Fungal allergy in asthma-state of the art and research needs.
Fungal allergy in asthma-state of the art and research needs.
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DOI：
10.1186/2045-7022-4-14
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发表时间：
2014
影响因子：
4.4
通讯作者：
Sergejeva S
中科院分区：
文献类型：
--
作者：
Denning DW;Pashley C;Hartl D;Wardlaw A;Godet C;Del Giacco S;Delhaes L;Sergejeva S
真菌致敏和长期或不受控制的真菌感染与哮喘控制不良、更严重疾病和并发症（如支气管扩张和慢性肺曲霉病）的可能性相关。模型表明，> 650万人患有严重哮喘伴真菌致敏（SAFS），高达50%的接受二级护理的成人哮喘患者患有真菌致敏，估计有480万成人患有过敏性支气管肺曲霉病（ABPA）。关于哪些真菌和真菌过敏原与哮喘相关、真菌致敏的自然史、真菌过敏是否存在暴露-反应关系、以及急性发作和并发症的发病机制和频率，还有很多不确定性。遗传关联已经被描述，但仅与表型弱相关。在ABPA，SAFS和相关条件下，大多数管理策略的证据基础薄弱。然而，直接的临床实践指南的管理是必要的。环境监测和控制疾病的最佳手段在预防残疾和并发症方面的作用尚不明确。在本文中，我们列出了支持真菌暴露，致敏和感染在哮喘中的作用的关键证据，对发病机制和自然史的理解，并确定了许多研究领域。
Sensitization to fungi and long term or uncontrolled fungal infection are associated with poor control of asthma, the likelihood of more severe disease and complications such as bronchiectasis and chronic pulmonary aspergillosis. Modelling suggests that >6.5 million people have severe asthma with fungal sensitizations (SAFS), up to 50% of adult asthmatics attending secondary care have fungal sensitization, and an estimated 4.8 million adults have allergic bronchopulmonary aspergillosis (ABPA). There is much uncertainty about which fungi and fungal allergens are relevant to asthma, the natural history of sensitisation to fungi, if there is an exposure response relationship for fungal allergy, and the pathogenesis and frequency of exacerbations and complications. Genetic associations have been described but only weakly linked to phenotypes. The evidence base for most management strategies in ABPA, SAFS and related conditions is weak. Yet straightforward clinical practice guidelines for management are required. The role of environmental monitoring and optimal means of controlling disease to prevent disability and complications are not yet clear. In this paper we set out the key evidence supporting the role of fungal exposure, sensitisation and infection in asthmatics, what is understood about pathogenesis and natural history and identify the numerous areas for research studies.
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影响因子：
6.1
作者：
Agarwal, R.;Chakrabarti, A.;Denning, D. W.
通讯作者：
Denning, D. W.
DOI：
10.1056/nejmoa0802629
发表时间：
2008-10-23
期刊：
The New England journal of medicine
影响因子：
--
作者：
Bochud PY;Chien JW;Marr KA;Leisenring WM;Upton A;Janer M;Rodrigues SD;Li S;Hansen JA;Zhao LP;Aderem A;Boeckh M
通讯作者：
Boeckh M
影响因子：
4.9
作者：
Atkinson, R. W.;Strachan, D. P.;Emberlin, J.
通讯作者：
Emberlin, J.
DOI：
10.1111/j.1365-2222.2012.03987.x
发表时间：
2012-05
期刊：
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
影响因子：
--
作者：
Agbetile J;Fairs A;Desai D;Hargadon B;Bourne M;Mutalithas K;Edwards R;Morley JP;Monteiro WR;Kulkarni NS;Green RH;Pavord ID;Bradding P;Brightling CE;Wardlaw AJ;Pashley CH
通讯作者：
Pashley CH
影响因子：
64.8
作者：
Aimanianda, Vishukumar;Bayry, Jagadeesh;Latge, Jean-Paul
通讯作者：
Latge, Jean-Paul