Review of current and future therapeutics in ABPA

Allergic bronchopulmonary aspergillosis is an allergic pulmonary condition caused by hypersensitivity to antigens of Aspergillus sp. found most commonly in patients with underlying asthma or cystic fibrosis. Host factors which alter the innate and adaptive immune responses to this abundant airborne fungus contribute to the development of chronic airway inflammation, bronchiectasis, and fibrosis. Traditionally, treatment has focussed on reducing fungal burden and immune response to fungal antigens. However, a significant proportion of patients continue to suffer recurrent exacerbations with progressive lung damage, and the side effect burden of existing treatments is high. New treatments including novel antifungal agents, monoclonal antibodies against aspects of the adaptive immune response as well as targeted immunotherapies may be better tolerated and achieve improved outcomes but have not yet been studied in large-scale randomised control trials.

Automated summary

Allergic bronchopulmonary aspergillosis is a pulmonary condition caused by hypersensitivity to Aspergillus sp. antigens, commonly found in patients with asthma or cystic fibrosis. Factors altering immune responses to the fungus contribute to chronic inflammation and fibrosis. Current treatments focus on reducing fungal burden and immune response, but many patients still suffer from recurrent exacerbations and lung damage. New therapies like antifungal agents and immunotherapies may offer better outcomes, but large-scale trials are needed.