title: Allergic bronchopulmonary aspergillosis in cystic fibrosis--state of the art: Cystic Fibrosis Foundation Consensus Conference.
abstract: Because of the difficulties of recognizing allergic bronchopulmonary aspergillosis (ABPA) in the context of cystic fibrosis (because of overlapping clinical, radiographic, microbiologic, and immunologic features), advances in our understanding of the pathogenesis of allergic aspergillosis, new possibilities in therapy, and the need for agreed-upon definitions, an international consensus conference was convened. Areas addressed included fungal biology, immunopathogenesis, insights from animal models, diagnostic criteria, epidemiology, the use of new immunologic and genetic techniques in diagnosis, imaging modalities, pharmacology, and treatment approaches. Evidence from the existing literature was graded, and the consensus views were synthesized into this document and recirculated for affirmation. Virulence factors in Aspergillus that could aggravate these diseases, and particularly immunogenetic factors that could predispose persons to ABPA, were identified. New information has come from transgenic animals and recombinant fungal and host molecules. Diagnostic criteria that could provide a framework for monitoring were adopted, and helpful imaging features were identified. New possibilities in therapy produced plans for managing diverse clinical presentations.
authors.affiliation: Department of Medicine, Santa Clara Valley Medical Center, Stanford University Medical School, San Jose, California 95128-2699, USA. stevens@stanford.edu
authors.forename: David A
authors.initials: DA
authors.lastname: Stevens
authors.forename: Richard B
authors.initials: RB
authors.lastname: Moss
authors.forename: Viswanath P
authors.initials: VP
authors.lastname: Kurup
authors.forename: Alan P
authors.initials: AP
authors.lastname: Knutsen
authors.forename: Paul
authors.initials: P
authors.lastname: Greenberger
authors.forename: Marc A
authors.initials: MA
authors.lastname: Judson
authors.forename: David W
authors.initials: DW
authors.lastname: Denning
authors.forename: Reto
authors.initials: R
authors.lastname: Crameri
authors.forename: Alan S
authors.initials: AS
authors.lastname: Brody
authors.forename: Michael
authors.initials: M
authors.lastname: Light
authors.forename: Marianne
authors.initials: M
authors.lastname: Skov
authors.forename: William
authors.initials: W
authors.lastname: Maish
authors.forename: Gianni
authors.initials: G
authors.lastname: Mastella
mesh_terms: D000818:Animals; D000935:Antifungal Agents / Q000627:therapeutic use*; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D001232:Aspergillus fumigatus; D003226:Congresses as Topic; D003550:Cystic Fibrosis / Q000150:complications* / Q000382:microbiology; D006801:Humans
chemical_list: D000935:Antifungal Agents