ABPA (Allergic Bronchopulmonary Aspergillosis) ke lefu le tebileng la ho hana le bakoang ke tšoaetso ea fungal ea litsela tsa moea. Batho ba nang le ABPA hangata ba na le asthma e matla le ho phatloha khafetsa hoo hangata ho hlokang tšebeliso ea nako e telele ea li-oral steroids le lithibela-mafu ho alafa tšoaetso ea bobeli ea baktheria.
Liphekolo tse peli tsa mantlha tsa ABPA ke meriana ea antifungal le molomo steroids. Meriana ea antifungal e sebetsa ka ho shebana le li-fungus tse bakang tšoaetso, ho fokotsa kholo ea eona le ho ata. Sena se ka thusa ho fokotsa khafetsa ea ho phatloha le ho tsitsisa boemo empa hape se ka baka litlamorao joalo ka ho nyekeloa ke pelo, 'me, ka seoelo, ho senyeha ha sebete. Oral steroids e sebetsa ka ho fokotsa ho ruruha le ho hatella karabelo ea sesole sa 'mele ho allergen, e ka thusang ho laola matšoao a ABPA. Leha ho le joalo, tšebeliso ea nako e telele e ka baka litla-morao tse kholo, tse kenyelletsang boima ba 'mele, ho feto-fetoha ha maikutlo le ho se sebetse hantle ha adrenal.
Litla-morao tsena li ka ama boleng ba bophelo haholo, empa liphekolo ka bobeli li ka hlokahala ho thibela lefu lena hore le se ke la mpefala. Ka hona, ho hlokahala liphekolo tse ncha kapa tse ntlafalitsoeng.
Ka lehlohonolo, ho bile le tsoelo-pele ea morao-rao ea ho laola ABPA, 'me tlhahlobo ea Richard Moss (2023) e totobatsa mefuta e' meli e tšepisang ea phekolo:
- Meriana ea antifungal e huloang alafa mafu a fungal matšoafong ka ho isa moriana ka kotloloho sebakeng sa tšoaetso. Sena se lumella hore motsoako o phahameng oa lithethefatsi o isoe sebakeng se amehileng ha o ntse o fokotsa ho pepeseha ha 'mele oohle' me kahoo o fokotsa litla-morao. Mohlala, itraconazole e hahelletsoeng e bonts'itsoe hore e fihla maemong a holimo ho lekana ho bolaea kapa ho thibela kholo ea fungus. Liteko tse ling li tla phethoa selemong sena (2023) ho hlahloba polokeho le katleho ea eona. Le hoja e ntse e tsoela pele, lithethefatsi tsena li fana ka tšepo bakeng sa mekhoa ea phekolo e sebetsang haholoanyane le e mamelloang hamolemo bakeng sa bakuli ba nang le ABPA.
- Biologic meriana ke mofuta o mocha ka ho feletseng oa phekolo o sebelisang li-antibodies tsa maiketsetso ho lebisa liseleng tse itseng kapa liprotheine tsa tsamaiso ea rona ea 'mele ea ho itšireletsa mafung ho e-na le ho sebelisa motsoako oa lik'hemik'hale. Omalizumab, mofuta oa biologic, e tlama ho immunoglobulin IgE le ho e thibela. IgE e kenya letsoho karabelong ea 'mele ea rona khahlanong le bahlaseli ba kantle ho naha mme e bapala karolo e kholo matšoao a ABPA. Ho bonahetse ho tima IgE ho fokotsa matšoao a ho kula. Litekong tsa bongaka, omalizumab e bontšitsoe haholo (a) e fokolitse palo ea li-flare-ups ha e bapisoa le kalafo ea pele, (b) e fokolitse tlhoko ea tšebeliso ea oral steroid le ho theola lethal dose le hlokahalang, (c) ho eketseha ha li-steroids, d) ho ntlafatsa tšebetso ea matšoafo le (e) ho ntlafatsa taolo ea asthma. Ho feta moo, li-antibodies tse ling tsa Monoclonal (Mabs) tse kang mepolizumab, benralizumab le dupilumab li bontšitse phokotso ea li-flare-ups, kakaretso ea IgE le phello ea steroid-sparing.
Ho ea ka Moss (2023), mekhoa ena e mecha ea phekolo e sebetsa haholo ho fokotsa maeto a lipetlele. Li-biologics li bonahala li sebetsa haholo, ka ho fokotsa ho fihla ho 90% ea ho phatloha ho hoholo ho bakuli ba ABPA le ho fihla ho 98% ea katleho ea ho fokotsa palo ea steroid ea molomo e hlokoang ke mokuli. Haeba liphekolo tsena tse ncha li tsoela pele ho sebetsa hantle, li ka fana ka bophelo bo bocha, bo holimo ho batho ba nang le ABPA. Ka kakaretso, liphetho tsena lia ts'episa, empa lipatlisiso tse ling lia hlokahala ho netefatsa katleho ea liphekolo tsena ka ho khetheha bakeng sa ABPA.
Pampiri ea mantlha: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9861760/