Aspergillosis Trust: Supporting People Affected by Aspergillosis
Raising Awareness of Aspergillosis
One of the Trust’s most important roles is increasing awareness of aspergillosis among:
- Patients and carers
- Healthcare professionals
- Researchers
- Policy makers
- The wider public
This includes helping people better understand conditions such as:
- ABPA (Allergic Bronchopulmonary Aspergillosis)
- CPA (Chronic Pulmonary Aspergillosis)
- Aspergilloma
- Invasive aspergillosis
- Severe asthma with fungal sensitisation (SAFS)
By promoting education and awareness, the Trust helps support earlier recognition and diagnosis of fungal disease.
Patient Support and Community
Living with aspergillosis can be physically and emotionally challenging. Many patients experience fatigue, breathlessness, anxiety, long treatment journeys and uncertainty about the future.
The Aspergillosis Trust helps provide:
- Patient-focused information
- Community support
- Awareness campaigns
- Educational events
- Opportunities for patient involvement
The charity also helps patients connect with others who understand the realities of living with chronic fungal disease, reducing feelings of isolation and helping people feel supported.
Supporting Research and Advocacy
The Trust actively supports research into aspergillosis and fungal disease, while also advocating for better services and greater recognition of fungal infections within healthcare systems.
This includes:
- Supporting patient participation in research
- Raising awareness of diagnostic delays
- Promoting better understanding of chronic fungal disease
- Working alongside clinicians, researchers and respiratory organisations
- Supporting international awareness activities
The organisation has collaborated with specialist centres, patient groups and international respiratory organisations to strengthen awareness and improve education around aspergillosis.
Working Together with the Wider Respiratory Community
The Aspergillosis Trust is part of a growing international effort to improve fungal disease awareness and patient support.
This includes collaboration and engagement with organisations such as:
- European Lung Foundation (ELF)
- European Respiratory Society (ERS)
- Specialist respiratory and infectious disease centres
- Patient advocacy organisations
- Researchers working in fungal disease and respiratory medicine
These partnerships help ensure that the experiences of people living with aspergillosis are represented within wider respiratory healthcare discussions.
Differences Between the Aspergillosis Trust and National Aspergillosis Centre Patient Support
The Aspergillosis Trust and the National Aspergillosis Centre (NAC) both play extremely important roles in supporting people affected by aspergillosis, but they are different types of organisations with different responsibilities and strengths. In many ways, they complement one another.
The National Aspergillosis Centre (NAC)
The National Aspergillosis Centre is an NHS Highly Specialised Service based at Wythenshawe Hospital in Manchester. It is a specialist clinical centre commissioned to diagnose, treat and manage complex aspergillosis cases — particularly Chronic Pulmonary Aspergillosis (CPA).
The NAC provides:
- Specialist medical diagnosis and treatment
- Advice and Guidance to clinicians across the UK
- Monitoring of antifungal therapy
- Clinical investigations and testing
- Research programmes
- Patient education resources
- NHS-supported patient support meetings and moderated support groups
The NAC CARES team (Community, Awareness, Research, Education and Support) runs:
- The patient information website aspergillosis.org
- Weekly Microsoft Teams meetings
- Educational webinars
- Facebook and online support communities
- Research participation activities
- World Aspergillosis Day educational events
Because the NAC is part of the NHS, its information tends to be strongly clinically focused and evidence-based, with close involvement from specialist doctors, nurses, pharmacists and researchers.
The Aspergillosis Trust
The Aspergillosis Trust is a patient-led charity rather than a clinical NHS service. It was created by patients and carers affected by aspergillosis to improve awareness, advocacy and community support.
The Trust focuses particularly on:
- Raising public and professional awareness
- Patient advocacy
- Representing the patient voice
- Community support
- Campaigning for earlier diagnosis and better recognition
- Helping reduce isolation among patients and carers
Because it is patient-led, the Trust brings a particularly strong lived-experience perspective. Many people find this valuable because the charity is run by people who directly understand the emotional, practical and social impact of living with aspergillosis.
A Simple Way to Think About the Difference
| NAC Patient Support | Aspergillosis Trust |
|---|---|
| NHS specialist clinical service | Independent patient charity |
| Led by healthcare professionals and NHS staff | Led by patients and carers |
| Focus on diagnosis, treatment, education and research | Focus on advocacy, awareness and peer support |
| Provides specialist clinical expertise | Provides lived-experience support |
| Closely linked to NHS care pathways | Represents the broader patient community |
| Produces medically reviewed educational resources | Amplifies the patient voice and patient needs |
How They Work Together
Importantly, these organisations are not competitors. They often collaborate closely on awareness campaigns, patient education, World Aspergillosis Day activities, webinars, conferences and research engagement.
Many patients benefit from engaging with both:
- The NAC for specialist medical expertise and educational resources
- The Aspergillosis Trust for advocacy, lived experience and broader patient community support
Together, they help create a stronger support network for people living with aspergillosis.
Why Patient Participation Matters
Patient experience is one of the most valuable resources in improving understanding of aspergillosis.
People living with aspergillosis often understand challenges that are not always visible in clinical appointments, including:
- Diagnostic delays
- Fatigue and fluctuating symptoms
- Treatment side effects
- Emotional impact
- Difficulties accessing information and support
By sharing experiences and becoming involved in awareness and advocacy activities, patients and carers can help improve understanding and support for others.
Participation does not need to be overwhelming. It can include:
- Sharing experiences confidentially
- Joining online discussions or support groups
- Supporting awareness campaigns
- Attending educational events
- Helping improve patient information
- Participating in surveys or research projects
Even small contributions can help improve awareness and care for future patients.
How to Learn More or Get Involved
- Aspergillosis Trust Website
- European Lung Foundation Aspergillosis Pages
- National Aspergillosis Centre Resources
The Aspergillosis Trust demonstrates the importance of patient-led advocacy in rare and under-recognised diseases. Through education, awareness and community support, the charity helps ensure that people living with aspergillosis are better informed, better supported and increasingly heard.
European Lung Foundation (ELF): Giving Patients a Voice in Respiratory Health
What makes ELF particularly valuable is that it is genuinely patient-led. Patients and carers are not simply consulted occasionally; they actively help shape educational resources, awareness campaigns, research priorities and clinical guideline discussions.
ELF and Aspergillosis
One particularly important area of ELF’s work is its commitment to supporting people affected by aspergillosis and other fungal lung diseases.
The ELF Aspergillosis Information Hub provides accessible, reliable information about:
- ABPA (Allergic Bronchopulmonary Aspergillosis)
- CPA (Chronic Pulmonary Aspergillosis)
- Aspergilloma
- Invasive aspergillosis
- Symptoms and diagnosis
- Treatment approaches
- Living with long-term fungal disease
- Patient experiences and support
The ELF Aspergillosis Patient Advisory Group
ELF has also established a dedicated Aspergillosis Patient Advisory Group, bringing together people from across Europe with direct lived experience of aspergillosis.
The group works alongside clinicians and researchers to improve awareness, encourage earlier diagnosis, develop patient education, influence research priorities and support better long-term care.
Why Patient Participation Matters
Aspergillosis is still under-recognised in many countries, and many patients experience long delays before receiving a diagnosis. Patient involvement can help change this.
By sharing experiences, joining discussions and supporting awareness activities, patients and carers can help improve understanding of fungal lung disease, strengthen educational materials, support newly diagnosed patients and raise awareness among healthcare professionals and the public.
Not everyone needs to become a public speaker or campaigner. Participation can include joining online meetings, completing surveys, sharing experiences confidentially, reviewing patient information, supporting awareness campaigns online or helping identify what matters most to patients.
Ways to Get Involved
- Visit the ELF Aspergillosis Information Hub
- Learn about the ELF Aspergillosis Patient Advisory Group
- Explore the ELF Patient Organisation Network
- Support the Healthy Lungs for Life campaign
- Watch ELF videos on YouTube
A Shared Effort
ELF demonstrates that respiratory healthcare works best when patients, carers, clinicians and researchers work together as partners.
For people affected by aspergillosis, involvement in organisations like ELF can help transform personal experience into something that improves understanding, care and support for others across Europe and beyond.
Every patient story, question, survey response and conversation contributes to building greater awareness of aspergillosis and improving the future of care.
Breathe deeply at the Asthma + Lung UK Garden
Asthma + Lung UK’s “Breathing Space Garden” at the RHS Chelsea Flower Show is a beautiful reminder of how much our surroundings can affect our lungs, our wellbeing, and our ability to pause and breathe.
Designed by award-winning garden designer Angus Thompson, the garden is inspired by the Japanese idea of yohaku no bi — “the beauty of empty space”. It brings together calming woodland planting, flowing water, accessible design, and quiet areas for rest, reflection, yoga, and tai chi.
The planting has been chosen with lung health in mind, using low-allergen species, soft textures, resilient trees, and calming green spaces that offer a gentler environment for people with sensitive lungs.
For people living with aspergillosis, asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis, and other lung conditions, this message is especially powerful. Clean air, reduced stress, accessible outdoor spaces, and thoughtful planting can all help people feel more comfortable and supported.
Importantly, the garden will continue to make a difference after Chelsea. It is due to be permanently relocated to the Breathing Space lung rehabilitation centre in Rotherham, where it will support people living with lung conditions for years to come.
RHS Chelsea Flower Show: 19–23 May 2026
Read more from Asthma + Lung UK
When Breathlessness Feels Severe — Even When Oxygen Levels Look “Normal”
Many people living with aspergillosis, severe asthma, bronchiectasis, or other chronic lung conditions describe a confusing and sometimes frightening experience:
“My oxygen saturations are normal, my peak flow is reasonable, there’s little wheeze, but I still feel like I’m drowning.”
This can be distressing for patients and frustrating for carers. Some people feel that because their oxygen levels or breathing tests appear “acceptable”, their symptoms are not fully understood.
Importantly, severe breathlessness can occur even when standard measurements such as oxygen saturations and peak flow readings appear relatively normal.
This does not mean the symptoms are imaginary or “all in the mind”. Breathlessness is complex and can have many different causes.
Why Breathlessness Is More Complicated Than Oxygen Levels
When doctors or nurses assess breathing problems, they often check:
- Oxygen saturation levels (sats)
- Peak flow readings
- Respiratory rate
- Presence of wheeze
- Chest sounds
These are all important. However, they do not always reflect how breathless a person feels.
Some people with chronic respiratory illness may have:
- Normal oxygen saturations
- Reasonable peak flow readings
- Little visible wheeze
- Minimal mucus production
…yet still experience intense sensations of:
- air hunger
- tight chest
- difficulty taking a satisfying breath
- feeling unable to “fill the lungs”
- panic associated with breathing
- extreme fatigue from breathing effort
What Can Cause This?
Breathlessness in aspergillosis and chronic lung disease is often caused by several factors happening together.
Inflammation and Airway Sensitivity
Conditions such as Allergic Bronchopulmonary Aspergillosis (ABPA), Severe Asthma with Fungal Sensitisation (SAFS), bronchiectasis, and Chronic Pulmonary Aspergillosis (CPA) can all cause inflamed and hypersensitive airways.
The lungs may feel irritated or tight even if oxygen exchange remains relatively preserved.
Small Airways Dysfunction
Some breathing problems occur in the smaller airways of the lungs and may not always show clearly on basic tests such as peak flow.
Patients can feel significant chest tightness or air trapping despite “good numbers”.
Muscle Fatigue
Breathing takes muscular effort. Chronic respiratory illness can place a long-term strain on the chest wall and breathing muscles, leading to exhaustion and increased awareness of breathing.
Mucus and Airflow Changes
Even relatively small amounts of mucus or airway narrowing can create sensations of chest heaviness or difficulty moving air.
Breathing Pattern Dysfunction (Dysfunctional Breathing)
This is increasingly recognised in people with chronic respiratory illness.
When breathing becomes difficult over months or years, people may unconsciously develop altered breathing patterns, including:
- rapid shallow breathing
- upper chest breathing
- frequent sighing
- over-breathing (hyperventilation)
- muscle tension around the chest and neck
This can worsen symptoms and create a vicious cycle where the sensation of breathlessness becomes amplified.
Symptoms may include:
- air hunger
- dizziness
- tingling
- tight chest
- panic sensations
- difficulty “switching off” breathing awareness
Importantly, this does not mean the illness is psychological or “not real”. Dysfunctional breathing can happen alongside genuine lung disease.
Why Inhalers Sometimes Seem to Help Less
Reliever inhalers such as salbutamol (Ventolin) are designed mainly to relax tightened airways.
If breathlessness is being driven partly by breathing pattern dysfunction, muscle fatigue, inflammation, hypersensitivity, or air trapping, inhalers may not always provide dramatic relief.
This can be confusing and upsetting for patients.
“But My Tests Are Normal…”
Many patients feel frustrated, frightened, or even dismissed when told that oxygen levels, peak flow readings, or chest examinations are “fine” despite severe breathlessness.
Normal oxygen saturations are reassuring in terms of immediate danger, but they do not always reflect the full experience of chronic respiratory illness.
Breathlessness is influenced by many factors including inflammation, airway sensitivity, breathing effort, muscle fatigue, anxiety associated with struggling to breathe, and altered breathing patterns.
Because of this, some people may feel profoundly breathless even when routine measurements appear relatively stable.
It can sometimes help to explain symptoms in practical, functional terms, such as:
- “I become breathless walking across the room.”
- “I recover much more slowly than usual.”
- “This feels much worse than my normal baseline.”
- “I feel exhausted by the effort of breathing.”
- “Breathing exercises seem to help settle things.”
These descriptions may help healthcare professionals understand how symptoms are affecting day-to-day life, rather than focusing only on oxygen levels or peak flow numbers.
Some patients also find it helpful to ask questions such as:
- Could breathing pattern dysfunction be contributing?
- Would respiratory physiotherapy help?
- Would pulmonary rehabilitation be appropriate?
- How should I judge when symptoms need urgent assessment?
Importantly, severe breathlessness should never simply be ignored. New, worsening, or unusual symptoms still require proper medical assessment.
At the same time, many people with chronic lung disease experience very real symptoms that are not always fully reflected by routine measurements alone.
Why Breathlessness Can Feel So Frightening
The sensation of breathlessness is created by the brain interpreting signals from the lungs, breathing muscles, chest wall, blood chemistry, and nervous system.
This means that the feeling of “not getting enough air” is not determined only by oxygen levels.
In chronic lung disease, several things can trigger the sensation of breathlessness, including:
- inflamed or sensitive airways
- extra effort needed to move air in and out
- air trapping in the lungs
- muscle fatigue
- rapid or shallow breathing
- stress hormones released during breathing distress
- heightened awareness of breathing sensations
When breathing becomes uncomfortable, the body naturally responds with anxiety and adrenaline. This is a protective survival response.
Unfortunately, this can sometimes create a cycle:
breathlessness → anxiety → faster breathing → more chest tightness → worse breathlessness
This does not mean symptoms are “psychological”. The physical sensation is real, but the body’s alarm systems can unintentionally amplify it.
What Can Help During an Episode of Breathlessness?
Different techniques help different people, and severe or rapidly worsening symptoms should always be medically assessed. However, some patients find the following approaches helpful during episodes of distressing breathlessness:
Slow the Breathing Rate
Trying to slow breathing gently can help reduce over-breathing and chest tightness.
Some people find it helpful to:
- breathe in gently through the nose
- breathe out slowly through pursed lips
- focus on making the out-breath longer than the in-breath
Use a Recovery Position
Sitting forward slightly with the arms supported on knees or a table can sometimes reduce the work of breathing.
Reduce Panic and “Air Hunger”
Trying to fight for bigger and bigger breaths can sometimes worsen symptoms.
Some patients find it more helpful to focus on:
- gentle breathing rhythm
- relaxing the shoulders and neck
- slowing breathing rather than deepening it
- focusing attention away from the chest where possible
Use Prescribed Treatments Appropriately
Follow the advice provided by your healthcare team regarding inhalers, nebulisers, airway clearance, or rescue medication.
If inhalers are not helping as expected, this should be discussed with a respiratory specialist rather than simply increasing use repeatedly.
Know Your “Usual” Pattern
Many patients find it useful to learn the difference between:
- their “usual” chronic breathlessness
- breathing pattern dysfunction or over-breathing episodes
- symptoms suggesting infection or acute deterioration
This can help patients feel more confident recognising when urgent medical assessment may be needed.
Can Breathing Retraining Help?
Some patients find breathing retraining exercises very helpful, especially when guided by:
- respiratory physiotherapists
- specialist breathing services
- pulmonary rehabilitation teams
- asthma nurse specialists
Breathing retraining may include:
- slowing breathing rate
- diaphragmatic (“belly”) breathing
- nasal breathing techniques
- recovery breathing positions
- relaxation techniques
- paced activity and pacing strategies
Some NHS respiratory teams recommend online breathing resources and guided exercises to help patients recognise and manage over-breathing patterns.
These approaches are usually intended to work alongside medical treatment — not instead of it.
Living With an “Invisible” Symptom
One of the hardest aspects of chronic breathlessness is that outward signs may not always match how severe symptoms feel internally.
Many patients report feeling dismissed when oxygen levels are normal or when tests appear “better than expected”.
The experience of breathlessness is real, even when routine measurements do not fully explain it.
This is one reason why specialist respiratory assessment can be important in complex conditions such as aspergillosis.
When to Seek Medical Help
You should seek urgent medical advice if breathlessness is:
- suddenly worsening
- associated with chest pain
- causing blue lips or fingertips
- associated with falling oxygen saturations
- accompanied by fever or signs of infection
- causing confusion or severe exhaustion
- significantly different from your usual symptoms
Even if previous episodes have been related to breathing pattern dysfunction, new or worsening symptoms should still be medically assessed.
Further Support
You may also find these resources helpful:
Last reviewed: May 2026
Produced by: National Aspergillosis Centre CARES Team / Aspergillosis Website
Sir David Attenborough at 100: Inspiring Wonder in Nature and Fungi
Celebrating 100 years of Sir David Attenborough and his extraordinary contribution to understanding nature, fungi and the living world.Today marks the 100th birthday of David Attenborough — a remarkable milestone for someone who has spent a lifetime helping the world see nature differently.
For many of us interested in fungi and aspergillosis, his work has also helped shine a light on a kingdom of life that was too often overlooked. Through documentaries exploring fungi, moulds, forests and hidden ecosystems, he helped bring the extraordinary world of fungi into homes around the globe — revealing not just beauty, but the vital role fungi play in life on Earth.
At a time when awareness of fungal disease and environmental mould exposure remains so important, that contribution matters greatly.
Happy 100th Birthday Sir David — and thank you for a century of curiosity, education and wonder.
Blue inhalers, combination inhalers and aspergillosis: what patients need to know
Blue reliever inhalers, such as salbutamol or Ventolin, remain important medicines and can be lifesaving during asthma symptoms or an asthma attack. However, asthma guidelines have changed because doctors now recognise that relying too heavily on a blue inhaler can be a sign that the underlying airway inflammation is not being well controlled.
What is a blue inhaler?
A blue inhaler usually contains a medicine called a short-acting beta2 agonist, often shortened to SABA. Salbutamol is the best-known example.
These inhalers work quickly by relaxing the muscles around the airways. This can relieve wheeze, chest tightness and breathlessness within minutes. However, a blue inhaler does not treat the airway inflammation that often drives asthma symptoms.
You can read more about reliever inhalers from Asthma + Lung UK.
Why are asthma guidelines changing?
Asthma is not just a condition of narrowed airways. It is also an inflammatory condition. A reliever inhaler may make breathing feel easier for a short time, but if inflammation is not treated, asthma may remain poorly controlled.
Frequent use of a blue reliever inhaler can therefore be a warning sign. It may mean that asthma treatment needs reviewing, especially if someone is needing their reliever often, waking at night, having flare-ups, or finding their normal activities limited.
The updated NICE/BTS/SIGN asthma guideline supports greater use of treatment plans that combine symptom relief with anti-inflammatory treatment.
What are AIR and MART inhalers?
Some patients are now prescribed a combination inhaler that contains:
- a fast-acting reliever medicine to open the airways
- an inhaled corticosteroid to reduce inflammation
These approaches are known as:
- AIR – Anti-Inflammatory Reliever
- MART – Maintenance and Reliever Therapy
With these plans, the combination inhaler may be used when symptoms occur. In MART, it is also used regularly every day as maintenance treatment.
The important difference is that when symptoms increase, the patient receives more anti-inflammatory treatment as well as more reliever medicine. This aims to reduce the cycle of worsening symptoms, repeated blue inhaler use, and untreated inflammation.
Useful patient information is available from Asthma + Lung UK on AIR inhalers and MART inhalers.
Does this mean everyone should stop using their blue inhaler?
No. This is the most important point.
The new guidance does not mean that every patient must immediately stop using a blue inhaler. It also does not mean that blue inhalers are “bad” or banned.
For many people, nothing will change straight away. Some patients will remain on their current inhalers. Others may be changed to an AIR or MART plan after review by their GP, asthma nurse or respiratory specialist.
Will some patients have their blue inhaler taken away?
Sometimes, but not always.
If a patient is moved onto an AIR or MART plan, their combination inhaler may become both their preventer and their reliever. In that situation, they may no longer routinely need a separate blue inhaler.
However, some patients may still keep a blue inhaler as backup, and others may continue with separate preventer and reliever inhalers. This depends on the individual patient, their diagnosis, their inhalers, and their asthma action plan.
Not all combination inhalers can be used as relievers. Only specific inhalers containing a fast-acting medicine such as formoterol are suitable for AIR or MART use. Patients should only use inhalers in this way if they have been specifically prescribed and instructed to do so.
Why this is more complicated for aspergillosis patients
People with aspergillosis-related lung disease often have more complex respiratory problems than standard asthma alone.
This may include:
- ABPA (Allergic Bronchopulmonary Aspergillosis)
- severe asthma with fungal sensitisation
- bronchiectasis
- mucus plugging
- chronic airway infection or fungal colonisation
- reduced lung reserve or scarring
For these patients, breathlessness is not always caused by asthma-type inflammation alone. It may also be related to mucus, infection, bronchiectasis, fungal activity, or structural lung damage.
This means that simply taking more inhaler may not always address the real cause of worsening symptoms.
Steroids: useful but needing balance
Inhaled corticosteroids can be very helpful in asthma and ABPA because they reduce airway inflammation. Good control of inflammation may reduce symptoms, flare-ups and the need for oral steroid courses.
However, steroid exposure also needs careful management in aspergillosis patients. Higher steroid doses may increase the risk of side effects such as oral thrush and, in some situations, may affect the balance between inflammation control and fungal growth.
This does not mean patients should avoid inhaled steroids. It means that treatment should be individualised and reviewed by a clinician who understands the patient’s full lung condition.
What should aspergillosis patients do?
- Do not stop your blue inhaler suddenly if it has been prescribed for you.
- Do not change your preventer or steroid inhaler without medical advice.
- Check your own asthma action plan. Make sure you know which inhaler is for daily prevention and which one is for symptoms.
- Ask whether your combination inhaler is suitable for AIR or MART use. Do not assume that all combination inhalers can be used this way.
- Request a review if you are using your reliever inhaler frequently, symptoms are worsening, or you are unsure what to do.
When to seek urgent help
Seek urgent medical help if your breathlessness is severe, your reliever is not helping as expected, you are struggling to speak in full sentences, your lips or fingers look blue, or your symptoms are rapidly worsening.
Follow your personal asthma action plan. If you think you are having an asthma attack, do not delay seeking emergency help.
The key message
The new guidance is not simply about “taking away blue inhalers”. It is about recognising that asthma symptoms often reflect airway inflammation, and that some patients do better when symptom relief and anti-inflammatory treatment are given together.
For people with aspergillosis, the message is especially important: inhaler treatment should be reviewed in the context of the whole lung condition, not changed because of a headline.
If you are unsure about your inhalers, speak to your GP, asthma nurse, respiratory consultant or aspergillosis team.
Further reading
Weekly Aspergillosis Research Update April - May 2026
Search term: aspergillosis
Period covered: late April–early May 2026
Key highlights this week
- Diagnostics: new evidence for pentraxin-3 and airway galactomannan testing.
- Treatment: voriconazole dosing may be difficult during ECMO and needs close monitoring.
- Resistance: azole-resistant Aspergillus fumigatus detected around patient homes in Brazil.
- Transplant medicine: aspergillosis remains the dominant invasive mould infection after lung transplantation.
- Future therapies: early laboratory work identifies a possible new antifungal drug target.
1. New diagnostic marker: pentraxin-3 for invasive pulmonary aspergillosis
Sun C et al. Diagnostic value of pentraxin 3 in plasma and bronchoalveolar lavage fluid for invasive pulmonary aspergillosis in non-neutropenic patients: a prospective multicenter clinical study. Emerging Microbes & Infections, 2026.
View on PubMed – PMID: 42054395
This prospective multicentre study looked at pentraxin-3 in blood and bronchoalveolar lavage fluid as a diagnostic marker for invasive pulmonary aspergillosis in patients who are not neutropenic.
Why it matters: diagnosing invasive aspergillosis can be especially difficult in patients outside the classic high-risk groups. This study supports the wider move toward combining tests and biomarkers rather than relying on one result alone.
2. Galactomannan testing in tracheobronchial aspirates after lung transplant
Monforte A et al. Diagnostic value of galactomannan in tracheobronchial aspirate for Aspergillus infection in lung transplant recipients (the GALACTBAS study). Journal of Clinical Microbiology, 2026.
View on PubMed – PMID: 42059612
This study assessed whether galactomannan testing in tracheobronchial aspirates can help diagnose Aspergillus infection in lung transplant recipients.
Why it matters: aspergillosis after lung transplantation often involves the airways. Testing airway samples may support earlier diagnosis and may sometimes be less invasive than deeper lung sampling.
3. Voriconazole levels may vary during ECMO
Yusuff H et al. Time-varying voriconazole clearance during extracorporeal membrane oxygenation. Antimicrobial Agents and Chemotherapy, 2026.
View on PubMed – PMID: 42059809
This paper looked at voriconazole clearance in critically ill patients receiving extracorporeal membrane oxygenation (ECMO).
Why it matters: voriconazole is commonly used to treat invasive aspergillosis, but drug levels can be unpredictable in critical illness. This supports the importance of therapeutic drug monitoring so dosing can be adjusted safely and effectively.
4. Azole-resistant Aspergillus found around patient homes in Brazil
de Barros Rodrigues DK et al. Environmental circulation of Aspergillus fumigatus with reduced susceptibility to agricultural triazole in Brazil: clonal dissemination of potentially resistant genotypes. Mycoses, 2026.
View on PubMed – PMID: 42037564
This study investigated environmental Aspergillus fumigatus around the homes of two patients with suspected aspergillosis caused by resistant isolates.
Why it matters: the findings add to concern that antifungal resistance can arise and circulate in the environment, including through exposure to agricultural triazoles. This is important because azole resistance can make aspergillosis harder to treat.
5. Invasive mould infections after lung transplantation: aspergillosis dominates
Pennington KM et al. Impact of invasive mold infection-coded diagnoses on utilization, costs, and mortality after lung transplantation. Chest, 2026.
View on PubMed – PMID: 42061698
This study assessed invasive mould infection-coded diagnoses after lung transplantation. Aspergillosis was the most common invasive mould infection reported.
Why it matters: lung transplant recipients remain among the highest-risk groups for severe aspergillosis. The study reinforces the need for prevention, early recognition, rapid diagnosis and specialist management.
6. A possible new antifungal target in Aspergillus fumigatus
Storer ISR et al. A protein-protein interaction inhibitor arrests the cell cycle in Aspergillus fumigatus. mBio, 2026.
View on PubMed – PMID: 42053292
This laboratory study explored a compound that interferes with protein-protein interactions and can arrest the cell cycle in Aspergillus fumigatus.
Why it matters: current antifungal options remain limited, and resistance is a growing problem. Early-stage work like this may help identify future antifungal drug classes.
7. Diabetes and fungal infection risk
Kaur H et al. Fungal infections in diabetes mellitus. Indian Journal of Medical Microbiology, 2026.
View on PubMed – PMID: 42061613
This review discusses fungal infections in people with diabetes, including mucormycosis, aspergillosis and cryptococcosis.
Why it matters: diabetes can affect immune function and increase susceptibility to some infections. For patients with existing lung disease, good diabetes management may be one part of reducing overall infection risk.
8. Aspergillosis during cancer immunotherapy
Niravath P et al. A Phase II Study of Docetaxel and Pembrolizumab plus Interleukin 12 Gene Therapy in Nonmetastatic, Anthracycline-Refractory Triple-Negative Breast Cancer (INTEGRAL). Clinical Cancer Research, 2026.
View on PubMed – PMID: 41661218
This cancer therapy study includes a reported case of pulmonary aspergillosis and respiratory failure during treatment.
Why it matters: modern cancer treatments can alter infection risk in complex ways. Aspergillosis should remain on the radar in patients who become unwell during or after intensive cancer therapy.
Other papers noted this week
- Canakinumab safety pharmacovigilance analysis – relevant to biologic therapy safety and infection monitoring. PMID: 41998856
- Canine sinonasal radiotherapy study – includes nasal aspergillosis in dogs, but is mainly veterinary/radiotherapy focused. PMID: 42007656
- Mucormycosis retrospective study – relevant to invasive fungal disease burden but not directly focused on aspergillosis. PMID: 42050055
Overall message
This week’s papers show how aspergillosis research is moving in several important directions at once: better diagnostic markers, more personalised antifungal dosing, growing concern about environmental resistance, and continued recognition of high-risk groups such as transplant recipients, critically ill patients and people with complex immune or metabolic conditions.
For patients, the main message is that aspergillosis is a complex condition and testing or treatment decisions often need specialist interpretation. No single test result tells the whole story; clinicians usually combine symptoms, scans, culture results, biomarkers and risk factors before deciding on diagnosis and treatment.
Weekly Aspergillosis Research Update: Week ending 27 April 2026
Highlights this week
- Occupational aspergillosis: workplace exposure to Aspergillus highlighted in a national study.
- ABPA and biologics: early evidence for tezepelumab in allergic bronchopulmonary aspergillosis.
- Mucus plugging: important mechanism in ABPA, bronchiectasis and chronic lung disease.
- Invasive disease: new analysis of antifungal treatment strategies.
- Resistance: ongoing global surveillance of antifungal susceptibility.
Occupational non-invasive aspergillosis
A French national multicentre study reviewed occupational cases of non-invasive aspergillosis over more than 20 years.
Why it matters: workplace exposure (dust, compost, damp buildings, waste handling) may contribute to disease in some patients and should be considered in clinical history-taking.
Reference: Michel A et al.
PMID: 42033338
Tezepelumab in allergic bronchopulmonary aspergillosis
A small 4-patient case series explored the use of tezepelumab in allergic bronchopulmonary aspergillosis (ABPA) with severe asthma.
Why it matters: adds to growing interest in biologics for ABPA, particularly where steroid burden is high. Evidence remains early and limited.
Reference: Sanz-Sanjosé B et al.
PMID: 42017435
Mucus plugging in chronic lung disease
A narrative review examined mucus plugging in chronic obstructive lung diseases and bronchiectasis, including ABPA.
Why it matters: mucus plugs can block airways, worsen breathlessness, and contribute to infection risk and scan abnormalities.
Reference: Schou C et al.
PMCID: PMC13103984
Invasive aspergillosis treatment
A systematic review and network meta-analysis compared antifungal treatment regimens for invasive aspergillosis.
Why it matters: invasive aspergillosis remains a high-mortality infection; early diagnosis and optimal antifungal therapy are critical. Triazoles and other antifungals remain central to management. :contentReference[oaicite:0]{index=0}
Reference: Gu Q et al.
PMID: 42012594
Natural killer cells and resistant Aspergillus
A laboratory study demonstrated antifungal activity of human natural killer cells against azole-resistant Aspergillus fumigatus.
Why it matters: improves understanding of immune defence mechanisms and may inform future therapies.
Reference: Namie H et al.
PMID: 42012259
Antifungal susceptibility surveillance
A multicentre Taiwan study examined susceptibility patterns of clinical Aspergillus isolates (2021–2023).
Why it matters: resistance patterns vary geographically, influencing antifungal treatment choices.
Reference: Hsieh M et al.
PMID: 42012212
Invasive aspergillosis in severe viral illness
A study explored invasive pulmonary aspergillosis complicating severe fever with thrombocytopenia syndrome.
Why it matters: reinforces the link between severe illness, immune disruption, and risk of invasive aspergillosis.
Reference: Du Q et al.
PMID: 42032512
Lower-priority or indirect papers
Veterinary study (canine nasal aspergillosis)
Primarily a veterinary oncology study with limited relevance to human disease.
Reference:
PMID: 42007656
Canakinumab pharmacovigilance
Focuses on drug safety rather than aspergillosis.
Reference:
PMID: 41998856
Overall message
This week’s research highlights the wide scope of aspergillosis—from environmental and occupational exposure to allergic disease, invasive infection, antifungal resistance, and immune responses. The most relevant developments for patients remain ABPA biologics, mucus plugging, and antifungal resistance trends.
Patient note
This summary is for general information only and does not replace medical advice. Always discuss treatment decisions with your specialist team.
Can Aspergillosis Be Cured? Understanding Treatment, Control, and Long-Term Therapy
Last reviewed: April 2026
Key points
- Aspergillosis is caused by fungi from the Aspergillus group.
- Most people breathe in Aspergillus spores regularly without becoming ill.
- In some people, damaged airways, lung cavities, mucus plugs, or immune responses allow the fungus or fungal material to persist.
- Antifungal treatment may aim to cure, but in many cases the goal is long-term control.
- Steroids can reduce harmful inflammation in allergic disease, but they can also reduce the body’s ability to clear fungus.
Table of contents
- Overview
- Why breathing in spores does not usually cause disease
- Why aspergillosis can be hard to clear
- Infection and ABPA: different reasons for persistence
- Do steroids influence this?
- Control vs cure
- Common antifungal treatments
- Why you may not hear many success stories
- When to seek medical advice
- Common questions
Overview
It is very common for people diagnosed with aspergillosis to feel worried when they read that others have been taking antifungal medication for months or even years.
This can lead to an understandable question:
“Does treatment actually work, or will I have this forever?”
The answer is more nuanced than a simple yes or no. Different forms of aspergillosis behave differently, and treatment goals vary depending on the condition.
Two of the most common conditions are:
- Allergic Bronchopulmonary Aspergillosis (ABPA) – an allergic immune reaction to Aspergillus in the airways
- Chronic Pulmonary Aspergillosis (CPA) – a long-term fungal infection, usually in areas of damaged lung tissue
Understanding this difference is key to understanding why treatment may continue for a long time.
If you would like a more detailed explanation of how these conditions are diagnosed and managed, see our guides to chronic pulmonary aspergillosis (CPA) and allergic bronchopulmonary aspergillosis (ABPA).
Why breathing in spores does not usually cause disease
Aspergillus spores are present in the environment, including air, soil, compost, dust, and decaying vegetation. Most people breathe in small numbers of these spores regularly without becoming ill.
In healthy lungs, spores are usually cleared by the immune system and by the normal cleaning mechanisms of the airways.
This means:
- Exposure to Aspergillus is common
- Most exposure does not lead to disease
- Aspergillosis usually develops only when there are additional risk factors, such as lung damage, mucus trapping, or altered immune responses
So it is not accurate to think of most patients as being “constantly reinfected”. A better way to think about it is that some lungs provide conditions where Aspergillus, or fungal material, can persist and continue to cause problems.
Why aspergillosis can be hard to clear
Aspergillosis can be difficult to clear for several reasons. These include the structure of the lungs, the biology of the fungus, limitations of drug penetration, and the way the immune system responds.
1. Damaged lung tissue can provide protected spaces
In CPA, Aspergillus often grows in areas of abnormal lung, such as cavities, scarred tissue, or areas affected by bronchiectasis.
These areas can act as protected spaces where the fungus is harder for the immune system and antifungal medicines to reach.
2. Thick mucus can trap fungus and fungal material
In airway diseases such as asthma, bronchiectasis, and ABPA, thick mucus can trap spores, hyphae, and fungal fragments.
This trapped material can continue to stimulate inflammation even when the fungus is not invading lung tissue.
3. Antifungal medicines may suppress rather than sterilise
Antifungal medications can reduce fungal activity and help prevent progression, but they may not always remove every trace of fungus from damaged lung spaces or mucus-filled airways.
For this reason, success is often measured by:
- Improved symptoms
- Stabilised weight and energy
- Fewer flare-ups
- Stable or improved scans
- Prevention of further lung damage
Infection and ABPA: different reasons for persistence
Chronic pulmonary aspergillosis: persistence of infection
In chronic pulmonary aspergillosis, the problem is fungal growth in damaged lung tissue.
- Lung cavities provide spaces where fungus can grow
- Drug penetration may be limited
- The immune system may not fully clear infection
Allergic bronchopulmonary aspergillosis: persistence of reaction
In ABPA, the main issue is an exaggerated immune response.
- Mucus traps fungal material
- Small amounts can trigger strong reactions
- Inflammation leads to more mucus
Do steroids influence this?
Yes. Steroids can be helpful but must be used carefully.
In ABPA, they reduce inflammation but may also reduce fungal clearance.
In chronic infection, steroids can increase the risk of persistence or progression.
Monitoring and drug interactions are important during treatment.
Control vs cure: what is the goal?
For many people, the realistic goal is:
- Stability rather than eradication
- Reduced symptoms
- Prevention of progression
Common antifungal treatments
- Itraconazole
- Voriconazole
- Posaconazole
These treatments are selected based on individual factors and require monitoring.
Why don’t I hear many success stories?
People who improve often post less, while those still struggling are more visible in forums.
When to seek medical advice
- Uncertainty about treatment
- Side effects
- Weight loss
- Worsening symptoms
Common questions
Can aspergillosis be cured?
Sometimes, but often it is managed long-term.
Are people constantly reinfected?
No. Most people clear spores regularly without issue.
Why is ABPA difficult to treat?
Because of ongoing immune reactions and mucus trapping.
Further reading
- Chronic Pulmonary Aspergillosis (CPA)
- Allergic Bronchopulmonary Aspergillosis (ABPA)
- Antifungal medicines
When ‘chest infections’ don’t respond: when to suspect ABPA or CPA (Clinical perspective)
Patients presenting with recurrent “chest infections” that do not respond to antibiotics are common in primary and secondary care. In a subset of these cases, the underlying cause may not be bacterial, but related to fungal disease or immune-mediated responses to Aspergillus.
This article summarises when to suspect allergic bronchopulmonary aspergillosis (ABPA) or chronic pulmonary aspergillosis (CPA), and how to move from repeated empirical treatment to a more structured diagnostic approach.
Key clinical message
Repeated antibiotic-treated exacerbations with limited response, particularly when symptoms improve with steroids and then relapse, should prompt reconsideration of the diagnosis.
When to suspect ABPA or CPA
Consider aspergillosis-related disease in patients with:
- Recurrent “chest infections” with poor or inconsistent antibiotic response
- Steroid-responsive symptoms with relapse on reduction or cessation
- Persistent or unexplained radiological abnormalities
- Underlying lung disease:
- Asthma
- Bronchiectasis
- Chronic obstructive pulmonary disease (COPD)
- Previous tuberculosis or lung damage
- Raised or previously documented abnormalities in:
- Total IgE
- Eosinophils
- Aspergillus-specific markers (if previously tested)
These features are not diagnostic in isolation but should raise suspicion when seen together.
ABPA vs CPA: clinical distinction
| Feature | ABPA | CPA |
|---|---|---|
| Primary mechanism | Immune-mediated (allergic) | Chronic fungal infection |
| Typical background | Asthma, bronchiectasis | Structural lung disease, prior TB, COPD |
| Steroid response | Often marked | Variable (may improve symptoms but not disease) |
| Antibiotic response | Limited | Limited |
| Radiology | Mucus plugging, bronchiectasis | Cavities, fungal balls, fibrosis |
Common pitfalls in practice
- Repeated empirical antibiotics despite poor response
- Short courses of steroids without a long-term management plan
- Reliance on chest X-ray alone in persistent or atypical cases
- Failure to recognise patterns across multiple consultations or admissions
These patterns can lead to prolonged diagnostic delay, which is well described in CPA and ABPA.
Suggested diagnostic approach
1. Reassess the working diagnosis
When standard treatment fails, explicitly reconsider whether the presentation remains consistent with bacterial infection.
2. Imaging
- Escalate from chest X-ray to CT thorax where appropriate
- Look for:
- Cavitation
- Fungal ball (aspergilloma)
- Mucus plugging
- Bronchiectasis
3. Blood tests
- Total IgE
- Eosinophil count
- Aspergillus-specific IgE and IgG (where available)
4. Microbiology / further testing
Depending on context, consider sputum culture, fungal markers, or specialist input.
The steroid–relapse pattern
A common clinical scenario:
Exacerbation → steroids → improvement → relapse
This should raise suspicion of an underlying inflammatory or fungal-driven process rather than recurrent bacterial infection alone.
When to consider referral
Referral to a specialist centre (e.g. National Aspergillosis Centre, Manchester) may be appropriate where:
- Diagnosis remains uncertain
- Symptoms are persistent or progressive despite treatment
- Antifungal therapy is being considered or not tolerated
- Radiology suggests CPA or complex disease
Referral decisions should be made in the context of overall patient condition, comorbidities, and goals of care.
Why diagnosis is often delayed
- Overlap with common respiratory conditions
- Partial response to standard therapies
- Fragmentation across care settings
- Limited exposure to aspergillosis in routine practice
Recognising the pattern is often the key step in reducing delay.
Practical takeaways
- If antibiotics are not working, reconsider the diagnosis
- If steroids repeatedly improve symptoms, ask why
- Use CT imaging to clarify persistent abnormalities
- Aim for a clear, shared management plan
Guidelines and further reading
- British Thoracic Society. Clinical Statement on Aspergillus-related chronic lung disease
- ISHAM Working Group. Guidelines for ABPA diagnosis and management
- Denning DW et al. Chronic pulmonary aspergillosis guidelines
Further professional resources
Aspergillosis.org – Information for healthcare professionals
This article is intended for educational purposes and should be interpreted in the context of individual clinical judgement.