cystic fibrosis: Results from the international prospective study "MFIP". J Cyst Fibros. 2018; 18(2):212-220. DOI: 10.1016/j.jcf.2018.10.001. View

12.

Saunders R, Modha D, Claydon A, Gaillard E . Chronic Aspergillus fumigatus colonization of the pediatric cystic fibrosis airway is common and may be associated with a more rapid decline in lung function. Med Mycol. 2016; 54(5):537-43. DOI: 10.1093/mmy/myv119. View

13.

Thronicke A, Heger N, Antweiler E, Krannich A, Roehmel J, Brandt C . Allergic bronchopulmonary aspergillosis is associated with pet ownership in cystic fibrosis. Pediatr Allergy Immunol. 2016; 27(6):597-603. DOI: 10.1111/pai.12590. View

14.

Briard B, Mislin G, Latge J, Beauvais A . Interactions between and Pulmonary Bacteria: Current State of the Field, New Data, and Future Perspective. J Fungi (Basel). 2019; 5(2). PMC: 6617096. DOI: 10.3390/jof5020048. View

15.

Ammerman E, Sweet S, Fenchel M, Storch G, Conrad C, Hayes Jr D . Risk and outcomes of pulmonary fungal infection after pediatric lung transplantation. Clin Transplant. 2017; 31(11). PMC: 5724976. DOI: 10.1111/ctr.13100. View

16.

Danziger-Isakov L, Worley S, Arrigain S, Aurora P, Ballmann M, Boyer D . Increased mortality after pulmonary fungal infection within the first year after pediatric lung transplantation. J Heart Lung Transplant. 2008; 27(6):655-61. PMC: 2447528. DOI: 10.1016/j.healun.2008.03.010. View

17.

Parisi G, Portale A, Papale M, Tardino L, Rotolo N, Licari A . Successful treatment with omalizumab of allergic bronchopulmonary aspergillosis in patients with cystic fibrosis: Case reports and literature review. J Allergy Clin Immunol Pract. 2019; 7(5):1636-1638. DOI: 10.1016/j.jaip.2019.01.056. View

18.

Sudfeld C, Dasenbrook E, Merz W, Carroll K, Boyle M . Prevalence and risk factors for recovery of filamentous fungi in individuals with cystic fibrosis. J Cyst Fibros. 2010; 9(2):110-6. PMC: 4113956. DOI: 10.1016/j.jcf.2009.11.010. View

19.

Arthurs S, Eid A, Deziel P, Marshall W, Cassivi S, Walker R . The impact of invasive fungal diseases on survival after lung transplantation. Clin Transplant. 2009; 24(3):341-8. DOI: 10.1111/j.1399-0012.2009.01076.x. View

20.

Hong G, Psoter K, Jennings M, Merlo C, Boyle M, Hadjiliadis D . Risk factors for persistent Aspergillus respiratory isolation in cystic fibrosis. J Cyst Fibros. 2018; 17(5):624-630. PMC: 6681666. DOI: 10.1016/j.jcf.2018.01.008. View