Weekly Aspergillosis Research Update – 15 June 2026
Key Points
- A large population study confirms that people who have survived tuberculosis (TB) have a substantially increased risk of developing chronic pulmonary aspergillosis (CPA).
- New UK data highlight the significant burden of Aspergillus-related chronic lung diseases in routine respiratory care.
- Research suggests that fungal balls (aspergillomas) are complex microbial ecosystems rather than simple collections of fungal growth.
- New diagnostic approaches using proteomics, DNA methylation and sequencing continue to show promise.
- Several studies explore improved diagnosis and treatment of aspergillosis in transplant recipients and other highly vulnerable patients.
Contents
- Tuberculosis Survivors and Aspergillosis Risk
- New UK Data on Aspergillus-Related Lung Disease
- Understanding Fungal Balls
- New Diagnostic Technologies
- Influenza-Associated Pulmonary Aspergillosis
- Transplantation and Immunotherapy Research
- What Does This Mean for Patients?
- References
Tuberculosis Survivors Face a Much Higher Risk of Pulmonary Aspergillosis
One of the most important studies published this week examined the long-term risk of pulmonary aspergillosis among people who have previously had tuberculosis (TB).
Researchers analysed nationwide health data and found that pulmonary aspergillosis occurred almost ten times more frequently in TB survivors than in matched controls. The incidence was 0.89 cases per 1,000 person-years among TB survivors compared with 0.09 cases per 1,000 person-years in the control group.
After adjusting for other risk factors, individuals with a history of TB remained nearly seven times more likely to develop pulmonary aspergillosis.
This finding reinforces a growing body of evidence showing that chronic pulmonary aspergillosis (CPA) is an important long-term complication of tuberculosis. Residual lung cavities and structural lung damage may provide an environment in which Aspergillus can establish chronic infection.
- Zo S, Lee KN, Han K, et al. Risk of Pulmonary Aspergillosis in Tuberculosis Survivors: A Nationwide Population-based Study.
International Journal of Antimicrobial Agents. 2026.
Patients who have previously had tuberculosis and continue to experience symptoms such as chronic cough, breathlessness, fatigue, weight loss or coughing up blood should discuss the possibility of CPA with their healthcare team.
New UK Data Highlight the Burden of Aspergillus-Related Lung Disease
A 10-year retrospective study from Imperial College Healthcare NHS Trust provides valuable insight into the scale of Aspergillus-related lung disease seen within a large UK respiratory service.
The researchers identified:
- 334 patients with serological allergic bronchopulmonary aspergillosis (sABPA)
- 145 patients with allergic bronchopulmonary aspergillosis (ABPA)
- 74 patients with chronic pulmonary aspergillosis (CPA)
- 38 patients with simple aspergilloma
- 11 patients with CPA-ABPA overlap disease
These figures demonstrate that Aspergillus-related conditions are encountered across a broad range of respiratory clinics and are not confined to specialist fungal centres.
- Venkatesan T, Nagi N, Nwankwo L, et al. Describing the Burden and Characteristics of Aspergillus-related Chronic Lung Disease at Imperial College Healthcare Trust: a 10-year Retrospective Study.
BMJ Open Respiratory Research. 2026.
The study highlights the importance of awareness among respiratory specialists, general physicians and primary care clinicians. Early recognition remains one of the biggest challenges in Aspergillus-related lung disease.
Fungal Balls Are More Complex Than Previously Thought
A fascinating multi-omics study examined fungal balls (aspergillomas) removed from patients with chronic pulmonary aspergillosis.
Traditionally, aspergillomas have been viewed as relatively simple accumulations of fungal material within pre-existing lung cavities. However, this research paints a much more complex picture.
The investigators found evidence that aspergillomas function as resilient microbial ecosystems involving interactions between Aspergillus species and bacteria, including organisms such as Pseudomonas aeruginosa.
The fungal communities also showed metabolic adaptations that may help them survive within the challenging environment of the lung cavity.
These findings may help explain why some aspergillomas remain difficult to eradicate and why bacterial co-infections can sometimes influence symptoms and treatment outcomes.
New Diagnostic Technologies Continue to Advance
Two veterinary studies published this week demonstrate the rapid development of advanced fungal diagnostic technologies.
Proteomics in Falcons
Researchers studying aspergillosis in falcons used plasma proteomics to identify potential biomarkers that may allow earlier diagnosis of infection.
Current diagnostic approaches often detect disease only after significant progression. The identification of blood-based biomarkers could eventually improve earlier detection and monitoring.
- Vieu S, Lozano C, Azmanis P, et al. Falcon Plasma Proteomics to Improve Avian Aspergillosis Diagnosis.
Journal of Proteomics. 2026.
DNA Methylation and Nanopore Sequencing in Chickens
A second study used host cell-free DNA methylation combined with nanopore sequencing to diagnose Aspergillus fumigatus infection in chickens with high accuracy.
Although these studies involve birds, they reflect wider trends in fungal diagnostics, where researchers are increasingly exploring:
- Proteomics
- Cell-free DNA analysis
- Next-generation sequencing
- Machine learning approaches
- Biomarker-based diagnostics
Future human diagnostics may rely less on culture-based testing and more on sophisticated molecular techniques that can identify disease earlier and more accurately.
Influenza and Aspergillosis: Understanding the Immune Response
A review published in Trends in Microbiology explores the mechanisms underlying influenza-associated pulmonary aspergillosis (IAPA).
Over the past decade, clinicians have recognised that severe influenza can predispose some patients to invasive Aspergillus infection.
The review discusses how viral infection can disrupt the delicate balance of immune responses in the lungs, creating conditions that allow Aspergillus to invade tissue.
The authors describe this balance as an inflammatory "rheostat" that regulates protection against infection while avoiding excessive tissue damage.
- Charrier Le Blan M, Biquand E, Briard B. Critical Role of the Inflammatory Rheostat in Influenza-associated Pulmonary Aspergillosis.
Trends in Microbiology. 2026.
While primarily relevant to critically ill hospitalised patients, the work improves our understanding of how viral infections and fungal infections interact.
Transplantation and Immunotherapy Research
Several studies this week focused on patients with severe immune suppression and organ transplantation.
Improved Diagnosis After Lung Transplantation
The GALACTBAS study suggests that galactomannan testing of tracheobronchial aspirates may improve detection of Aspergillus infection in lung transplant recipients.
The findings support the idea that some transplant-associated Aspergillus infections begin within the bronchial tree and may not always be detected early using traditional bronchoalveolar lavage (BAL) samples.
- Monforte A, Martín-Gómez MT, Berastegui C, et al. Diagnostic Value of Galactomannan in Tracheobronchial Aspirate for Aspergillus Infection in Lung Transplant Recipients.
Journal of Clinical Microbiology. 2026.
Kidney Transplant Patients
A prospective multicentre study found that invasive aspergillosis remained one of the most serious fungal complications after kidney transplantation, with mortality exceeding 40%.
Emerging Immunotherapies
Another review evaluated growing evidence supporting the use of immune-enhancing treatments such as:
- Interferon-gamma (IFN-γ)
- Anti-programmed death-1 (anti-PD-1) therapies
These approaches aim to strengthen antifungal immunity alongside standard antifungal treatment in selected patients with severe invasive mould infections.
Although still considered specialist therapies, interest in immunomodulation continues to grow.
What Does This Mean for Patients?
Several themes emerge from this week's publications:
- Previous tuberculosis remains one of the most important risk factors for chronic pulmonary aspergillosis.
- Aspergillus-related lung diseases continue to be under-recognised outside specialist centres.
- Fungal balls are biologically complex and involve interactions between fungi, bacteria and the lung environment.
- Diagnostic technology is advancing rapidly, particularly in biomarker and sequencing-based approaches.
- Research into immune-based treatments continues to expand alongside antifungal drug development.
Although many of these studies are early-stage or aimed primarily at researchers and specialists, together they show a field that is continuing to improve our understanding of how Aspergillus causes disease and how it might be diagnosed and treated more effectively in the future.
When to Seek Medical Advice
Patients with known lung disease should seek medical advice if they experience:
- Persistent or worsening breathlessness
- New or worsening cough
- Unexplained weight loss
- Fatigue that is worsening over time
- Coughing up blood (haemoptysis)
- New chest pain
- Persistent fever or night sweats
Individuals who have previously had tuberculosis should be particularly aware that chronic pulmonary aspergillosis can develop months or years after apparent recovery from TB.
References
- Zo S, Lee KN, Han K, et al. Risk of Pulmonary Aspergillosis in Tuberculosis Survivors: A Nationwide Population-based Study.
International Journal of Antimicrobial Agents. 2026. - Venkatesan T, Nagi N, Nwankwo L, et al. Describing the Burden and Characteristics of Aspergillus-related Chronic Lung Disease at Imperial College Healthcare Trust: a 10-year Retrospective Study.
BMJ Open Respiratory Research. 2026. - Liu C, Ribeiro MM, Yang J, et al. Multi-omics Profiling of Fungal Balls in Chronic Pulmonary Aspergillosis Patients Reveals Microbiome Dynamics and Metabolic Adaptations.
mBio. 2026. - Vieu S, Lozano C, Azmanis P, et al. Falcon Plasma Proteomics to Improve Avian Aspergillosis Diagnosis.
Journal of Proteomics. 2026. - Drag MH, Hvilsom C, Poulsen LL, et al. MethylSense: High Accuracy Machine Learning-Based Diagnostics for Aspergillus fumigatus Infection in Chickens Using Host Cell-free DNA Methylation and Nanopore Sequencing.
Journal of Clinical Microbiology. 2026. - Charrier Le Blan M, Biquand E, Briard B. Critical Role of the Inflammatory Rheostat in Influenza-associated Pulmonary Aspergillosis.
Trends in Microbiology. 2026. - Monforte A, Martín-Gómez MT, Berastegui C, et al. Diagnostic Value of Galactomannan in Tracheobronchial Aspirate for Aspergillus Infection in Lung Transplant Recipients.
Journal of Clinical Microbiology. 2026. - Serris A, Guihot A, Joffre J, et al. Emerging Evidence for Anti-PD-1 and IFN-γ as Adjunctive Immunotherapy in Invasive Mold Infections.
mBio. 2026.
Author: Graham Atherton, National Aspergillosis Centre (NAC)
Clinical Review: National Aspergillosis Centre Clinical Team
Last Reviewed: 15 June 2026
For Patient Education Only: This article is intended for educational purposes and should not replace professional medical advice.
Clinical Trials Update: Progress in ABPA and Invasive Aspergillosis Research
Date reviewed: 8 June 2026
Clinical research into aspergillosis continues to move forward, although there have been relatively few major new trial launches in recent weeks. The most significant developments involve two areas:
- Growing evidence supporting biologic treatment for Allergic Bronchopulmonary Aspergillosis (ABPA).
- Progress towards completion of a major international trial of a new antifungal drug for invasive aspergillosis.
Contents
- ABPA: More Evidence for Dupilumab
- Olorofim Trial Moves Towards Completion
- Why These Studies Matter
- What We Didn't Find This Month
- Common Questions
- When to Seek Medical Advice
ABPA: More Evidence for Dupilumab
One of the most encouraging developments in recent years has been the emergence of biologic therapies for ABPA. Researchers continue to publish and present results from the Phase II LIBERTY ABPA AIRED study, which investigated the biologic drug dupilumab.
Dupilumab works by blocking two important inflammatory pathways (Interleukin-4 and Interleukin-13) that contribute to allergic inflammation in asthma and ABPA.
Additional scientific presentations and publications appearing during 2025 and 2026 continue to show consistent benefits for many patients:
- Improved lung function.
- Fewer severe respiratory exacerbations.
- Reduced need for oral corticosteroids.
- Better asthma control.
- Improved quality of life.
- Reductions in total Immunoglobulin E (IgE) and Aspergillus-specific IgE levels.
Although biologics are not suitable for everyone with ABPA, these results continue to strengthen the evidence that targeted immune therapies may offer an alternative to long-term steroid treatment for some patients.
For people living with ABPA, this remains one of the most promising areas of current research.
Olorofim Trial Moves Towards Completion
The other major development concerns olorofim, a novel antifungal medication being developed for difficult-to-treat invasive fungal infections.
The large international Phase III OASIS trial has been comparing olorofim with standard treatment in patients with invasive aspergillosis.
Recent updates suggest that recruitment has now effectively closed and that the study is entering its final follow-up and analysis phase.
This is an important milestone because it usually means researchers have enrolled enough participants and are now collecting the final outcome data needed to determine whether the treatment works and how safe it is.
However, the most important information is still awaited:
- The primary trial results have not yet been published.
- No peer-reviewed Phase III paper is currently available.
- The effectiveness of olorofim compared with current standard treatments remains under formal evaluation.
If the final results are positive, olorofim could become an important additional treatment option for patients with invasive aspergillosis, particularly those whose infections are resistant to existing antifungal drugs or who cannot tolerate current therapies.
Why These Studies Matter
Research into aspergillosis has traditionally lagged behind many other respiratory and infectious diseases. It is therefore encouraging to see progress occurring in two key areas:
- Allergic disease (ABPA) – where biologics are offering the possibility of reducing steroid dependence.
- Invasive disease – where new antifungal drugs may help address drug resistance and treatment failure.
These studies also reflect a broader trend towards more personalised treatment approaches, matching therapies to the specific type of aspergillosis and the underlying immune response of the patient.
What We Didn't Find This Month
While there has been progress in ongoing studies, we did not identify any major new:
- ABPA clinical trials.
- Chronic Pulmonary Aspergillosis (CPA) treatment trials.
- Severe Asthma with Fungal Sensitisation (SAFS) interventional studies.
- Aspergillus bronchitis treatment trials.
- Major environmental intervention studies.
- Newly terminated or withdrawn aspergillosis drug-development programmes.
This is not unusual. Large clinical trials often take several years to complete, and periods of data analysis between recruitment and publication can be lengthy.
Common Questions
Is dupilumab available for ABPA?
Dupilumab is already licensed for several allergic and eosinophilic conditions, including some forms of severe asthma. Its use specifically for ABPA varies between countries and healthcare systems. Decisions about treatment remain highly individual and should be discussed with a specialist team.
What is a Phase III trial?
Phase III studies are large clinical trials designed to determine whether a new treatment works and how safe it is compared with existing treatments. Positive Phase III results are often required before regulatory approval.
Could olorofim be used for CPA?
Research has explored olorofim in a variety of fungal diseases, but the current Phase III programme focuses on invasive aspergillosis. Further evidence would be needed before routine use in Chronic Pulmonary Aspergillosis.
When might the OASIS results be available?
There is currently no confirmed publication date. As recruitment appears to have finished, the next major milestone will be release of the primary efficacy and safety results.
When to Seek Medical Advice
Clinical trial news is exciting, but it should not replace advice from your healthcare team.
Seek medical attention if you experience:
- Worsening breathlessness.
- New or worsening haemoptysis (coughing blood).
- Persistent fever.
- Sudden deterioration in asthma control.
- Significant side effects from antifungal or biologic treatments.
If you are interested in taking part in clinical research, speak with your specialist team about studies that may be available in your area.
Key Takeaway: The strongest current momentum in aspergillosis research remains in biologic treatments for ABPA and new antifungal therapies for invasive aspergillosis. While no major new trials have appeared this month, ongoing studies continue to move closer to delivering results that could influence future care.
Last reviewed: 8 June 2026
Help Us Improve Our Damp Homes and Health Questionnaire
We are asking patients, carers and members of the public to help us improve a draft questionnaire for our new UK Citizen Science project on damp homes, mould and health.
Draft 1 of questionnaire download here: Health Effects of Indoor Mould Questionnaire
Key points
- We are developing a questionnaire for a Citizen Science project about damp homes, mould and health.
- Before using it in the study, we want feedback from people who may complete it.
- We are not just asking people to check spelling or grammar.
- We want to know whether the questionnaire asks the right questions, is easy to understand, and collects useful information.
- Your comments can help shape the final version of the study.
Why are we doing this project?
Damp homes and indoor mould are common problems in the UK. Many people worry that dampness, condensation and mould may affect their breathing, allergies, infections, fatigue or general wellbeing.
Our Citizen Science project aims to learn more about the links between homes, indoor mould and health by working directly with patients, carers and householders.
Citizen Science means that members of the public are not just research subjects. They help shape the research, collect information, and improve the questions being asked.
What is the questionnaire for?
The questionnaire is designed to collect information about:
- the type of home someone lives in
- signs of damp, condensation or mould
- heating and ventilation
- previous water damage, leaks or flooding
- respiratory symptoms and other health problems
- whether symptoms seem to change in different environments
- how damp or mould affects everyday life and wellbeing
This information will help researchers understand whether there are patterns between housing conditions and health. It will also help guide the next stages of the project, including possible home sampling and laboratory analysis.
Why do we need feedback?
A questionnaire can look clear to researchers but feel very different to the people completing it.
Patients and householders may notice:
- questions that are confusing
- questions that are too difficult to answer
- important topics that are missing
- sections that feel repetitive
- questions that need a “Don’t know” option
- places where more explanation is needed
This is why your feedback is so important.
What sort of comments are we looking for?
We are especially interested in comments on the following areas.
1. Is the questionnaire easy to understand?
Please tell us if any wording is unclear, too technical, or open to different interpretations.
2. Are any important questions missing?
For example, should we ask more about:
- previous mould exposure in other homes
- roof leaks, plumbing leaks or flooding
- diagnosed respiratory conditions
- asthma, allergic bronchopulmonary aspergillosis, chronic pulmonary aspergillosis or other lung conditions
- steroid treatment or immune-suppressing medicines
- whether symptoms improve away from home
- whether symptoms changed after moving house
3. Is the questionnaire too long?
Long questionnaires can be tiring, especially for people living with chronic illness. We want to collect enough information to make the study useful, but not so much that people give up before finishing.
4. Are any questions difficult to answer accurately?
Some people may not know exact details about their home, heating system, building age or past water damage. We want to identify questions where people may need clearer options, such as “Not sure” or “Don’t know”.
5. Are any questions sensitive?
Questions about housing, health and personal circumstances can sometimes feel sensitive. Please tell us if any question needs a clearer explanation of why it is being asked.
The most important question
One of the most useful questions we can ask is:
If this study could answer one question about damp homes, mould and health, what would you most like to know?
This helps us understand what matters most to patients, carers and householders.
How to send us your comments
Click here for a short Google Form where you can send your feedback.
The feedback form will ask questions such as:
- How easy was the questionnaire to understand?
- Were any questions unclear or confusing?
- Do you think any important questions are missing?
- Were any questions unnecessary or repetitive?
- Was the questionnaire too long, too short, or about right?
- If this study could answer one question about damp homes, mould and health, what would you most like to know?
- Do you have any other comments or suggestions?
You do not need to answer every question. Any feedback is helpful.
This is not a grammar exercise
We are not mainly asking people to proofread the questionnaire.
What we really want to know is:
Does this questionnaire help us collect the information needed to understand whether damp homes and mould may be affecting health, and are we asking the right questions?
Thank you
Thank you for helping us improve this questionnaire. Your comments will help us design a better study and make sure the project reflects the experiences and priorities of the people affected by damp homes and mould.
By sharing your views at this early stage, you are helping shape research that could improve understanding of indoor mould, housing conditions and health.
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Aspergillosis Research Update: Earlier Diagnosis, Better Testing and New Treatment Possibilities
Research update covering mid-May to early June 2026
Key points
- New research suggests Aspergillus infection may develop during tuberculosis treatment, rather than only years afterwards.
- A large cystic fibrosis registry study has improved understanding of who is most at risk of developing Allergic Bronchopulmonary Aspergillosis (ABPA).
- A case report highlights that ABPA can occasionally cause severe mucus plugging and even lung collapse.
- New studies continue to improve testing for Chronic Pulmonary Aspergillosis (CPA), including Aspergillus antibody tests.
- Several papers evaluated newer diagnostic tools including PCR, galactomannan, lateral flow testing and metagenomic sequencing.
- Researchers are increasingly exploring treatments that support the immune system, rather than only targeting the fungus directly.
Introduction
The last two weeks have seen a wide range of new aspergillosis research covering diagnosis, risk factors, immune responses and future treatment possibilities.
A clear theme emerging from recent studies is the move towards earlier diagnosis and more personalised approaches to care. Researchers are also increasingly investigating how the immune system interacts with Aspergillus and whether improving immune function could become part of future treatment strategies.
Can Aspergillus infection begin during tuberculosis treatment?
One of the most interesting studies came from Peru, where researchers investigated Aspergillus infection among patients receiving treatment for pulmonary tuberculosis.
Traditionally, doctors have believed that Chronic Pulmonary Aspergillosis often develops months or years after tuberculosis causes lung damage. However, this study raises the possibility that Aspergillus infection may sometimes emerge during active tuberculosis treatment itself.
This finding is important because CPA is a recognised complication of tuberculosis worldwide. If future studies confirm these findings, clinicians may need to monitor some tuberculosis patients more closely for signs of fungal infection much earlier than previously thought.
Large registry study improves understanding of ABPA risk
Researchers in Turkey analysed data from a national cystic fibrosis registry to examine how often Allergic Bronchopulmonary Aspergillosis develops and which patients are most likely to be affected.
Large registry studies are valuable because they include information from many patients over extended periods of time. This allows researchers to identify patterns that smaller studies may miss.
The study helps improve understanding of how frequently ABPA develops, which patients appear to be at greatest risk, and which factors may be associated with disease development.
ABPA can sometimes cause severe airway blockage
A striking case report described a patient whose ABPA presented with complete collapse of one lung and respiratory failure.
Although uncommon, this case highlights an important aspect of ABPA that many patients already recognise from personal experience: mucus plugging can sometimes become severe.
In ABPA, inflammation causes excessive mucus production within the airways. In some cases, thick mucus plugs can partially or completely block sections of the lung.
Improved blood tests for Chronic Pulmonary Aspergillosis
Researchers have reported new work aimed at improving Aspergillus antibody testing for Chronic Pulmonary Aspergillosis.
Diagnosis of CPA often depends on a combination of symptoms, CT scan findings, evidence of Aspergillus infection and Aspergillus antibody testing. Current blood tests are useful but not perfect. Improving their accuracy could help reduce missed diagnoses and improve confidence when diagnosing CPA.
New diagnostic technologies continue to advance
PCR testing
A clinical evaluation of a commercial Aspergillus fumigatus PCR test in patients with haematological malignancies examined how accurately the test identifies invasive pulmonary aspergillosis.
Metagenomic sequencing
Researchers also published a systematic review and meta-analysis examining metagenomic next-generation sequencing for invasive pulmonary aspergillosis.
This technology analyses genetic material from all organisms present in a sample rather than looking for a single pathogen. Although currently expensive and not widely available, it may play an increasing role in future fungal diagnostics.
Lateral flow testing
Another study evaluated a lateral flow device designed to detect Aspergillus antigens. These tests could eventually help make fungal diagnostics faster and more accessible.
New insights into galactomannan testing
Researchers investigated whether comparing galactomannan levels in bronchial washing samples and blood samples could improve diagnosis of pulmonary aspergillosis.
Galactomannan is one of the most widely used fungal biomarkers. Refining how it is interpreted may improve diagnostic accuracy and help clinicians distinguish between infection and other conditions.
Could future treatment involve strengthening the immune system?
Some of the most exciting research focused on immune-based therapies. Rather than directly targeting Aspergillus, researchers are exploring ways to improve the body's ability to fight infection.
Anti-PD-1 and interferon-gamma
A study examined emerging evidence for anti-PD-1 therapy and interferon-gamma as adjunctive immunotherapy in invasive mould infections.
These approaches aim to reverse immune exhaustion and improve natural antifungal responses. They remain experimental, but they represent an important future direction.
Enhancing neutrophil function
Another study examined how G-CSF may improve neutrophil activity during Aspergillus fumigatus infection.
Neutrophils are among the body's most important immune cells for controlling Aspergillus. Improving their function could potentially help patients whose immune systems struggle to clear fungal infections.
Therapeutic drug monitoring remains important
A case report highlighted how voriconazole blood levels changed significantly as inflammation improved during treatment.
This reinforces an important principle already recognised by specialist centres: antifungal drug levels can change over time, and therapeutic drug monitoring remains an important part of safe and effective treatment.
What does this mean for patients?
Several themes stand out from this fortnight's research.
First, researchers continue to focus heavily on earlier diagnosis. Better blood tests, improved PCR methods, lateral flow devices and sequencing technologies all aim to identify aspergillosis more accurately and more quickly.
Second, there is growing interest in understanding which patients are most at risk of developing aspergillosis. This may eventually lead to more personalised monitoring and earlier intervention.
Finally, scientists are increasingly exploring immune-based therapies. While antifungal drugs remain the foundation of treatment, future care may involve helping the immune system fight fungal infection more effectively.
When should patients seek medical advice?
Patients should seek medical advice if they experience:
- worsening breathlessness
- persistent cough
- new coughing up of blood
- unexplained weight loss
- increasing fatigue
- persistent chest symptoms despite treatment
Patients with previous tuberculosis, bronchiectasis, severe asthma or cystic fibrosis should be particularly aware of symptoms that do not improve as expected.
References
- Bigot J et al. Aspergillus serology for chronic pulmonary aspergillosis diagnosis. Journal of Clinical Microbiology, 2026. PubMed
- Demir HI et al. Yearly distribution and risk factors for ABPA in the Turkish cystic fibrosis registry. Chronic Illness, 2026. PubMed
- Gibert C et al. Clinical evaluation of a commercial Aspergillus fumigatus PCR assay. Journal of Infectious Diseases, 2026. PubMed
- Lv H et al. Diagnostic accuracy of metagenomic next-generation sequencing for invasive pulmonary aspergillosis. International Journal of Infectious Diseases, 2026. PubMed
- Madden AE et al. Prevalence and clinical implications of Aspergillus infection among tuberculosis patients in Peru. Journal of Infection, 2026. PubMed
- Medina A et al. Real-life performance of AspLFD in lower respiratory tract and serum specimens. Diagnostic Microbiology and Infectious Disease, 2026. PubMed
- Rai DK et al. ABPA presenting as unilateral lung collapse with respiratory failure. BMJ Case Reports, 2026. PubMed
- Serris A et al. Anti-PD-1 and interferon-gamma as adjunctive immunotherapy in invasive mould infections. mBio, 2026. PubMed
- Toychiev A et al. Vitamin D status and immune response in pulmonary tuberculosis patients with CPA. Tuberculosis, 2026. PubMed
- Yamaguchi K et al. Bronchial washing-to-serum galactomannan antigen ratio for pulmonary aspergillosis diagnosis. Journal of Microbiological Methods, 2026. PubMed
Last reviewed: 1 June 2026
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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.
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
Help shape the future of aspergillosis care across Uk & Europe
“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:
- ELF information on aspergillosis
- ELF Patient Advisory Groups
- ELF Aspergillosis Patient Advisory Group
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.
How Inflammation in One Part of the Body Can Affect the Rest of the Body
Last reviewed: 24 March 2026
Audience: Patients, families, and non-specialist clinicians
Author: Aspergillosis.org editorial team
Many people think of inflammation as something that stays in one place: a painful joint, an inflamed lung, an irritated sinus, or a bowel flare. In reality, inflammation is often a whole-body process. Signals released at one site can travel through the blood, nervous system, and immune system, influencing other organs and changing how the body feels and functions overall.
This helps explain why a local health problem can sometimes lead to symptoms that seem much broader, such as fatigue, poor concentration, low mood, loss of appetite, aches, disturbed sleep, or worsening of other long-term conditions.
Key points
- Inflammation is not always confined to one organ or body part.
- Inflamed tissues release chemical messengers that can circulate throughout the body.
- The brain, heart, kidneys, liver, gut, lungs, and immune system all communicate with one another.
- This “cross-talk” can be helpful in short-term illness, but harmful when inflammation becomes prolonged.
- Ongoing inflammation is linked with fatigue, brain fog, low mood, cardiovascular strain, and worsening of other chronic diseases.
Table of contents
- What is inflammation?
- Why inflammation does not always stay local
- How the body communicates during inflammation
- Common whole-body effects of inflammation
- Why this matters in lung disease and aspergillosis
- Acute inflammation versus chronic inflammation
- What can help?
- When to seek medical advice
- Common questions
- References
What is inflammation?
Inflammation is part of the body’s defence system. It is one of the ways the immune system responds to infection, injury, irritation, allergens, or tissue damage. In the short term, inflammation is often helpful. It can help the body fight infection, clear damaged tissue, and begin repair.
But inflammation can also become too strong, too prolonged, or poorly controlled. When that happens, the effects may no longer stay limited to the original problem area.
Why inflammation does not always stay local
When tissue becomes inflamed, immune cells release small signalling proteins called cytokines and other inflammatory mediators. These act like chemical messages. Some stay nearby, but many enter the bloodstream and influence distant organs.
This is why inflammation in one part of the body can sometimes cause:
- tiredness or exhaustion
- feeling unwell or “washed out”
- poor concentration or “brain fog”
- worsening appetite
- sleep disruption
- higher strain on the heart or kidneys
- worsening of other inflammatory conditions
Researchers increasingly describe this as systemic inflammation or organ cross-talk. In other words, organs do not operate in isolation. They are part of an interconnected network.
How the body communicates during inflammation
1. Chemical messengers in the blood
Inflamed tissues can release cytokines such as interleukin-6 (IL-6), interleukin-1 beta (IL-1β), and tumour necrosis factor alpha (TNF-α). These may affect blood vessels, metabolism, the brain, the heart, and other immune cells.
These signals are useful during short-term illness, but if they remain elevated they may contribute to chronic symptoms and long-term health effects.
2. Organ-to-organ immune cross-talk
Modern immunology shows that the gut, liver, lungs, brain, heart, kidneys, and bone marrow can influence one another through immune signalling. A problem in one organ may therefore alter immune behaviour somewhere else.
This can be protective, but it can also become part of a vicious circle, especially in chronic disease.
3. Nerve signalling between the body and brain
Inflammation is not communicated only by blood. The nervous system also plays a role. Signals from inflamed tissues can travel through nerves, including the vagus nerve, to the brain. The brain then responds by adjusting immune activity and body-wide stress responses.
This helps explain why inflammation can affect fatigue, mood, motivation, sleep, and mental clarity.
4. Stress, hormones, and metabolism
Inflammation also interacts with the body’s hormonal and metabolic systems. This can influence energy use, blood sugar regulation, muscle strength, and appetite. Over time, chronic inflammation may put extra strain on the cardiovascular and kidney systems.
Common whole-body effects of inflammation
Fatigue
One of the most common effects of inflammation is fatigue. This is not simply feeling sleepy. It can be a profound lack of physical and mental energy. Many chronic inflammatory illnesses are associated with this kind of exhaustion.
Brain fog and mood changes
Inflammatory signals can affect the brain, contributing to reduced concentration, slowed thinking, low motivation, anxiety, or low mood. This does not mean symptoms are “all in the mind”. It means that immune activity can influence brain function.
Heart and blood vessel effects
Inflammation can make blood vessels less healthy over time and may contribute to a higher cardiovascular risk. This is one reason why long-standing inflammatory diseases are often linked to heart and circulatory problems.
Kidney effects
The kidneys are sensitive to inflammatory stress. In some conditions, long-term systemic inflammation can contribute to kidney damage or worsen existing kidney disease. Kidney disease itself can also increase inflammation, creating a two-way relationship.
Muscle weakness and reduced stamina
Ongoing inflammation can alter how muscles use energy and recover after activity. This may contribute to weakness, reduced exercise tolerance, and slower recovery after exertion.
Why this matters in lung disease and aspergillosis
For people with chronic lung conditions, including some forms of aspergillosis, inflammation in the airways or lungs may have effects beyond breathing alone. The lungs are not separate from the rest of the body.
Inflammation in the lungs may contribute to:
- general fatigue
- poor stamina
- sleep disruption
- brain fog
- loss of appetite
- worsening of other conditions
This can be especially relevant for people living with long-term inflammatory lung disease, repeated infections, allergic inflammation, or complex treatment burdens.
It is also one reason why patients sometimes feel that their symptoms are “bigger” than what would be expected from the lungs alone. Often, that experience is real and biologically plausible.
Acute inflammation versus chronic inflammation
Acute inflammation
This is the short-term response seen with infection, injury, or a sudden flare. It may cause fever, pain, swelling, and marked tiredness. Usually, it settles when the trigger is controlled.
Chronic inflammation
This is lower-grade or persistent inflammation that continues over time. It may be driven by chronic infection, immune dysregulation, ongoing tissue damage, obesity, autoimmune disease, long-term lung disease, or other medical problems. Chronic inflammation is often less dramatic but may have broader long-term effects.
What can help?
The right approach depends on the underlying cause. Broadly, management focuses on:
- identifying and treating the cause of inflammation where possible
- controlling infections or allergic triggers
- optimising treatment of the underlying disease
- supporting sleep, nutrition, and pacing of activity
- monitoring the effects on other organs when relevant
There is rarely a single quick fix for chronic inflammation. Good management usually means looking at the whole person, not just the inflamed organ.
When to seek medical advice
Please seek medical advice if inflammation-related symptoms are worsening or if you develop:
- new or severe breathlessness
- chest pain
- confusion or marked drowsiness
- new swelling, reduced urine output, or signs of dehydration
- persistent fevers
- rapid decline in energy, mobility, or daily functioning
If symptoms are sudden, severe, or alarming, seek urgent medical help.
Common questions
Does inflammation always damage the whole body?
No. Short-term, controlled inflammation is a normal and useful response. Problems are more likely when inflammation is severe, repeated, or persistent.
Can one inflamed organ affect another?
Yes. There is now strong evidence that organs influence one another through immune, vascular, metabolic, and nerve-based pathways.
Can inflammation cause fatigue even if blood tests are not dramatically abnormal?
Yes. Symptoms and blood markers do not always match perfectly. Some people experience substantial fatigue and other systemic symptoms even when routine blood tests are only mildly abnormal or intermittently raised.
Is this relevant to chronic lung disease?
Yes. Lung inflammation can have effects that go beyond breathing, including fatigue, reduced stamina, and wider body effects.
References
- Dou J, et al. The Interplay of Cross-Organ Immune Regulation in Inflammation and Cancer. MedComm. 2025.
- Jin H, Li M, et al. A body–brain circuit that regulates body inflammatory responses. Nature. 2024.
- Katkenov N, et al. Systematic Review on the Role of IL-6 and IL-1β in Cardiovascular Diseases. Journal of Cardiovascular Development and Disease. 2024.
- Nowak KL, et al. Targeting Inflammation in CKD. Current Opinion in Nephrology and Hypertension. 2025.
- Paganin W, et al. Inflammatory biomarkers in depression: a scoping review. 2024.
- Mehta NN, et al. IL-6 and Cardiovascular Risk: A Narrative Review. 2024.
- Che H, et al. Organ cross-talk: molecular mechanisms, biological functions and therapeutic opportunities. 2026.
Disclaimer: This article is for general information and education. It is not a substitute for personalised medical advice. If you are worried about worsening symptoms, new symptoms, or the effect of inflammation on your health, speak to your clinical team.
Using AI Safely When You Have Aspergillosis
Artificial intelligence (AI) tools (for example, ChatGPT and other “medical chatbots”) can help people living with aspergillosis understand information, prepare for appointments, and feel more confident asking questions.
Used well, AI can be like a helpful explainer.
Used badly, it can be misleading — especially for conditions like aspergillosis where treatment decisions are complex.
This page explains what is safe, what is not safe, and how to use AI in a way that supports (not replaces) your clinical team.
Who is this page for?
This guidance is for people affected by:
-
Chronic Pulmonary Aspergillosis (CPA)
-
Allergic Bronchopulmonary Aspergillosis (ABPA)
-
Severe Asthma with Fungal Sensitisation (SAFS)
-
Aspergillus bronchitis
-
Other long-term Aspergillus-related lung problems
A simple rule that keeps you safe
AI should improve your understanding — it should not change your treatment.
If an AI tool suggests starting, stopping, or changing medication, do not act on it without speaking to your clinician.
What AI is good for
AI tools are usually helpful for:
Explaining medical words in plain language
Examples:
-
“What is Aspergillus Immunoglobulin G (IgG)?”
-
“What does ‘eosinophils’ mean?”
-
“What is a CT scan finding such as ‘cavity’ or ‘bronchiectasis’?”
Understanding medicines (general information)
AI can explain:
-
What a medicine is for
-
How it works in the body
-
Common side effects (in general terms)
-
Why monitoring is needed
This can be helpful for antifungal medicines such as itraconazole, voriconazole, posaconazole, and isavuconazole.
Preparing for appointments
AI can help you create a list of questions, for example:
-
“What monitoring do I need while on antifungals?”
-
“What symptoms should prompt urgent review?”
-
“How do we judge whether treatment is working?”
Summarising research articles
If you paste a paragraph from a paper (or describe it), AI can often translate it into patient-friendly language.
(Always remember: AI can sometimes get details wrong — see below.)
Organising your story
Many people find it useful to ask AI to format:
-
A timeline of symptoms
-
A list of medicines and dates
-
A short “what I want from this appointment” summary
This can make consultations more productive.
What AI is NOT safe for
AI should not be used for:
Diagnosis
Aspergillosis diagnosis usually depends on a careful combination of:
-
Symptoms and clinical history
-
Imaging (often computed tomography, CT)
-
Blood tests
-
Sputum tests / microbiology
-
Sometimes bronchoscopy results
AI cannot reliably “diagnose” from symptoms or a single test result.
Treatment decisions
Do not use AI to decide:
-
Whether you should start or stop antifungals
-
Steroid doses or tapering plans
-
Whether you “should” try biologics (for example, omalizumab)
-
Whether a side effect is safe to ignore
These decisions must be individualised and clinician-led.
Urgent situations
If you have worsening breathlessness, fever, chest pain, or coughing blood (haemoptysis), seek medical advice urgently.
AI is not an emergency service.
Why aspergillosis needs extra caution
Aspergillosis care can be complicated because:
-
Some antifungal medicines have important drug interactions
-
Blood levels may need monitoring (therapeutic drug monitoring)
-
Side effects can overlap with symptoms of lung disease
-
Different Aspergillus-related conditions can look similar but need different management
AI tools can also:
-
Over-generalise from asthma guidance
-
Confuse chronic disease with invasive disease
-
“Hallucinate” (invent) facts, references, or confident-sounding explanations
-
Be out of date
Privacy and confidentiality: what not to share with AI
To protect your privacy, avoid typing in:
-
Your full name
-
Date of birth
-
NHS number
-
Home address
-
Phone number
-
Identifiable clinic letters or reports (unless anonymised)
A safer way to write questions
Instead of pasting an entire letter, use a summary like:
“Adult with chronic lung disease, on itraconazole 200 mg daily, recent CT shows cavities, asking about monitoring and side effects.”
That’s usually enough for education and planning questions.
A safe “4-step” way to use AI
-
Ask AI to explain (terms, tests, general concepts)
-
Ask AI to help you prepare questions
-
Discuss those questions with your clinician
-
Only change treatment after clinical advice
A quick safety checklist
Before trusting an AI answer, ask:
-
Is this general education, or is it telling me what I should do?
-
Does it recommend changing my medicine or dose?
-
Does it mention checking interactions or monitoring?
-
Does it conflict with my current plan?
-
Is this situation urgent?
If any answer worries you: pause and ask your care team.
Example prompts patients can use safely
You can copy/paste these into an AI tool:
-
“Explain Chronic Pulmonary Aspergillosis (CPA) in plain language.”
-
“What questions should I ask about long-term itraconazole treatment?”
-
“What monitoring is commonly recommended for antifungal medicines?”
-
“Can you help me write a one-page symptom and medication summary for my clinic appointment?”
-
“Here is a paragraph from a research paper — can you summarise it in patient-friendly language and list any uncertainties?”
Tip: If you want a more cautious response, add:
“Please be conservative and tell me what you’re unsure about.”
Signs an AI answer may be unreliable
Be cautious if the AI:
-
Sounds very confident but gives no clear reasoning
-
Gives exact doses or taper schedules
-
Claims “this is definitely ABPA/CPA” from limited information
-
Provides references you cannot find elsewhere
-
Dismisses side effects, interactions, or monitoring
-
Encourages you to delay medical care
Final reminder
AI can be a helpful tool for understanding and preparing — but it is not a substitute for a specialist team.
If you are unsure, or something feels wrong, it is always reasonable to contact your clinician, specialist nurse, or GP.
Medical disclaimer
This page is for general information only and is not medical advice. Always follow the guidance of your healthcare team, especially regarding diagnosis, medicines, and urgent symptoms.
Looking further into the future - could we control lung damage, preserve healthy lung tissue better?
Can Lungs Repair Themselves?
What New Research Means for People with CPA (and Other Aspergillosis)
A recent scientific discovery has helped researchers understand how certain lung cells decide whether to focus on repairing damage or defending against infection. The work, highlighted by the Mayo Clinic and published in Nature Communications, describes a molecular “switch” inside specialised lung cells that influences this balance.
For people living with Chronic Pulmonary Aspergillosis (CPA) — and also those with Allergic Bronchopulmonary Aspergillosis (ABPA) — this kind of research is relevant. But it needs careful explanation.
This is not about rebuilding destroyed lungs.
It is about understanding how to better protect and preserve the lung tissue that remains.
The Discovery: A “Repair vs Defence” Switch
Researchers identified a regulatory circuit in alveolar type II (AT2) cells — specialised cells that:
-
Produce surfactant (which keeps air sacs open)
-
Act as a reserve “repair” population in the lung
-
Can regenerate other essential lung cells after injury
The study showed that these cells operate under tight control. When infection is present, they prioritise defence. When injury needs healing, they can switch into repair mode.
The key insight is that this switch is biologically regulated. It is not random. That means, in theory, it may one day be possible to influence it.
What “Repair” Means — and What It Does Not Mean
When we talk about lung repair in this context, we must be very clear.
It does not mean:
-
Lung cavities caused by CPA will close in the foreseeable future
-
Established fibrosis will melt away
-
Bronchiectasis will reverse
-
Severely distorted lung architecture will rebuild
CPA cavities represent major structural remodelling — destruction of alveoli, scarring, altered blood supply, and thickened pleura. Reconstructing that complex architecture is biologically extremely challenging and not currently realistic within the next decade.
What repair does realistically mean
In chronic lung disease, “repair” is more likely to mean:
-
Supporting survival of remaining alveoli
-
Preventing excessive fibrotic signalling
-
Helping lung lining cells recover more efficiently after inflammation
-
Reducing cumulative injury from repeated infection
-
Slowing progression of structural change
In other words:
Not rebuilding what is gone — but better protecting what remains.
For many people with CPA, this is a crucial distinction.
Why Preservation Is a Major Goal in CPA
CPA usually develops in lungs already weakened by conditions such as tuberculosis, non-tuberculous mycobacteria, chronic obstructive pulmonary disease, or severe pneumonia.
Over time, CPA can lead to:
-
Expanding cavities
-
Progressive scarring
-
Reduced gas exchange
-
Reduced exercise tolerance
Many patients have limited lung reserve. Even small additional losses of functioning lung tissue can significantly increase breathlessness or fatigue.
If future therapies could slow the rate of progression — even modestly — that would meaningfully affect long-term outcomes.
Flattening the decline curve is not trivial. It changes quality of life.
Why This Also Matters in ABPA
In ABPA, repeated inflammatory episodes can lead to:
-
Airway remodelling
-
Mucus plugging
-
Development or progression of bronchiectasis
Better control of inflammatory signalling — combined with improved epithelial recovery — could reduce long-term airway damage.
Again, this is about preservation rather than reversal.
Where Development Has Reached
The current research is still laboratory-based. It used advanced techniques such as:
-
Single-cell sequencing
-
Imaging of lung tissue
-
Preclinical models of injury
No human treatments based on this discovery are yet available.
However, the significance lies in identifying:
-
A defined molecular pathway
-
A controllable regulatory mechanism
-
A clearer understanding of why repair fails in chronic inflammation
That foundational knowledge is what eventually allows targeted drug development.
The Balance Challenge in Aspergillosis
There is an additional complexity in fungal lung disease.
Any attempt to promote repair must not weaken antifungal defence.
The immune system must:
-
Control Aspergillus
-
Avoid causing excessive inflammatory damage
Future therapies would need to strike that balance carefully.
What This Means for Patients Now
This discovery does not change current treatment.
The most effective preservation strategies today remain:
-
Consistent antifungal therapy when indicated
-
Careful inflammatory control
-
Biologic therapies where appropriate
-
Airway clearance
-
Vaccination and infection prevention
-
Avoiding damp and mould exposure
-
Pulmonary rehabilitation
These measures are already forms of lung preservation.
A Realistic and Hopeful Perspective
It is unlikely that cavities from CPA will be repaired in the near future.
It is realistic that within the next 5–10 years we may see improved strategies aimed at:
-
Slowing structural progression
-
Supporting endogenous repair cells
-
Reducing fibrotic signalling
-
Improving recovery after exacerbations
For people living long-term with CPA or ABPA, even incremental preservation could significantly affect independence and quality of life.
The science is still early — but understanding how the lung decides to repair itself is an important step forward.
Reference
Sawhney, A.S., Deskin, B.J., Cai, J. et al. A molecular circuit regulates fate plasticity in emerging and adult AT2 cells. Nat Commun 16, 8924 (2025). https://doi.org/10.1038/s41467-025-64224-1
How to Ask Fewer, Better Questions in Appointments
Focusing on what matters most to you—without feeling you’re wasting time
Many patients and carers worry about “asking too much” in clinic. Appointments are short, clinicians are busy, and you may already have a long list of questions in your head. The aim isn’t to stop asking questions—it’s to ask the right ones, at the right time, in the right way.
Here are practical strategies that help you stay focused, feel heard, and make the most of limited time.
1. Decide your Top 3 priorities before you go
Before the appointment, write down everything you’re thinking about. Then circle just three things that matter most right now.
Good priorities are usually:
-
A symptom that is new, worsening, or frightening
-
A treatment issue that affects daily life (side-effects, adherence, cost, function)
-
A decision you need to make soon
If it doesn’t change what happens in the next few weeks, it may not need airtime today.
If you remember only one thing: appointments are for decisions, not encyclopaedias.
2. Separate “need to know” from “nice to know”
It’s easy to mix curiosity with urgency.
Need to know (ask now):
-
Is this symptom important?
-
Is this treatment still right for me?
-
What should I do if X happens?
-
Are we monitoring the right things?
Nice to know (park for later):
-
Mechanisms, pathways, emerging research
-
Rare side-effects without symptoms
-
“What if” scenarios far in the future
Keep a “parking list” for later reading or discussion.
3. Frame questions around impact, not theory
Clinicians work best when questions are grounded in real life.
Instead of:
-
“I read a paper saying X might affect Y…”
Try:
-
“I’m noticing X in daily life—does that change what we do?”
-
“Is this symptom something you’d want to investigate?”
This signals relevance and helps clinicians triage quickly.
4. Ask one question at a time
Long, multi-part questions feel overwhelming and are easy to partially answer.
Break them down:
-
First: Is this important?
-
Then (if yes): What do we do about it?
-
Then (if needed): What should I watch for?
You’ll often find later questions become unnecessary once the first is answered.
5. Use the “Is this something we should…” test
This single phrase keeps questions concise and respectful of time:
-
“Is this something we should investigate?”
-
“Is this something that changes treatment?”
-
“Is this something I should worry about?”
A clear yes/no (or not yet) is often all you need.
6. Accept that not everything fits in one appointment
It’s okay—and normal—to say:
-
“I know we may not have time today—what should I prioritise?”
-
“Which of these matters most from your point of view?”
This shows partnership, not passivity.
If something needs more time, ask how best to handle it:
-
Another appointment
-
A nurse specialist
-
Written advice
-
Monitoring and review later
7. Bring written notes (but don’t read them all out)
A short list helps you stay focused under pressure.
Tip:
-
Highlight your top 3
-
Tick them off as they’re addressed
-
If time runs out, you still covered what mattered most
8. For carers: ask on behalf, not over
Carers often worry about dominating the conversation.
Helpful approaches:
-
Ask the patient first: “What do you most want answered today?”
-
Step in only if something important is being missed
-
Offer to follow up questions outside the appointment if possible
9. Reassure yourself: clinicians don’t expect perfection
You are not expected to:
-
Understand everything
-
Ask the “right” questions every time
-
Cover your entire condition in one visit
Good clinicians prefer:
a focused conversation
over
a rushed, overloaded one
10. A simple closing question that saves time
If time is tight, end with:
-
“Is there anything you think I should have asked but didn’t?”
This often surfaces the most important point of all.
The takeaway
You are not wasting time by asking questions—you’re wasting time by asking too many unfocused ones.
Clarity, prioritisation, and relevance help everyone:
-
You leave with answers that matter
-
Clinicians can make better decisions
-
Anxiety is reduced, not fuelled