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Review
. 2013:2013:723129.
doi: 10.1155/2013/723129. Epub 2013 Jul 21.

Aspergillus-associated airway disease, inflammation, and the innate immune response

Sanjay H Chotirmall  1 , Mazen Al-Alawi, Bojana Mirkovic, Gillian Lavelle, P Mark Logan, Catherine M Greene, Noel G McElvaney
Affiliations
Review

Aspergillus-associated airway disease, inflammation, and the innate immune response

Sanjay H Chotirmall et al. Biomed Res Int. 2013.

Abstract

Aspergillus moulds exist ubiquitously as spores that are inhaled in large numbers daily. Whilst most are removed by anatomical barriers, disease may occur in certain circumstances. Depending on the underlying state of the human immune system, clinical consequences can ensue ranging from an excessive immune response during allergic bronchopulmonary aspergillosis to the formation of an aspergilloma in the immunocompetent state. The severest infections occur in those who are immunocompromised where invasive pulmonary aspergillosis results in high mortality rates. The diagnosis of Aspergillus-associated pulmonary disease is based on clinical, radiological, and immunological testing. An understanding of the innate and inflammatory consequences of exposure to Aspergillus species is critical in accounting for disease manifestations and preventing sequelae. The major components of the innate immune system involved in recognition and removal of the fungus include phagocytosis, antimicrobial peptide production, and recognition by pattern recognition receptors. The cytokine response is also critical facilitating cell-to-cell communication and promoting the initiation, maintenance, and resolution of the host response. In the following review, we discuss the above areas with a focus on the innate and inflammatory response to airway Aspergillus exposure and how these responses may be modulated for therapeutic benefit.

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Figures

Figure 1
Figure 1
Focal area of ground glass change in the medial aspect of the right lower lobe in a patient with ABPA.
Figure 2
Figure 2
A pulmonary aspergilloma in a 24-year-old patient with cystic fibrosis. CT images show a fungus ball within the preexisting left upper lobe cavity, and the air-crescent sign is demonstrated in the nondependent part of the cavity on both CT imaging performed in the supine and prone position.
See this image and copyright information in PMC

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