Weekly aspergillosis research update infographic showing diagnostics, treatment challenges, antifungal resistance and patient risk factors

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.

by GAtherton

Infographic summarising weekly aspergillosis research including ABPA biologics, antifungal resistance, occupational exposure and invasive aspergillosis studies (April 2026)

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.

by GAtherton

Help us understand how damp homes affect health

We are supporting a UK research project looking at how damp homes may affect health, including respiratory health and conditions such as aspergillosis.

This study is being led by the National Aspergillosis Centre at Manchester University NHS Foundation Trust, and is being shared through aspergillosis.org to support research into damp homes and health.

We are currently inviting people across the UK to register their interest in taking part.

Registering your interest should take less than one minute and does not commit you to taking part.


Register your interest now

Why this matters

Damp and mould are often linked to health problems, but there is still limited real-world evidence from people’s homes across the UK.

This project aims to help improve understanding of how home environments may affect health by gathering information from people living in a wide range of housing conditions.

Who can register interest?

We would like to hear from people living in the UK, including:

  • people with lung or respiratory conditions
  • people without any known lung or breathing condition
  • people who have experienced damp or mould at home
  • people who have not experienced damp or mould at home
  • members of the general public who would like to contribute to the research

We are keen to hear from people with different health backgrounds and a wide range of home environments.

What is the study about?

This research is exploring how damp homes may affect health. The aim is to improve understanding of the relationship between home environments and health symptoms in real-world settings.

This project is for research purposes only and does not provide medical advice or diagnosis.

What might taking part involve later?

If the study opens, some people who register interest may later be invited to:

  • complete a short questionnaire about their home and health symptoms
  • receive a simple home sampling kit by post
  • collect and return a small household sample, for example dust from the home, for research purposes

The home sampling part is intended to be simple and practical. Full instructions would be provided.

Registering your interest now does not commit you to taking part later.

Important information

  • Registering interest is voluntary.
  • You do not have to take part in the full study later.
  • Your details will only be used to contact you about this project.
  • Your data will be handled in line with UK data protection regulations.
  • You can decide later whether or not to take part.

Frequently asked questions

Am I signing up to take part in the study now?

No. At this stage, you are only registering your interest in hearing more about the study.

Do I need to have a lung condition to register interest?

No. We would like to hear from people with and without lung conditions.

Do I need to have damp or mould in my home?

No. We are interested in hearing from people with a wide range of home environments and experiences.

Will I definitely receive a kit?

Not necessarily. Registering interest helps the research team understand the level of interest and contact people if the study opens.

Will I get personal results about my home or health?

At this stage, no individual results are being promised. More information would be provided if the study proceeds.

What happens after I register interest?

You do not need to do anything further straight away. If the study opens, you may be contacted with more information so you can decide whether you would like to take part.

Register your interest

Ready to help? Complete the form below.

This secure form should take less than one minute to complete.

If the form does not load, you can open it here:

Open the form in a new window

by GAtherton

Infographic showing weekly aspergillosis research update April 2026 including blood mNGS diagnosis, lung immune modulation therapy, and isavuconazole drug modelling

Weekly aspergillosis update – 20 April 2026

This week’s papers point in three useful directions for aspergillosis research: better diagnosis, more precise immune modulation, and improved antifungal pharmacology modelling. The most directly relevant study for day-to-day human aspergillosis care is a new paper on blood metagenomic next-generation sequencing (mNGS) for invasive pulmonary aspergillosis.

1. Blood metagenomic next-generation sequencing for invasive pulmonary aspergillosis

Chen Y, Tang X, Lu S, Guo L, Wang L, Min L, Niu T, Zhou Y.
The diagnostic and prognostic utility of blood metagenomic next-generation sequencing for invasive pulmonary aspergillosis.
Microbiology Spectrum, 17 April 2026.
View on PubMed (PMID: 41995327)

This study addresses one of the hardest clinical problems: distinguishing true invasive pulmonary aspergillosis from colonisation when Aspergillus is detected. A reliable blood-based test could be especially useful where bronchoscopy is not possible or results are unclear.

At present, this should be seen as promising rather than practice-changing, but it is exactly the type of work needed to improve early and accurate diagnosis.

2. Gene delivery of immunomodulatory cytokines to the lung

Makuyana N et al.
Gene delivery of immunomodulatory cytokines to the lung preserves respiratory function during inflammatory challenge.
Science Immunology, 17 April 2026.
View on PubMed (PMID: 41996474)

This preclinical study explores whether delivering immunomodulatory cytokines directly to the lungs can reduce damaging inflammation. The work is linked to influenza-associated pulmonary aspergillosis, where immune-driven lung injury can be severe.

The key idea is that fungal lung disease is not only about infection, but also about how the immune system responds. This represents a shift toward combining antifungal treatment with targeted immune modulation—although this approach is still at an early, experimental stage.

3. Isavuconazole pharmacokinetic modelling (preprint)

Choules MP et al.
Development of an Isavuconazole Physiologically-based Pharmacokinetic Model for Adult and Pediatric Populations.
Research Square, 17 April 2026 (preprint).

This study uses physiologically based pharmacokinetic (PBPK) modelling to predict how isavuconazole behaves in adults and children, including potential drug–drug interactions.

The findings suggest broadly similar interaction risks across age groups, but highlight greater uncertainty and caution in children under 3 years, particularly with drugs such as digoxin and warfarin.

As a preprint, this is best viewed as supportive pharmacology data, not a change to clinical practice.

4. Histopathology in infectious disease diagnosis

Boubacar E et al.
Histopathological Diagnosis of Infectious Diseases: Experience From a Tertiary Care Center in a Sub-Saharan African Country.
International Journal of Surgical Pathology, 16 April 2026.
View on PubMed (PMID: 41989331)

This broader study included a small number of aspergillosis cases and highlights the continued importance of histopathology, particularly when infections mimic cancer or other conditions.

5. Avian aspergillosis biomarker research

Vieu S et al.
Falcon plasma proteomics to improve avian aspergillosis diagnosis.
Journal of Proteomics, 14 April 2026.
View on PubMed (PMID: 41990917)

This veterinary study explores new plasma biomarkers for diagnosing aspergillosis in birds. While not directly applicable to human care, it reflects a broader research trend toward earlier, less invasive diagnosis.

What matters most this week?

The most important development is the blood mNGS study, which targets a real diagnostic gap. The immunology paper is conceptually important for future treatments, while the isavuconazole modelling work supports ongoing improvements in antifungal use.

Bottom line

This week reinforces three key directions in aspergillosis research:

  • Earlier and more accurate diagnosis
  • Better understanding of immune-driven lung damage
  • More precise antifungal drug use and interaction modelling

by GAtherton

Epigenetics and Aspergillosis: Why Your Body Responds Differently – and What Future Treatments May Look Like

Last reviewed: April 2026
Audience: Patients, carers, GPs, specialist nurses

This article explains how the immune system, environment, and emerging research all connect. If helpful, you can explore each topic in more detail using the links throughout this page.

Key Points

  • Epigenetics controls how your genes behave without changing your DNA sequence.
  • It helps explain why people with similar lung disease develop different forms of aspergillosis.
  • Both the human immune system and the fungus itself use epigenetic mechanisms.
  • These processes influence inflammation, immune response, and treatment effectiveness.
  • Future treatments may combine antifungals, biologics, and epigenetic approaches.
  • There are currently no epigenetic therapies for aspergillosis in routine NHS care.

Table of Contents

What is epigenetics?

If you are new to aspergillosis, you may find it helpful to first read our overview of what aspergillosis is.

Epigenetics refers to changes in how your genes are used by your body, without changing the underlying DNA sequence.

You can think of your DNA as a library of instructions. Epigenetics controls:

  • Which instructions are read
  • When they are used
  • How strongly they are activated

This allows your body to adapt to its environment—but it can also contribute to disease.

How epigenetics works (simple explanation)

There are three main mechanisms:

  • DNA methylation – switches genes off
  • Histone modification – controls how tightly DNA is packaged (affecting access to genes)
  • MicroRNAs – fine-tune gene activity

These processes are now recognised as key regulators of immune and fungal biology
(Nie et al., 2018).

Why this matters in aspergillosis

Patients often ask:

“Why did I develop this when others didn’t?”

Epigenetics helps explain why similar exposures to Aspergillus can result in:

  • Allergic disease
  • Chronic infection
  • No disease

This reflects differences in immune system “programming”.

Importantly, this programming is influenced by:

  • Past infections
  • Lung damage (e.g. COPD, TB)
  • Environmental exposure
  • Medications

Is the body “testing” responses before they become permanent?

It can sometimes feel as though the body is “trying out” different ways of responding to infection or environmental exposure.

This idea comes close to how epigenetics works—but it is important to understand it carefully.

A useful way to think about it

Epigenetics allows the body to rapidly adjust how genes behave in response to the environment. This can happen over days, months, or years, and may influence how the immune system reacts to fungi such as Aspergillus.

In this sense, epigenetics can be thought of as allowing the body to explore different “settings” of immune response—for example:

  • A stronger allergic response (as seen in ABPA)
  • A weaker or less effective response (as seen in CPA)
  • A balanced response with minimal symptoms

What epigenetics does not do

It is important to be clear that the body is not deliberately “testing” changes in a planned way, and epigenetic changes are not directly converted into permanent genetic mutations.

Instead:

  • Epigenetic changes are fast and flexible
  • Genetic changes (mutations) occur slowly and randomly
  • Natural selection acts over long timescales to favour traits that improve survival

How the two processes connect

Although separate, epigenetics and evolution can interact over time.

If a particular way of responding to infection is consistently helpful, individuals whose genes naturally produce a similar response may be more likely to thrive over generations.

This means:

  • Epigenetics shapes how the body responds in the short term
  • Evolution shapes which responses persist in the long term

Why this matters in aspergillosis

This helps explain why:

  • Different people respond very differently to the same fungal exposure
  • Symptoms can change over time
  • Modern environments (such as damp housing or long-term steroid use) may produce responses that our immune systems were not originally adapted for

Can epigenetic changes be inherited?

Most epigenetic changes happen within a single lifetime and are not passed on to children. However, there is growing evidence that some epigenetic changes may persist or be transmitted across generations under certain conditions.

This is sometimes called transgenerational epigenetic inheritance.

For example, research suggests that:

  • Environmental exposures (such as diet, stress, or infection) may leave lasting epigenetic marks
  • Some of these marks may influence how genes behave in the next generation
  • This effect is usually partial and not always predictable

In humans, this area is still being studied, and the extent to which epigenetic changes are inherited remains uncertain.

What this means in practice

It is important not to overinterpret this idea:

  • Epigenetic inheritance is not a replacement for genetic inheritance
  • Most traits and diseases are still determined by DNA and environment
  • There is currently no evidence that conditions like aspergillosis are directly passed on through epigenetic changes

However, this research does suggest that environment and health may have longer-term effects than previously thought, potentially influencing future generations in subtle ways.

In simple terms:

Epigenetics allows the body to adapt quickly. Evolution determines what lasts.

Different diseases, different immune patterns

See also:

Allergic pattern (ABPA)

  • Strong Th2 immune response
  • High IgE and eosinophils
  • Exaggerated reaction to fungal spores

Epigenetic changes may increase expression of cytokines such as IL-4, IL-5, and IL-13, driving allergic inflammation.

Chronic infection pattern (CPA)

  • Reduced ability to clear fungus
  • Persistent infection in damaged lung areas
  • Chronic inflammation and tissue damage

Epigenetic changes may “lock in” ineffective immune responses.

Damp, mould, and environmental exposure

Long-term exposure to damp and mould is highly relevant.

It may:

  • Alter airway cell behaviour
  • Increase sensitivity to fungal spores
  • Promote ongoing inflammation

These effects may persist through epigenetic changes, even after exposure is reduced.

See:

Why treatment works differently

Epigenetics may explain why patients respond differently to treatment.

  • Some respond well to steroids
  • Others develop resistance or side effects
  • Biologic response varies between individuals

A key mechanism involves reduced activity of enzymes such as histone deacetylase 2 (HDAC2), which is important for steroid response.

See also: Why antibiotics do not always work

Biologics vs epigenetics

Biologics

  • Target specific immune signals (e.g. IgE, IL-5)
  • Fast and precise
  • Widely used in severe asthma and ABPA

Read more about biologics

Epigenetics

  • Acts at a deeper level
  • Influences multiple pathways
  • May create longer-lasting effects

Epigenetics is unlikely to replace biologics—it is more likely to enhance and personalise them.

What research is trying to do

1. Restoring steroid sensitivity

Research is exploring how to restore HDAC2 activity and improve steroid effectiveness.

2. Trained immunity (immune memory)

Immune cells can be “trained” by past exposures. This may lead to:

  • Better defence
  • Or harmful chronic inflammation

Scientists are studying how to reset this balance.

3. MicroRNA biomarkers

MicroRNAs may help predict:

  • Disease severity
  • Risk of relapse
  • Treatment response

4. Metabolic and immune reprogramming

Immune cell metabolism is closely linked to epigenetic regulation. Modifying this may improve immune function.

Epigenetics in Aspergillus itself

The fungus is not passive—Aspergillus fumigatus also uses epigenetic control.

This influences:

  • Virulence (how aggressive it is)
  • Biofilm formation
  • Resistance to antifungal drugs

Recent research shows that epigenetic regulators directly affect fungal interaction with the host
(Liu et al., 2026).

Other studies show control of toxin production and colonisation
(Hao et al., 2023).

What this means for the future

The most realistic model is layered care:

  • Antifungals
  • Steroids
  • Biologics
  • Environmental control
  • Future epigenetic approaches

Epigenetics may:

  • Improve treatment response
  • Reduce relapse
  • Enable personalised care

These approaches are still in development.

Common Questions

Can I change my epigenetics?

Not directly. However, reducing damp exposure and maintaining general health may support better immune regulation.

Are these treatments available?

No. They are still in research.

Why do my symptoms fluctuate?

Immune regulation changes over time. Epigenetics may contribute alongside infection and exposure.

Is this the next generation of treatment?

It is better seen as an additional layer that may improve existing treatments.

When to seek medical advice

  • Worsening breathlessness
  • Increased cough
  • Chest pain
  • Weight loss
  • Sudden symptom changes

This article is for education and does not replace clinical advice.

References

by GAtherton

Weekly Aspergillosis Research Update (7–11 April 2026)

Last reviewed: April 2026
Audience: Patients, carers, GPs, specialist nurses, and healthcare professionals

Key Points (Summary)

  • Invasive pulmonary aspergillosis (IPA) can closely mimic other serious infections, including miliary tuberculosis, particularly in highly immunocompromised patients.
  • Metagenomic next-generation sequencing (mNGS) is emerging as a valuable diagnostic tool in complex or unclear cases, though it is not yet widely available.
  • Bruton tyrosine kinase (BTK) inhibitors are associated with a measurable risk of invasive fungal infections, with aspergillosis the most frequently reported.
  • Host genetics (e.g. toll-like receptor variants) may influence susceptibility to invasive fungal disease, but this is not yet used clinically.
  • Azole antifungal drugs remain high-risk for drug–drug interactions, particularly in patients receiving cancer therapies.
  • Basic science research continues to identify new fungal targets and pathways, which may inform future treatments.

Contents

Diagnosis and difficult cases

When aspergillosis looks like something else

A case report
(Ji H et al., 2026 – full text)
describes a patient with acute leukaemia who developed widespread “miliary” lung nodules—an imaging pattern classically associated with tuberculosis.

Despite this, the final diagnosis was invasive pulmonary aspergillosis (IPA).

Clinical interpretation

  • Radiological appearances in immunocompromised patients can be non-specific.
  • Aspergillosis may present without classic features such as halo signs or cavitation.
  • Coinfection (e.g. TB + fungal disease) can further complicate interpretation.

This reinforces an important principle in clinical practice: lack of response to treatment should prompt reconsideration of the diagnosis.

The emerging role of mNGS

In this case, metagenomic next-generation sequencing (mNGS) helped establish the diagnosis by detecting fungal DNA directly from clinical samples.

Strengths of mNGS

  • Broad pathogen detection (fungi, bacteria, viruses)
  • Useful in culture-negative infections
  • Can identify unexpected pathogens

Current limitations

  • Limited availability outside specialist centres
  • Cost and turnaround time
  • Interpretation challenges (distinguishing infection from colonisation)

Bottom line: mNGS is promising, but currently complements rather than replaces standard diagnostics (culture, PCR, antigen testing).

Treatment-related risk and immunosuppression

BTK inhibitors and invasive fungal infection

A systematic review and meta-analysis
(PMID: 41954633)
including over 23,000 patients found that:

  • Aspergillosis was the most commonly reported invasive fungal infection
  • Central nervous system involvement was reported in a subset

Why BTK inhibitors increase risk

  • They impair B-cell signalling
  • They affect macrophage and neutrophil function
  • This reduces the body’s ability to control fungal spores

Clinical implications

  • Risk stratification is important
  • Some patients may require antifungal prophylaxis
  • Early recognition of symptoms is critical

This aligns with increasing recognition that modern targeted therapies can have unintended immunological effects.

Genetics and susceptibility

The role of innate immunity

A systematic review
(PMID: 41962654)
examined toll-like receptor (TLR) polymorphisms and fungal infection risk.

TLRs are part of the innate immune system and are responsible for recognising fungal components such as:

  • β-glucans
  • Cell wall proteins

Key insight

  • Certain genetic variants were more frequently reported in patients with invasive aspergillosis

Important context:

  • This does not yet translate into routine testing
  • It may become relevant in the future for personalised risk prediction

Asthma and Aspergillus sensitisation

A 12-week prospective study
(PMID: 41949214)
found that:

  • ~29% of asthma patients were sensitised to Aspergillus fumigatus
  • No significant short-term differences in outcomes were seen compared to non-sensitised patients

Interpretation

  • Sensitisation alone does not necessarily indicate active disease
  • Clinical context remains critical

Important distinction:

  • Sensitisation = immune response to Aspergillus
  • ABPA (Allergic Bronchopulmonary Aspergillosis) = a specific inflammatory disease requiring treatment

Drug interactions

Itraconazole and erlotinib interaction

A case report
(PMID: 41953502)
demonstrated increased exposure to erlotinib when co-administered with itraconazole.

Mechanism

  • Itraconazole inhibits CYP3A4
  • This reduces drug metabolism
  • Drug levels rise, increasing risk of toxicity

Clinical message

  • Always review medications when starting antifungals
  • Particular caution is needed in cancer, transplant, and multi-morbid patients

Useful tool:
Antifungal Interactions Checker

Emerging research and future treatments

Epigenetic regulation in Aspergillus fumigatus

A study
(PMID: 41928566)
identified the role of HosA in regulating fungal growth and virulence.

This type of work helps identify:

  • Potential drug targets
  • Mechanisms of antifungal resistance

New experimental antifungal compounds

A review
(Full text (PMC))
discusses sodium new houttuyfonate (SNH), which has shown activity in animal models of invasive aspergillosis.

Important caution:

  • This is early-stage research
  • It is not available as a treatment

What this means for patients

  • Aspergillosis can sometimes be difficult to diagnose, especially if symptoms overlap with other conditions.
  • If treatment is not working, your medical team may need to review or repeat tests.
  • Some medications (especially for cancer or immune conditions) can increase risk of fungal infection.
  • Antifungal medications are effective but require careful monitoring for interactions.
  • New research is promising, but most advances take time to reach routine care.

When to seek medical advice

Seek medical attention urgently if you have:

  • Worsening breathlessness
  • Persistent fever
  • Coughing up blood
  • New chest pain
  • Symptoms not improving with treatment

If you are immunocompromised, symptoms may progress quickly and should be assessed promptly.

References

Author & Review

This article is part of the Aspergillosis.org weekly research update series. It is intended for general educational purposes and reflects a structured summary of recent research.

Disclaimer: This content is not a substitute for medical advice. Always consult your healthcare team for individual care decisions.

by GAtherton

Help shape the future of aspergillosis care across Uk & Europe

Many people living with aspergillosis, and many carers, reach a point where they ask:

“Can patients do more than just cope with this condition?”

The answer is yes.

The European Lung Foundation (ELF)
and its
Aspergillosis Patient Advisory Group (PAG)
give patients and carers a chance to contribute to something bigger: better awareness, better information, better research, and better care.

What is ELF?

ELF is a Europe-wide organisation that brings patients, carers, healthcare professionals and researchers together to improve lung health information, treatment and care.

One of ELF’s strongest advantages is that it works across Europe, not just in one country. It also makes key information available in several languages, helping more people access reliable information about lung conditions, including aspergillosis.

You can read ELF’s patient information on aspergillosis here:
Aspergillosis – European Lung Foundation.

What is the Aspergillosis Patient Advisory Group?

The Aspergillosis PAG is part of ELF’s wider network of
Patient Advisory Groups.
These groups bring together people with experience of specific lung conditions, or experience as carers, so that patient views can help improve treatment and healthcare.

The Aspergillosis PAG works to raise awareness of aspergillosis and improve diagnosis, treatment and care. It also works alongside healthcare professionals and researchers involved in the Chronic Pulmonary Aspergillosis Network (CPAnet), helping identify research priorities and information gaps for both patients and professionals.

Why does this matter?

Aspergillosis is still not well understood in many places. Diagnosis can be delayed, information can be hard to find, and patients often feel that few people truly understand what living with the condition is like.

By involving patients and carers directly, ELF helps ensure that real-life experience is not left out of the conversation. This can influence education, awareness work, research priorities and wider discussions about care across Europe.

What is in it for the patient or carer?

This is an important question, because volunteering your time and energy is a big ask, especially when you are already managing illness, fatigue, appointments, uncertainty or caring responsibilities.

So it is only fair to be clear and honest about what people may gain from taking part.

1. A chance to make your experience count

Many people with aspergillosis have learned difficult lessons the hard way. Getting involved gives you a chance to turn that experience into something useful — helping improve information, shape priorities and make life a little easier for future patients.

2. Better understanding and confidence

Being involved can help you better understand how research, awareness work and patient representation operate. Some people find that this gives them more confidence when speaking about their condition and navigating their own care.

3. Connection beyond your local area

Because ELF is Europe-wide, patients are not limited to the perspective of one hospital, one region or one country. For people living with a relatively uncommon condition, that wider connection can feel valuable and reassuring.

4. The opportunity to be heard

Many patients are used to feeling overlooked. PAGs are designed so that patient and carer perspectives are actively included in projects and discussions, rather than being an afterthought.

5. A sense of purpose

Some people find that involvement helps them move from simply living with a difficult condition to doing something constructive with that experience. It will not suit everyone, but for some it can be meaningful.

6. Support and training

ELF says it provides support, guidance and training to help people share their perspective and get involved in projects. It also encourages interested patients and carers to use its free online European Patient Ambassador Programme (EPAP), which introduces the skills and knowledge needed to represent yourself and others effectively.

What it is not

It is also important to be realistic.

  • It is not medical care.
  • It does not replace your doctor, nurse or specialist team.
  • It is not a route to faster treatment.
  • It is not a paid role.

ELF states that PAG involvement is voluntary and that it is unable to pay for people’s time.

Who can join?

ELF says most PAGs are open to new members from European countries. In general, people are invited to get involved if they are over 18, have experience as a patient or carer, live in a European country, can communicate in English, are interested in improving healthcare and treatment across Europe, and are willing to share their perspective.

That said, this should not feel like an all-or-nothing commitment. Not everyone can give a lot of time, and health can change. Even modest involvement can still be worthwhile.

Why mention this to our groups?

Many people in aspergillosis support communities have exactly the kind of insight that is valuable here: the reality of diagnosis, treatment, daily management, side effects, uncertainty, isolation, and learning how to cope.

Those experiences matter. They can help improve what is researched, what is explained, and how future patients are supported.

Interested?

You can explore more here:

You do not need to be an expert. You do not need to be highly confident. You do not need to commit to everything.

But if you have lived with aspergillosis, or cared for someone who has, your experience may be more valuable than you think.

In short: this is a voluntary opportunity to help improve understanding, research and care for aspergillosis across Europe, while connecting with a wider patient community and making sure lived experience is heard.

by GAtherton

Cystic Fibrosis, CFTR Gene Variants, and Aspergillosis

Last reviewed: 8 April 2026

Some people with aspergillosis are told they have cystic fibrosis (CF), or that they carry a CFTR gene variant. This can be unexpected and may raise concerns about whether this explains their symptoms or diagnosis.

This article explains how cystic fibrosis and CFTR gene variants relate to Aspergillus-related lung disease, what current research shows, and—importantly—what conclusions should not be drawn.

Contents

Key points

  • Most people with aspergillosis do not have cystic fibrosis.
  • Most people with cystic fibrosis do not develop ABPA or CPA.
  • ABPA is linked to mucus and immune responses, not just infection.
  • CFTR variants may contribute to risk in some people, but are usually only one factor.
  • CPA is mainly driven by structural lung damage, not CFTR genetics.

Back to top ↑

Important reassurance

Most people with aspergillosis do not have cystic fibrosis, and most people with cystic fibrosis do not develop Aspergillus-related disease.

Although these conditions can overlap, they are usually separate. Genetic findings such as CFTR variants should be interpreted carefully and in context.

Back to top ↑

What is cystic fibrosis?

Cystic fibrosis is a genetic condition caused by changes in the CFTR gene. This gene regulates salt and water movement across cells.

When CFTR function is reduced:

  • mucus becomes thick and sticky
  • airways are harder to clear
  • microorganisms persist more easily

This creates an environment where bacteria and fungi can accumulate over time.

Back to top ↑

What is a CFTR gene variant?

CFTR variants range from severe mutations (causing cystic fibrosis) to mild or uncertain variants.

Carriers (with one variant):

  • are common in the general population
  • usually have no symptoms
  • may have subtle effects in some cases

These subtle effects may include reduced mucus clearance or increased susceptibility to airway inflammation.

Back to top ↑

How CFTR affects the lungs

CFTR dysfunction affects the lungs in several key ways:

  • Mucus dehydration: mucus becomes thick and difficult to clear
  • Impaired clearance: particles and microbes remain in the airways
  • Chronic inflammation: immune responses become exaggerated

This combination creates a “retention environment” where inhaled organisms—including Aspergillus—may persist.

Back to top ↑

How Aspergillus behaves in the lungs

Aspergillus is inhaled by everyone, but its effects vary depending on the lung environment.

  • Healthy lungs: spores are cleared
  • Impaired clearance: spores may persist
  • Sensitive immune system: allergic reactions may develop
  • Damaged lungs: chronic infection may develop

This explains why Aspergillus-related disease is diverse and depends heavily on underlying lung conditions.

Back to top ↑

ABPA and cystic fibrosis

ABPA is an allergic immune reaction to Aspergillus.

It is recognised in cystic fibrosis because:

  • mucus retention increases exposure to Aspergillus
  • immune responses can be exaggerated

However:

  • Many CF patients never develop ABPA
  • Most ABPA patients do not have CF

Some studies suggest CFTR variants may increase susceptibility, but this is not consistent across all research.

Key message: ABPA and CF can overlap, but one does not imply the other.

Back to top ↑

CPA and cystic fibrosis

CPA is a chronic fungal infection that develops in structurally damaged lungs.

The most important risk factor is:

pre-existing lung damage

This includes:

  • bronchiectasis
  • previous tuberculosis
  • COPD

Cystic fibrosis can lead to bronchiectasis, and therefore indirectly increase CPA risk.

However:

  • CPA is rarely driven directly by CFTR genetics
  • most CPA patients do not have CF

Key message: CPA is primarily a disease of lung structure, not genetics.

Back to top ↑

Modern CF treatments and Aspergillus

CFTR modulators (such as elexacaftor/tezacaftor/ivacaftor) have transformed CF care.

They:

  • improve CFTR function
  • thin mucus
  • improve clearance

Studies suggest:

  • reduced Aspergillus detection in some patients
  • fewer ABPA exacerbations in some cases

However:

  • ABPA still occurs
  • existing lung damage remains
  • immune responses are not fully corrected

Overall: these therapies improve risk but do not eliminate Aspergillus-related disease.

Back to top ↑

Does a CFTR variant explain symptoms?

No single factor explains complex lung disease.

Symptoms may result from:

  • underlying lung disease
  • infection
  • inflammation
  • environmental exposure

A CFTR variant may contribute, but is rarely the sole cause.

Back to top ↑

What should patients take from this?

  • CF and CFTR variants can sometimes contribute
  • ABPA has the strongest connection
  • CPA is mainly driven by lung damage
  • Most patients with aspergillosis do not have CF

Back to top ↑

When to seek medical advice

Seek advice if symptoms worsen, change, or include coughing up blood, fever, or chest pain.

Back to top ↑

Conclusion

Cystic fibrosis and CFTR gene variants can play a role in some patients with Aspergillus-related lung disease, particularly where mucus clearance is affected. However, they should not be overemphasised. In most cases, they are just one part of a broader clinical picture involving lung structure, immune response, and environmental exposure.

Back to top ↑

References

This article is for general information and does not replace advice from your clinical team.

by GAtherton

Weekly Aspergillosis Research Update: 31 March – 7 April 2026

This week’s research reinforces several consistent themes in aspergillosis: ongoing diagnostic confusion (particularly with tuberculosis and cancer), increasing movement toward precision medicine, and continued development of both antifungal therapies and biomarkers. There is also a growing emphasis on host-pathogen interactions rather than fungal burden alone.

Key Highlights

  • Isavuconazole levels can become unexpectedly high due to genetics and drug interactions.
  • Chronic pulmonary aspergillosis (CPA) can mimic lung cancer, risking delayed diagnosis.
  • New biomarker (EDN) for ABPA shows promise for diagnosis and monitoring.
  • Azole resistance research highlights differences between Aspergillus species.
  • New antifungal approaches emerging (olorofim, nitroxoline).
  • Host response is central – fibroblasts and immune pathways actively influence disease.
  • TB vs aspergillosis confusion persists in real-world settings.

Contents

Clinical & Diagnostic Studies

CPA mistaken for lung cancer

Paper: PubMed

A case report describes chronic pulmonary aspergillosis presenting as suspected lung malignancy in a patient with asthma and ABPA overlap.

Why this matters: CPA continues to be misdiagnosed due to tumour-like imaging appearances. This reinforces the need to consider fungal disease in patients with underlying lung conditions.

Invasive sinus aspergillosis causing bone destruction

Paper: Free full text

Granulomatous invasive aspergillosis led to facial bone destruction and neurological symptoms.

Why this matters: Delayed diagnosis of invasive disease can lead to severe structural damage. Early imaging and specialist input are critical.

Aspergillus infection in suspected TB patients

Paper: PubMed

Study shows overlap between tuberculosis and aspergillosis in symptomatic patients.

Why this matters: Persistent global issue—shared symptoms delay correct diagnosis and treatment, particularly relevant for CPA pathways.

Invasive aspergillosis in critical illness

Paper: PubMed

Case of invasive pulmonary aspergillosis in a patient with severe viral illness.

Why this matters: Reinforces that aspergillosis is not limited to traditional risk groups and can complicate severe systemic illness.

Treatment & Pharmacology

Isavuconazole toxicity linked to genetics

Paper: Free full text

Case report of supratherapeutic isavuconazole levels linked to CYP3A5 genotype and interacting medications.

Why this matters: Even “predictable” antifungals show variability. Supports therapeutic drug monitoring and future personalised dosing approaches.

Olorofim pharmacokinetics

Paper: PubMed

Study demonstrates tissue distribution of olorofim in preclinical models.

Why this matters: Supports ongoing development of a key next-generation antifungal, particularly for resistant disease.

Nitroxoline shows antifungal activity

Paper: PubMed

Repurposed drug demonstrates activity against Aspergillus via copper disruption and oxidative stress.

Why this matters: Highlights potential for non-azole antifungal strategies in future treatment.

Biology, Immunology & Resistance

Azole resistance and Aspergillus genomics

Paper: PubMed

Genomic study of Aspergillus section Fumigati explores resistance mechanisms and pathogenicity.

Why this matters: Different species may respond differently to antifungals—accurate identification is increasingly important.

Fibroblasts actively support lung defence

Paper: PubMed

Study shows fibroblasts contribute to immune defence and tissue repair during infection.

Why this matters: Disease outcomes depend on host response, not just fungal burden—important for future therapies.

Immune pathway targeting in fungal keratitis

Paper: PubMed

PIM1 inhibition reduces inflammation via STING pathway signalling.

Why this matters: Supports growing interest in targeting immune pathways alongside antifungal therapy.

Biomarkers & Diagnostics

Eosinophil-derived neurotoxin (EDN) in ABPA

Paper: PubMed

EDN proposed as a biomarker for allergic bronchopulmonary aspergillosis.

Why this matters: Could improve diagnosis and monitoring, helping distinguish ABPA from asthma or sensitisation alone.

Commentary on ISHAM ABPA guidelines

Paper: PubMed

Discussion of updated international guidance on ABPA diagnosis and management.

Why this matters: Highlights ongoing refinement of diagnostic criteria and classification systems.

Wider Context

Fungal extracellular vesicles

Paper: PubMed

Review of fungal vesicles in pathogenesis and host interaction.

Why this matters: Emerging area that may influence future diagnostics and therapies.

Aspergillosis in broader disease settings

  • Cystic fibrosis study: PubMed
  • Adenovirus meta-analysis: PubMed
  • Haematology correspondence: PubMed

Why this matters: Aspergillosis continues to appear across a wide range of conditions, particularly in critically ill or immunocompromised patients.

Overall Interpretation

This week’s literature reinforces several strategic priorities:

  • Earlier and more accurate diagnosis remains essential, particularly in distinguishing CPA from TB and cancer.
  • Precision medicine is advancing, with growing roles for pharmacogenomics, drug monitoring, and species-level identification.
  • New antifungal options are progressing, but remain largely in development.
  • Host response is increasingly recognised as central to disease progression and outcomes.

Overall, the field continues to move toward more personalised, biology-driven approaches to diagnosis and management.

by GAtherton

Aspergillosis Research Update: Week Ending: 30 March 2026

Contents

Key highlights

  • Increasing clarity on influenza-associated pulmonary aspergillosis (IAPA) and ongoing uncertainty around prophylaxis
  • New insights into immune recognition of Aspergillus relevant to vaccine development
  • Evidence that persistent Aspergillus colonisation may worsen bronchiectasis outcomes
  • Early-stage research into drug repurposing strategies
  • Continued reports of complex co-infections in immunocompromised patients

Paper summaries

Incidence and outcomes of influenza-associated pulmonary aspergillosis and the role of antifungal prophylaxis: a structured literature review

Sedik S, Felber D, Schellongowski P, Salzer HJF, Bellmann R, Muhr T, Auer J, Krippl P, Lux M, Zajic P, Werner M, Bauer N, Watzinger N, Mesaric G, Tinawi Y, Dichtl K, Wolfgruber S, Biswas S, Prattes J, [...] Hoenigl M
Critical Care, 26 March 2026
PMID: 41888868

Summary
This structured review examines how often influenza-associated pulmonary aspergillosis occurs, the outcomes associated with it, and whether antifungal prophylaxis has a role in prevention.

Key points

  • IAPA remains a serious complication of influenza in critically ill patients.
  • Mortality appears high, particularly in patients requiring intensive respiratory support.
  • The evidence for antifungal prophylaxis remains inconclusive.
  • Diagnostic uncertainty continues, especially when trying to distinguish colonisation from invasive disease.

Relevance
This is important because it mirrors concerns seen with COVID-19-associated pulmonary aspergillosis and underlines the need for clearer ICU diagnostic and prevention pathways.


Effect of transient versus persistent Aspergillus colonisation on clinical outcomes in bronchiectasis

Michaud A, Jarand J, Thornton CS
ERJ Open Research, 23 March 2026
PMID: 41878279

Summary
This study looks at whether transient and persistent Aspergillus colonisation have different effects on people with bronchiectasis.

Key points

  • Persistent colonisation was associated with worse respiratory outcomes.
  • Patients with persistent colonisation appeared to have more symptoms and exacerbations.
  • Transient colonisation seemed less clinically important.
  • The findings sit outside Allergic Bronchopulmonary Aspergillosis (ABPA), which makes them especially interesting.

Relevance
This is one of the most clinically relevant papers this week for chronic lung disease. It suggests Aspergillus in sputum may not always be an incidental finding, especially if it is repeatedly present.


α-1,3-Glucan-Driven Remodeling of the Conidial Cell Wall in an Aspergillus fumigatus Vaccine Strain Alters Innate Immune Recognition

Singh K, Ankur A, Yarava JR, Fernandes CM, Vascelli G, Sulla A, Zelante T, Del Poeta M, Wang T
Journal of the American Chemical Society, 26 March 2026
PMID: 41883285

Summary
This experimental paper explores how changes in the Aspergillus fumigatus conidial cell wall alter how the innate immune system detects the fungus.

Key points

  • Changes in α-1,3-glucan altered the structure of the fungal cell wall.
  • That remodelling changed how the fungus was recognised by innate immune pathways.
  • The work may help inform future vaccine design or immune-targeted therapies.

Relevance
This is early-stage science rather than immediately practice-changing work, but it improves understanding of how Aspergillus may evade immune recognition and how future preventive strategies could be designed.


Synergistic antifungal activity of antiretrovirals with amphotericin B against Aspergillus species

Khan AA, Salama EA, Seleem MN
PLOS One, 25 March 2026
PMID: 41880294

Summary
This laboratory study investigates whether antiretroviral drugs can enhance the antifungal activity of amphotericin B against Aspergillus species.

Key points

  • Some antiretrovirals showed synergistic activity with amphotericin B.
  • The combination improved inhibition of hyphal growth.
  • This raises the possibility of drug repurposing in invasive aspergillosis.

Relevance
This is interesting as a proof-of-concept study. It is not ready for clinical use, but it points toward possible future combination strategies, especially where resistance or toxicity limits current treatment options.


Coexistence of pulmonary aspergillosis and cryptococcosis following treatment for SARS-CoV-2 infection in a kidney transplant recipient: a rare case report and literature review

Hu C, Ying L, Zhan Y, Wang J, Ye J, Lu J, Jin H, Tan X, Gu L, Yao Y, Jiang N
BMC Nephrology, 23 March 2026
PMID: 41872830

Summary
This case report describes a kidney transplant recipient who developed both pulmonary aspergillosis and cryptococcosis after SARS-CoV-2 infection.

Key points

  • Demonstrates the potential for multiple opportunistic fungal infections in highly immunosuppressed patients.
  • Shows how diagnosis can become particularly complex when symptoms and imaging overlap.
  • Reinforces the need for a broad differential diagnosis in transplant recipients and similar high-risk groups.

Relevance
Although a single case, it is a useful reminder that fungal infection in immunocompromised patients may not always be limited to one pathogen, particularly after severe viral infection or intense immunosuppression.


Severe COVID-19 in the Republic of Korea: Epidemiology, Risk Factors, Therapeutics, and Prognostic Models From Nationwide Data

Choi JY
Journal of Korean Medical Science, 23 March 2026
PMID: 41873446

Summary
This review of nationwide Korean data includes discussion of severe COVID-19 complications, including COVID-19-associated pulmonary aspergillosis.

Key points

  • There was a trend toward increased COVID-19-associated pulmonary aspergillosis (CAPA).
  • Risk appeared higher in patients needing the most advanced respiratory support, including ECMO.

Relevance
This reinforces the continuing importance of CAPA internationally and supports ongoing vigilance in critical care settings, especially where viral lung injury and immunomodulatory treatment intersect.

Temporal Trends and Clinical Outcomes of Pediatric Invasive Fungal Diseases: A Ten-Year Retrospective Study from a Tertiary-Care Center in Thailand

Niyomthammarat C, Meesilpavikkai K, Chintanapakdee W, Sophonphan J, Anugualruengkitt S, Puthanakit T, Jantarabenjakul W
Research Square, 23 March 2026
Status: Preprint v1

Summary
This ten-year retrospective study of paediatric invasive fungal disease includes a substantial number of invasive aspergillosis episodes.

Key points

  • Invasive aspergillosis was one of the major fungal disease categories identified.
  • Outcomes varied according to underlying condition and likely also the speed of diagnosis and treatment.

Relevance
This paper does not currently have a PubMed listing because it is a preprint rather than a final indexed journal paper, but it still offers useful background on paediatric invasive fungal disease burden.

Initial presentation, etiology and risk factors for adverse outcomes in infection-associated plastic bronchitis in children

Cao H, Liang D, Huang H, He Q, Wu L
Frontiers in Pediatrics, 28 March 2026
PMCID: PMC13021623

Summary
This retrospective paediatric study is not primarily an aspergillosis paper, but it mentions allergic bronchopulmonary aspergillosis among conditions relevant to plastic bronchitis.

Key points

  • ABPA appears as part of the broader differential diagnosis in children with this presentation.
  • The study mainly concerns airway obstruction and risk factors for poor outcome rather than aspergillosis itself.

Relevance
This has limited direct relevance to most aspergillosis readers, but it is a useful contextual reminder that Aspergillus-related disease can form part of wider airway pathology discussions.

Note: I have not added a PubMed link here because no PMID was supplied. If you want, I can convert this heading to a Europe PMC or PMC link instead.


Aspergillus deflectus-associated disseminated invasive aspergillosis in a German Shepherd dog with discospondylitis: first isolation in Europe

Gernone F, Uva A, Aresu L, Bonfanti U, Ricciardi M, Miglianti M, Barrs VR
Veterinary Research Communications, 25 March 2026
PMID: 41880044

Summary
This veterinary case report documents disseminated invasive aspergillosis caused by Aspergillus deflectus in a German Shepherd dog, reported as the first isolation in Europe.

Key points

  • Expands awareness of the range of Aspergillus species capable of causing invasive disease.
  • Shows how invasive aspergillosis can present as a disseminated multisystem infection.

Relevance
This is not directly about human disease, but it contributes to the wider ecological and pathogenic picture of Aspergillus species.

Overall themes this week

  1. Colonisation versus disease remains a major question.
    Persistent Aspergillus colonisation may be clinically important in bronchiectasis and should not automatically be dismissed.
  2. Severe viral infection remains a major trigger for invasive aspergillosis.
    Both influenza and COVID-19 continue to feature strongly in the literature.
  3. Innovation is active but mostly early-stage.
    Vaccine science, immune recognition work, and drug repurposing studies are all progressing, but none are ready to change routine care yet.
  4. Complex patients are at risk of complex fungal disease.
    Transplant recipients and critically ill patients remain especially vulnerable to difficult-to-diagnose opportunistic infections.

What this means for patients

  • Finding Aspergillus repeatedly in samples may sometimes matter more than a single isolated result.
  • Severe viral illness can increase the risk of serious fungal complications in some people.
  • Researchers are exploring better ways to prevent and treat aspergillosis, but most of these approaches are still under investigation.
  • People with weakened immune systems remain at greatest risk of invasive disease.

by GAtherton