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Master Thesis

Caractérisation des atteintes aspergillaires bronchopulmonaires chez les adultes mucoviscidosiques

Abstract : Aspergillus fumigatus (A.f) is the most common fungi isolated in adult cystic fibrosis (CF) patients. A wide range of clinico-immunological presentations have been reported, from asymptomatic colonization to allergic bronchopulmonary aspergillosis (ABPA). Most available published data on pulmonary aspergillosis in CF patients come from pediatric cohort. Our objectives were (1) to determine the prevalence of pulmonary aspergillosis manifestations and their impact on lung function in adults with CF, (2) to evaluate the performance of sputum galactomannan (GM) and real-time PCR to detect A.f, and (3) to assess the clinical relevance of a new classification built with cluster analysis. We conducted a monocentric prospective study including 134 adults with CF. A.f sensitization was highly prevalent (35.8%) and ABPA was present in 16.4% of patients. Both conditions were associated with worse lung function decline. A.f colonization was not associated with accelerated lung function decline. Fungal culture was overall positive in 47% of patients whereas sputum A.f. PCR was positive in only 35.8% of patients. Sputum GM was positive in 76.1% patients and was not correlated to a specific aspergillosis-related manifestation. Among the 5 phenotypes identified with cluster analysis, those with high A.f. hypersensitivity markers had worse lung function decline. These findings confirm that A. fumigatus-related and ABPA occur frequently and are associated with worse lung function in adults with CF. They also suggest that A.f colonization has no impact on lung function in adults with CF.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03215134
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Submitted on : Monday, May 3, 2021 - 10:47:15 AM
Last modification on : Saturday, September 4, 2021 - 3:26:07 AM

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  • HAL Id : dumas-03215134, version 1

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Lucile Regard. Caractérisation des atteintes aspergillaires bronchopulmonaires chez les adultes mucoviscidosiques. Médecine humaine et pathologie. 2019. ⟨dumas-03215134⟩

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