Kusiyana pakati peABPA neCPA

Allergic broncho pulmonary aspergillosis (ABPA) uye chronic pulmonary aspergillosis (CPA) marudzi maviri akasiyana easpergillosis. Izvo zvose zvirwere zvisingaperi asi zvakasiyana mumagadzirirwo uye kazhinji kuratidzwa. Unoziva here kusiyana kwezviviri izvi?

Ichi chinyorwa chichafananidza biology, zviratidzo uye kuongororwa / kurapwa kwezvirwere zviviri izvi.

The Biology

Muchidimbu

Chikonzero chekupedzisira cheese ABPA neCPA chakatadza kubvumidzwa kwe Aspergillus spores (conidia) kubva mumapapu izvo zvinotungamirira kuchirwere. Nekudaro, iyo chaiyo nzira yekuti chirwere chinokonzereswa sei mune maviri akasiyana. Musiyano mukuru ndewekuti ABPA is allergic reaction to Aspergillus spores nepo CPA iri utachiona.

Iyi webhusaiti ine peji rega pachirwere chega chega chinogona kuwanikwa nekudzvanya aya ma link ari pazasi:

ABPA - https://aspergillosis.org/abpa-allergic-broncho-pulmonary-aspergillosis/

CPA - https://aspergillosis.org/cpa-chronic-pulmonary-aspergillosis/

Ngatitangei kutarisa ABPA. Sezvambotaurwa, ABPA inokonzerwa neallergic reaction to Aspergillus spores. Maitiro acho anowedzeredzwa ne-co-morbid zvirwere senge cystic fibrosis (CF) uye asthma. Sezvinotsanangurwa pane peji reABPA, Aspergillus maspores mukati uye mawo pachawo haakonzeri kusawirirana - nekudaro anofemerwa nemunhu wese asingazivi mazuva ese. Muvanhu vane hutano, spores inokurumidza kubviswa kubva mumapapu nemuviri. Mhedzisiro inoitika kana maspores asina kubviswa mumapapu, zvichivapa nguva yekukura uye kugadzira hyphae (yakareba-senge shinda) inoburitsa chepfu inokuvadza. Muviri unobva wagadzira allergic immune immune kune inomera spores uye hyphae. Kusawirirana uku kunosanganisira kuzvimba. Kuzvimba mhedzisiro yemaseru akawanda akasiyana edziviriro anomhanya kunzvimbo iyi kamwechete kuedza kurwisa vapambi. Ipo ichidikanwa mumhinduro inoshanda yekudzivirira muviri, inokonzeresa kuzvimba uye kushatirwa kwenzira dzemhepo, zvichigadzira zvimwe zvezviratidzo zvikuru zvine chekuita neABPA sekukosora uye kupfupika kwekufema.

Zvino ngatitarisei CPA. CPA, sezvataurwa pamusoro apa, haina kuratidzwa neallergic reaction to Aspergillus spores. Chirwere ichi hachina kujeka kuchekwa pane ABPA uye hachina kunyanya kuwanda. Izvo, zvisinei, zvinokonzerwa nemapores asina kucheneswa zvakanaka kubva mumapapu. Muchiitiko ichi, vanoisa nzvimbo yekugara mumapapu akakuvadzwa kana mapako aripo mukati memapapu uye anotanga kumera ipapo. Nzvimbo dzemapapu akakuvadzwa zviri nyore kuti utachiona hupinde sezvo kune mashoma masero ekudzivirira kudzivirira (ona kuti varwere vane CPA vanowanzove nehutachiona hunoshanda - kureva kuti havana immunocompromised). Aya makomba anowanzo mhedzisiro yezvirwere zvekare zvemapapu senge chronic obstructive pulmonary disorder (COPD) kana tuberculosis (TB).

Vamwe varwere veCPA vane akawanda ari pasi pemamiriro ezvinhu. Muchidzidzo che2011, tsanangudzo yemamiriro ezvinhu epasi pevarwere ve126 CPA muUk akaonekwa; zvakaonekwa kuti tuberculosis, non-tuberculous mycobacterial infection uye ABPA (hongu, ABPA inogona kuva nengozi yeCPA) ndiyo inonyanya kuisa njodzi yekukura kweCPA (verenga chidzidzo chakazara pano - https://bit.ly/3lGjnyK). The Aspergillus utachiona hunogona kukura munzvimbo dzakakuvadzwa mukati memapapu uye dzimwe nguva hunotanga kupinda munyama yakapoteredza. Kana izvi zvikaitika, maseru edziviriro munzvimbo dzakatenderedza anowanzo kurwisa hutachiona uye saka anorambidzwa kupinda zvachose mumapapu. Uku kupararira kwe periodic kwe Aspergillus hutachiona hunogona, zvisinei, kukuvadza tsinga dzeropa dziri pedyo zvichikonzera chimwe chezviratidzo zvikuru zvine chekuita neCPA iri kukosora ropa (hemoptysis).

Ndeapi masero ekudzivirira anoonekwa?

ABPA:

  • Sezvo ABPA ichinyanya kutapukira, mazinga eIgE antibody anokwira zvakanyanya (> 1000) sechikamu chemhinduro yealergic yemuviri. IgE inoita basa rakakosha mukusagadzikana sezvo ichikurudzira mamwe maseru edziviriro kuti asunungure makemikari anoyananisa. Aya makemikari anobatsira kubvisa allergen kubva mumuviri wako uye / kana kutora mamwe maseru edziviriro kuti abatsirewo. Imwe yeaya makemikari anozivikanwa ndeye histamine. Yese IgE mazinga uye Aspergillus-specific IgE mazinga ari maviri akasimudzwa muvarwere vane ABPA.
  • IgG antibodies kuti Aspergillus dzinowanzokwidziridzwawo; IgG ndiyo inonyanya kuzivikanwa mhando yeantibody uye inoshanda nekusunga kune Aspergillus maantigens izvo zvinotungamirira mukuparadzwa kwavo.
  • Eosinophils inogona kusimudzwa iyo inoshanda nekuburitsa makemikari ane chepfu anoparadza hutachiona hunopinda.

CPA:

  • Yakasimudzwa mazinga e Aspergillus IgG antibodies aripo
  • IgE mazinga anogona kukwidziridzwa zvishoma muvarwere veCPA, asi kwete akakwira sevarwere veABPA

zviratidzo

Nepo paine kupindirana kwezviratidzo pakati pezvirwere zviviri izvi, zvimwe zviratidzo zvinowanzoitika nemhando imwe yeaspergillosis.

ABPA inobatanidzwa neallergic zviratidzo zvakadai sekukosora uye kugadzirwa kwemachu. Kana uine asthma, ABPA inogona kukonzera kuwedzera kwezviratidzo zvako zveasthmatic (zvakadai sekufema uye kupfupika kwekufema). Kuneta, fivha uye kunzwa kwese kwekushaya simba/kurwara (malaise) kunogonawo kuvepo.

CPA haina kunyanyobatana nekugadzirwa kwemucus uye zvakanyanya nekukosora nekukosora ropa (hemoptysis). Zviratidzo zvakadai sokuneta, kufema uye kuora muviri zvinoonekwawo.

Mukuvhota paFacebook kwakaitwa neNational Aspergillosis Center, mubvunzo uyu wakabvunzwa zvakasiyana kune vanhu vane ABPA neCPA:

'Ndezvipi zvinhu zvine chokuita nemararamiro ako azvino uno zvauri kunyanya kunetseka nazvo uye zvaungada kuvandudza zvakanyanya?'

Mhinduro 5 dzepamusoro dzeABPA dzaive:

  • Kuneta
  • Kufuridzira
  • Kuchema
  • Kushaya muviri
  • Wheeze

Pamusoro 5 mhinduro dzeCPA dzaive:

  • Kuneta
  • Kufuridzira
  • Kushaya muviri
  • kufunganya
  • Kurasikirwa nehuremu / kukosora / kukosora ropa / mhedzisiro yeanorwisa-fungals (ona mhinduro idzi dzese dzakawana mavhoti akafanana)

Izvi zvinobatsira pakuenzanisa zvakananga zviratidzo zvinoshumwa kubva kuvarwere pachavo.

Kuongororwa/kurapwa

Iyo ABPA peji pane ino webhusaiti inotsanangura yakagadziridzwa yekuongorora maitiro - ona iyi link https://aspergillosis.org/abpa-allergic-broncho-pulmonary-aspergillosis/

Kuongororwa kweCPA kunoenderana neradiological uye microscopic zvakawanikwa, nhoroondo yemurwere uye bvunzo dzemurabhoritari. CPA inogona kukura kuita mafomu akasiyana akadai sechisingaperi cavitary pulmonary aspergillosis (CCPA) kana chisingaperi fibrosing pulmonary aspergillosis (CFPA) - kuongororwa kwakasiyana zvishoma kune imwe neimwe zvichienderana nezvakawanikwa neradiological. Chinhu chinonyanyozivikanwa chinowanikwa paCT scan yemurwere weCPA is aspergilloma (morphological kuonekwa kwefungal ball). Nepo ichi chiri hunhu hweCPA haigone kushandiswa yega kuona kuongororwa uye inoda aspergillus IgG yakanaka kana precipitins bvunzo yekusimbisa. Lung cavities iripo kweinenge mwedzi 3 inogona kuonekwa kana isina aspergilloma, iyo, pamwe chete neserological kana microbiological uchapupu, inogona kuratidza CPA. Mimwe miyedzo yakadai Aspergillus antigen kana DNA, biopsy inoratidza fungal hyphae pamicroscope, Aspergillus PCR, uye masampuli ekufema anokura Aspergillus mutsika dzinoratidzawo. Pamwe chete nezviratidzo zvinotsanangurwa nemurwere, musanganiswa wezviwanikwa izvi unodiwa kuti uone kuongororwa.

Kurapa kwezvirwere zviviri izvi kunowanzo sanganisira triazole therapy. Kune ABPA, corticosteroids inowanzoshandiswa kudzora mhinduro yemuviri kune spores uye itraconazole ndiyo yazvino mutsara wekutanga antifungal kurapwa. Biologics inogona kunge iri sarudzo kune avo vane yakanyanya asthma. Ona zvimwe nezve biologics pano - https://aspergillosis.org/biologics-and-eosinophilic-asthma/.

KuCPA, kurapwa kwemutsara wekutanga ndeye itraconazole kana voriconazole uye kuvhiyiwa kunogona kunge kwakakodzera kubvisa aspergilloma. Kuongororwa uye chirongwa chekurapa chinoitwa neanopa mazano ekufema.

Ndinovimba izvi zvakupa mufananidzo wakajeka pazvirwere zviviri izvi. Chinhu chikuru chekutora ndechekuti ABPA inoratidzwa nekusawirirana kune aspergillus spores nepo CPA isiri.

Yakagadziridzwa Kuwedzeredzwa muna Ndira 5, 2022 na Katy McGuinness