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首页> 外文期刊>Journal of Allergy >Immunopathology and Immunogenetics of Allergic Bronchopulmonary Aspergillosis
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Immunopathology and Immunogenetics of Allergic Bronchopulmonary Aspergillosis

机译：过敏性支气管肺曲霉病的免疫病理学和免疫遗传学

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Allergic bronchopulmonary aspergillosis (ABPA) is a Th2 hypersensitivity lung disease in response to Aspergillus fumigatus that affects asthmatic and cystic fibrosis (CF) patients. Sensitization to A. fumigatus is common in both atopic asthmatic and CF patients, yet only 1%–2% of asthmatic and 7%–9% of CF patients develop ABPA. ABPA is characterized by wheezing and pulmonary infiltrates which may lead to pulmonary fibrosis and/or bronchiectasis. The inflammatory response is characterized by Th2 responses to Aspergillus allergens, increased serum IgE, and eosinophilia. A number of genetic risks have recently been identified in the development of ABPA. These include HLA-DR and HLA-DQ, IL-4 receptor alpha chain (IL-4RA) polymorphisms, IL-10 −1082GA promoter polymorphisms, surfactant protein A2 (SP-A2) polymorphisms, and cystic fibrosis transmembrane conductance regulator gene (CFTR) mutations. The studies indicate that ABPA patients are genetically at risk to develop skewed and heightened Th2 responses to A. fumigatus antigens. These genetic risk studies and their consequences of elevated biologic markers may aid in identifying asthmatic and CF patients who are at risk to the development of ABPA. Furthermore, these studies suggest that immune modulation with medications such as anti-IgE, anti-IL-4, and/or IL-13 monoclonal antibodies may be helpful in the treatment of ABPA.
机译：过敏性支气管肺曲霉病（ABPA）是一种Th2超敏性肺部疾病，是对烟曲霉的一种反应，可影响哮喘和囊性纤维化（CF）患者。在特应性哮喘和CF患者中，对烟曲霉的过敏很常见，但只有1％–2％的哮喘患者和7％–9％的CF患者会发生ABPA。 ABPA的特征是喘息和肺部浸润，可能导致肺纤维化和/或支气管扩张。炎症反应的特征在于对曲霉变应原的Th2反应，血清IgE升高和嗜酸性粒细胞增多。最近在ABPA的开发中发现了许多遗传风险。这些包括HLA-DR和HLA-DQ，IL-4受体α链（IL-4RA）多态性，IL-10 -1082GA启动子多态性，表面活性剂蛋白A2（SP-A2）多态性和囊性纤维化跨膜电导调节基因（CFTR） ）突变。研究表明，ABPA患者在遗传上有可能对烟曲霉抗原产生偏斜和升高的Th2反应。这些遗传风险研究及其升高的生物标志物的后果可能有助于鉴定有发生ABPA风险的哮喘和CF患者。此外，这些研究表明，用抗IgE，抗IL-4和/或IL-13单克隆抗体等药物进行免疫调节可能有助于ABPA的治疗。

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