Rob's fungal immunity: last 16 Flashcards
Give examples of aspergillu environmental organisms
Aspergillus niger Aspergillus fumigatus Inhaled leading to fungal allergic airway disease. Spores get into lungs really easily
T/F people with asthma due to fungi like aspergillus are getting it due to immunosupression
F they are getting it because of an exaggerated immune response
Outline a type of fungal disease fo each category of hypersensitivity reacton
Type 1 (IgE/histamine mediated) –> allergic rhinitis, allergic asthma, ABPA Type 2 –> unknown Type III–> hypersensitivity pneumoniits/aspergilloma Type IV –> hypersensitivity pneumonitis
T/f there is just one allergen in fungi that causes hypersensitive response
F
Outline why fungal allergens are confusing for immune system
Cross reactivtiy between candida allegens in the gut and breathed in allergens in the lung (immune system doesn’t know which it is responding to) And Because they are eukaryotic, some allergens from fngi have promoted autoimmue response against self antigens in the lung
What leads to allergic and what leads to invasive fungal disease
Wheter host response is ineffective or exaggerated
What type of hypersensitivity reactions are occurring in fungal infections
I, III and IV
What is the primary driver of allergic fungal disease
Aspergillus
What is ABPA
Allergic bronchopulmonary aspergillosus which causes IgE response and is a form of bronchiectasis High eosinophil levels in peripheral blood Loads of mucus Overexagerated immune response
Which conditions presispose to ABPA
Asthma or cystic fibrosis
Radiological features of ABPA
• Dilated bronchi with thick walls • Ring or linear opacities • Upper or central region predeliction • Proximal bronchiectasis • Lobar collapse due to mucous impaction (hyper dense mucus) • Fibrotic scarring
What happens to size of airways with ABPA
DILATION (this is bronchiectasis) Bronchiectasis is a long-term condition where the airways of the lungs become abnormally widened, leading to a build-up of excess mucus that can make the lungs more vulnerable to infection Because of mucus plugging
Management of ABPA
Corticosteroids Itraconazole for steroid sparing effect (a triazole) Recombinant IgE monoclonal antibodies
What is an anti-IgE antibody
Omalizumab
What is hypersensitivity pneumonitis
Fibrotic lung disease Evidence for fungal sensitisation