Serum Cytokine Changes in a Patient with Chronic Pulmonary Aspergillosis Overlapping with Allergic Bronchopulmonary Aspergillosis: A Case Report

Yusei Tsukamoto; Yuya Ito; Yasushi Obase; Takahiro Takazono; Nana Nakada; Nobuyuki Ashizawa; Tatsuro Hirayama; Kazuaki Takeda; Shotaro Ide; Naoki Iwanaga; Masato Tashiro; Naoki Hosogaya; Susumu Fukahori; Chizu Fukushima; Katsunori Yanagihara; Koichi Izumikawa; Hiroshi Mukae

doi:10.2169/internalmedicine.2234-23

Serum Cytokine Changes in a Patient with Chronic Pulmonary Aspergillosis Overlapping with Allergic Bronchopulmonary Aspergillosis: A Case Report

Intern Med. 2023 Oct 27. doi: 10.2169/internalmedicine.2234-23. Online ahead of print.

Authors

Yusei Tsukamoto¹, Yuya Ito¹, Yasushi Obase^{1

2}, Takahiro Takazono^{1

3}, Nana Nakada¹, Nobuyuki Ashizawa^{1

4}, Tatsuro Hirayama⁵, Kazuaki Takeda¹, Shotaro Ide^{1

6}, Naoki Iwanaga¹, Masato Tashiro^{1

3

4}, Naoki Hosogaya⁷, Susumu Fukahori¹, Chizu Fukushima⁷, Katsunori Yanagihara⁸, Koichi Izumikawa^{3

4}, Hiroshi Mukae^{1

2}

Affiliations

¹ Department of Respiratory Medicine, Nagasaki University Hospital, Japan.
² Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan.
³ Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Japan.
⁴ Infection Control and Education Center, Nagasaki University Hospital, Japan.
⁵ Department of Pharmacotherapeutics, Nagasaki University Graduate School of Biomedical Sciences, Japan.
⁶ Infectious Diseases Experts Training Center, Nagasaki University Hospital, Japan.
⁷ Clinical Research Center, Nagasaki University Hosipital, Japan.
⁸ Department of Laboratory Medicine, Nagasaki University Hospital, Japan.

PMID: 37899245
DOI: 10.2169/internalmedicine.2234-23

Abstract

Allergic bronchopulmonary aspergillosis (ABPA) and chronic pulmonary aspergillosis (CPA) are diseases caused by Aspergillus infection, and CPA can develop from ABPA in some cases. We herein report a patient with CPA overlapping with ABPA. Serum cytokine levels were evaluated at 4 time points: the ABPA diagnosis, CPA diagnosis, 6 months after the start of voriconazole (VRCZ), and 12 months after re-administration of VRCZ. Interleukin (IL)-13 levels decreased upon glucocorticoid treatment, whereas IL-25 and IL-33 levels decreased rapidly with the initiation of antifungals. Early antifungal therapy may be important to control disease progression and prevent CPA overlap.

Keywords: Allergic bronchopulmonary aspergillosis (ABPA); IL-10; IL-33; chronic pulmonary aspergillosis (CPA).