Roswell Park's Infectious-Diseases Chief Surveys

[Guest guest]

Roswell Park's Infectious-Diseases Chief Surveys Forefront Of Aspergillosis

Science For New England Journal Of Medicine

Main Category: Infectious Diseases / Bacteria / Viruses

Article Date: 05 May 2009 - 6:00 PDT

http://www.medicalnewstoday.com/articles/148871.php

Medical News Today (press release) - UK

A review summing up current understanding of aspergillosis -an infection that

can attack cancer patients and others with weakened immune systems-by Brahm H.

Segal, MD, Chief of Infectious Diseases at Roswell Park Cancer Institute (RPCI),

has been published in the New England Journal of Medicine.

As Dr. Segal notes in the Journal's April 30 issue, aspergillosis is the

umbrella term for illnesses caused by spores of Aspergillus, a common fungus.

" We inhale them at work, in our back yards, almost everywhere, " he said

recently. " They're in the soil and air all around us, but, for the majority of

us, they're harmless. "

" Those at risk fall into two groups. The first includes people with severely

compromised immune systems, like patients receiving chemotherapy for leukemia,

transplant recipients, and people with rare disorders of the white blood cells,

such as chronic granulomatous disease.

" The acute, invasive form of aspergillosis usually manifests as an aggressive

pneumonia that can be difficult to treat-and may be fatal. There are also slowly

progressive forms of lung aspergillosis that generally occur in patients with

pre-existing lung disease without severe immune impairment. "

In the second category, he said, are those suffering from allergies. " They don't

have an immune deficiency, but fungi trigger a response that may show up as

severe asthma and lead to structural lung disease. "

" What I find interesting is that only a small number of people actually fall

ill. It's fascinating how well our immune systems are calibrated. We do it just

right, almost always fighting off fungi without overreacting with allergy or

excessive inflammation. "

Titled simply " Aspergillosis, " the paper reminds readers that for the past

billion years almost every form of life has evolved anti-fungus defenses.

In humans, Dr. Segal writes, epithelial cells lining the respiratory tract are

the first line of defense-a physical barrier to inhaled fungi. They gobble up

spores or clear them away with a flow of mucus. White blood cells, such as

macrophages, neutrophils and natural killer cells, also attack the fungus and

usually stop the invasion cold.

When the immune system fails, however, aspergillosis can dig in for the long

term. Leukemia patients who undergo multiple chemotherapy cycles, for instance,

are at particularly high risk.

Fortunately, he reports, effective therapies do exist. Recent developments in

diagnostic methods and antifungal therapy have led to improved outcomes,

although managing drug side effects during treatments that may last 12 weeks or

longer can present challenges. Reducing mold exposure is a key preventive step.

Antifungal agents can be administered preemptively, but may introduce drug

interaction problems or make aspergillosis harder to diagnose.

New therapies and even vaccines based on rapidly growing knowledge of immunity

mechanisms and antifungal agents are areas of active research, he writes,

suggesting that deeper understanding of both human and fungal genetics may also

offer clues to more advanced therapies.

" I was deeply honored to be invited to write this review, " he said. " I hope both

general-interest readers and frontline people who deal directly with

aspergillosis will find it to be of interest. "

Source

Roswell Park Cancer Institute

[Guest guest]

If medicine is a " universal " like music, why in the United States do we not see

statistics published in the United States about aspergillosis?

Why are the Public Health Entities not reporting publicly the numbers of this

condition as it is in the UK?

There are cases of occupational asthma reporting requirements, but where are

these numbers or are the agencies charged with our health neglecting their duty

to report to the public?

>

> Roswell Park's Infectious-Diseases Chief Surveys Forefront Of Aspergillosis

Science For New England Journal Of Medicine

> Main Category: Infectious Diseases / Bacteria / Viruses

> Article Date: 05 May 2009 - 6:00 PDT

>

> http://www.medicalnewstoday.com/articles/148871.php

>

> Medical News Today (press release) - UK