Vitamin D deficiency may increase the risk of Amphotericin B-related kidney toxicity

Amphotericin B (AmB) is the drug of choice for the treatment of many fungal infections.  Despite this, the drug can cause several serious side effects, one of which being nephrotoxicity (toxicity to the kidneys). Conventional AmB can be adapted into a lipid emulsion preparation, which can reduce the risk of nephrotoxicity, while preserving its efficacy and remaining a lower cost option. Unfortunately this does not solve the problem, and nephrotoxicity remains an issue for many patients.

Vitamin D deficiency has been found to be a major problem worldwide, and can increase the risk of kidney-related disease, including drug-induced nephrotoxicity. A recent study by Daniela Ferreira and colleagues at the University of Sao Paulo looked at standard and vitamin D-deficient rats and found that the deficient rats treated with AmB presented with impaired renal function. This suggests that vitamin D deficiency may play a key role in the development of AmB-induced nephrotoxicity. Therefore, the authors state that it is essential to monitor levels of vitamin D in patients treated with both conventional and lipid formulations of AmB, in order to reduce the development of kidney disease.

Read the full paper here

New diagnostic tool paves the way for faster and earlier diagnosis of chronic pulmonary aspergillosis

A new screening test kit will speed up diagnosis of chronic pulmonary aspergillosis (CPA) say researchers from the University of Manchester. The test, available commercially from LDBio diagnostics, is very simple and needs no power source or equipment and therefore is likely to be very useful in resource poor settings.

CPA is a fungal disease associated with lung damage caused by other conditions including TB which is prevalent in low to middle income countries. CPA can get progressively worse over time and so early diagnosis is crucial to improve patient outcomes.

The team from the University of Manchester and the NHS Mycology Reference Centre, based at Wythenshawe Hospital, tested the LDBio Aspergillus ICT kit on blood samples collected from 154 CPA patients identified at the National Aspergillosis Centre in Manchester and 150 healthy volunteers. They found that the test had improved sensitivity (91.6%) and specificity (98.0%) for diagnosis of CPA in UK patients compared to existing diagnostic tests.

Limitations of current diagnostic procedures include high cost, long turn-around times, poor reproducibility and variations in performance. The new test is cheap, fast, reproducible and reliable. Therefore it is particularly useful in low to middle income countries where CPA diagnostics are a necessity for early recognition of CPA complicating TB, and to distinguish between these similarly presenting conditions.

Professor David Denning, Professor of Infectious Diseases in Global Health at the University of Manchester and Director of the National Aspergillosis Centre at the Manchester University NHS Foundation Trust said:

“With over 7 million people suffering TB in the lungs each year and 5-10% of them later getting the fungal infection aspergillosis in the lungs, a simple cost-effective test for aspergillosis is sorely needed. This new test fulfils these basic requirements and we are delighted to report that its diagnostic performance surpasses all the older tests as well. A real win-win for early diagnosis and reducing lung scarring and death.” 

The findings were published this month in the Journal of Clinical Microbiology.

Citation:

Evaluation of LD Bio Aspergillus ICT lateral flow assay for IgG and IgM antibody detection in chronic pulmonary aspergillosis. Elizabeth Stucky Hunter, Malcolm D. Richardson, David W. Denning. Journal of Clinical Microbiology Jun 2019, JCM.00538-19; DOI: 10.1128/JCM.00538-19

Read the paper!

World Continence Week 2019

This week is World Continence Week, an annual event designed to raise awareness of bladder weakness and pelvic health. These are very common problems – bladder weakness alone affects 1 in 3 people – but there still remains a stigma which needs to be tackled. Due to chronic coughing, many aspergillosis patients will face stress incontinence (loss of urine due to pressure put on the bladder), which can impact on airway clearance techniques and life in general. Unfortunately, incontinence is seen as part and parcel of ageing (or illness, pregnancy etc.), so many don’t access the help they need. However, incontinence can be helped, and in many cases cured, with exercises, surgery or medication. World Continence Week aims to educate people on how common pelvic health issues are, reduce the stigma surrounding them and link people with the help they may need.

For more information:

Love your lungs week 2019

This week is the British Lung Foundation’s Love Your Lungs Week, a chance to raise awareness about breathlessness and lung disease. As many aspergillosis sufferers will know, lung disease can be difficult to diagnose and can have a significant impact on quality of life. The BLF are raising awareness of their online breath test – a quick and easy way to check whether or not your level of breathlessness is something you should be concerned about. Often people put off mentioning breathlessness to their doctors because they’re not sure it’s something they should be worried about, or they’re worried that their doctors will be disapproving about their lifestyle or smoking habit. However, breathlessness is a serious symptom and can be indicative of severe lung conditions, such as lung cancer, COPD and rarer diseases like aspergillosis. Breathlessness needs to be checked out so that people can access the treatment they need to prevent their quality of life diminishing. Even if breathlessness isn’t due to a health condition, your GP can help you with advice on improving fitness levels and stopping smoking.

You can help by raising awareness about the significance of breathlessness and lung health online and in your communities. Lung disease affects 1 in 5 people, which means you may know several people whose lives could be changed by taking the BLF breathlessness test.

Resources:

Carers Week 2019

The 10th-16th June is national carers week in the UK, and this year’s theme is “help build carer friendly communities”. Though most people wouldn’t identify themselves as a carer (instead just calling themselves a partner/parent/child/friend etc.), there are millions of people around the UK providing unpaid care and support to a family member or friend. Caring for someone can be hugely rewarding, but can also impact on many aspects of life – carers need the help and support available to be able to look after their own wellbeing too.

Isolation and loneliness are major problems faced by carers; time and financial pressures can prevent them from reaching out to friends and family and participating in activities for their own interest. Also, despite contributing massively to society, carers are far less likely than the rest of the population to consider what they do as worthwhile. So… clearly as a society we need to change this and do more to help care for our carers!

The theme “help build carer friendly communities” aims to help link carers with the information and support they need so that they can care for others, and look after themselves. Raising awareness of carers in the media, in work and in communities helps link carers to the available support, whilst making the rest of us aware of the amazing jobs they do!

For information on support and resources available for carers, click here.

Click here to read a touching carers week blog by Jill, an aspergillosis patient.

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