A Simple Guide for Aspergillillosis Patients and Carers**

Part of the Aspergillosis Immune System Knowledge Hub
(See also: Articles 2, 3, and 4)

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When you live with aspergillosis, asthma, bronchiectasis, or fungal allergy, the immune system plays a major role in your symptoms and how your condition behaves. This article explains the key parts of the immune system in a clear, accessible way.

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🧬 1. B Cells — the Antibody Makers

B cells produce antibodies, which act like “tags” that help the immune system recognise germs.

They make different types, including:

• IgE — triggers allergy

• IgG — provides long-term immunity and helps diagnose chronic infection

• IgA — protects the nose, throat, and gut

In Aspergillosis:

• ABPA: B cells overproduce IgE against Aspergillus.

• CPA: High Aspergillus IgG helps confirm chronic infection.

• SAFS/Bronchitis: Mixed or subtle antibody patterns.

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🧠 2. T Cells — the Immune System’s Directors

T cells guide and regulate the immune response.

Types include:

• Helper T cells (Th cells): tell B cells what antibodies to make

• Killer T cells: destroy infected or damaged cells

• Regulatory T cells: calm the immune system and prevent over-reaction

In Aspergillosis:

• ABPA: Helper T cells become overactive, driving allergic inflammation.

• CPA: T cells attempt to control fungal growth but cannot fully clear it.

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🟡 3. IgE — the Allergy Antibody

IgE causes:

• wheezing

• swelling

• itching

• mucus production

• allergic reactions

In ABPA, IgE levels become very high because the body incorrectly treats Aspergillus as a major allergen.

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🟢 4. IgG — the Memory and Detection Antibody

IgG helps the immune system remember past infections.
A raised Aspergillus IgG level is one of the main tests for CPA.

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🔥 5. Mast Cells — the Alarm Cells

Mast cells sit in the lungs, nose, sinuses, skin, and gut.
When triggered (often by IgE), they release:

• histamine

• leukotrienes

• inflammatory chemicals

This causes:

• wheezing

• chest tightness

• mucus production

• itching or burning sensations

• coughing

They are very active in ABPA and severe asthma.

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🌈 6. Histamine — Why Symptoms Feel the Way They Do

Histamine release leads to:

• swelling and redness

• increased mucus

• nerve irritation → itch, tickle, burning

• airway narrowing → wheeze and breathlessness

This explains why flare-ups can feel sudden or “out of proportion” to test results.

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🧩 7. Putting It Together: Immune Pathways in Aspergillosis

Understanding these pathways helps you and your clinical team choose the right treatments.

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Next articles:

• **Understanding your immune system
• How the Immune System Knows “Self”
• What Happens in Autoimmune Disease (Addison’s Explained)
• Eosinophils and Type-2 Inflammation in Aspergillosis
• **Where Do All These Immune Cells Live, and Where Are They Made?

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