EAACI position paper on the diagnosis and therapeutic management of allergic bronchopulmonary aspergillosis (ABPA)
EAACI position paper on the diagnosis and therapeutic management of allergic bronchopulmonary aspergillosis (ABPA)
Strategic research directions # 1, 2, 6. Rationale for establishing a task force: Aspergillus fumigatus (AF) causes multiple hypersensitivity conditions. Allergic bronchopulmonary aspergillosis (ABPA), the most severe, occurs in asthma (8% prevalence), cystic fibrosis (15%) and bronchiectasis. It poses four major difficulties:-Fungal exposure: AF is a ubiquitous airborne fungus. A better understanding of the health implications, aerobiology and ecology of AF, other Aspergilli and airborne fungi needs improved investigation.-Clinical presentation: ABPA may be difficult to distinguish from other causes of pulmonary exacerbation, from SAFS, or even from baseline in high-risk populations. Overlooked ABPA exposes to irreversible pulmonary remodeling.-Fungal sensitization: Demonstration of specific IgE for AF through blood or skin tests has a low positive predictive value for ABPA; -Diagnostic criteria: The 1977 score was barely updated in 2013 by the ISHAM. Further updates are called for by recent studies. An allergy society-endorsed recommendation for ABPA is lacking.Aim:Provide the EAACI and the medical community with state-of-the-art position papers, taking advantage of the collaboration established with the EAACI WG Aerobiology and Pollution:-what is currently known about AF and related hypersensitivity diseases;-what are the current best options for the diagnosis of ABPA;-what are the currently unmet needs in ABPA.Outcomes and possible benefits for EAACI: close gaps in clinical and pathology guidelines, provide evidence-based recommendations for treatment options, address new matters of concern, delivering consensual information; contribute to the education of students, physicians and allied health professionals; provide clinical decision tools for physicians; foster clinical and translational research in the climate change-related domain of hypersensitivity to AF and fungi. improve the EAACI visibility in the field of fungal allergy.
Chair: Joana Vitte
Secretary: Monika Raulf