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Shah A, Panjabi C. Allergic Bronchopulmonary Aspergillosis: A Perplexing Clinical Entity. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2016; 8:282-97. [PMID: 27126721 PMCID: PMC4853505 DOI: 10.4168/aair.2016.8.4.282] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 05/15/2015] [Indexed: 01/30/2023]
Abstract
In susceptible individuals, inhalation of Aspergillus spores can affect the respiratory tract in many ways. These spores get trapped in the viscid sputum of asthmatic subjects which triggers a cascade of inflammatory reactions that can result in Aspergillus-induced asthma, allergic bronchopulmonary aspergillosis (ABPA), and allergic Aspergillus sinusitis (AAS). An immunologically mediated disease, ABPA, occurs predominantly in patients with asthma and cystic fibrosis (CF). A set of criteria, which is still evolving, is required for diagnosis. Imaging plays a compelling role in the diagnosis and monitoring of the disease. Demonstration of central bronchiectasis with normal tapering bronchi is still considered pathognomonic in patients without CF. Elevated serum IgE levels and Aspergillus-specific IgE and/or IgG are also vital for the diagnosis. Mucoid impaction occurring in the paranasal sinuses results in AAS, which also requires a set of diagnostic criteria. Demonstration of fungal elements in sinus material is the hallmark of AAS. In spite of similar histopathologic features, co-existence of ABPA and AAS is still uncommon. Oral corticosteroids continue to be the mainstay of management of allergic aspergillosis. Antifungal agents play an adjunctive role in ABPA as they help reduce the fungal load. Saprophytic colonization in cavitary ABPA may lead to aspergilloma formation, which could increase the severity of the disease. The presence of ABPA, AAS, and aspergilloma in the same patient has also been documented. All patients with Aspergillus-sensitized asthma must be screened for ABPA, and AAS should always be looked for.
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Affiliation(s)
- Ashok Shah
- Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India.
| | - Chandramani Panjabi
- Department of Respiratory Medicine, Mata Chanan Devi Hospital, New Delhi, India
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Participation of T regulatory cells in equine recurrent airway obstruction. Vet Immunol Immunopathol 2014; 158:128-34. [PMID: 24503328 DOI: 10.1016/j.vetimm.2013.12.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 11/26/2013] [Accepted: 12/18/2013] [Indexed: 01/08/2023]
Abstract
Recurrent airway obstruction (RAO) is an equine immune-mediated disease with a high incidence worldwide. The aim of this work was to contribute to the understanding of RAO pathogenesis by studying T cells bearing regulatory markers in peripheral blood (PB) and in bronchoalveolar lavage fluid (BALF) recovered from the same group of susceptible horses before and after exposure to moldy hay, which has been shown to induce RAO signology in our horse herd. With this purpose, mononuclear cells were obtained from the BALF and PB from horses before and after antigenic challenge and were stained with fluorochrome-conjugated antibodies against CD4, CD25 and Foxp3 and subsequently analyzed by flow cytometry. The results indicated that the percentage of CD4+, Foxp3+ cells clearly increased in PB and BALF obtained from horses with RAO. In addition, the percentage of CD4+, CD25(high) cells was greatly augmented in BALF of RAO positive horses compared with a baseline. No changes were observed in the PB compartment. The percentage of CD4+, CD25(high), Foxp3+ cells in BALF increased in horses with active disease compared to horses in remission; this cell population also does not show changes in the PB compartment when RAO positive and RAO negative horses were compared. On the other hand, when the percentage of CD4, Foxp3 positive cells were compared with the percentage of CD4+, CD25(high) cells, the numbers were very similar. This observation was true for PB and BALF cells from non exposed horses as well as horses exposed to antigen. In all the experimental situations studied, the population expressing all of the markers CD4+, CD25(high), Foxp3+ represent only a minor percentage of CD4+, CD25(high) or CD4+, Foxp3 subpopulations; therefore, an significant number of CD4+, CD25(high), Foxp3- and CD4+, CD25(null), Foxp3+ cells must exist. Finally, we conclude that horses with RAO show an airway accumulation of T cells bearing regulatory markers that probably are modulating the course of this disease, and that these T cells may be involved in the resolution of immune-mediated bronchial inflammation.
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Upadhyay SK, Shankar J, Singh Y, Basir SF, Madan T, Sarma PU. Expressed sequence tags of Aspergillus fumigatus: Extension of catalogue and their evaluation as putative drug targets and/or diagnostic markers. Indian J Clin Biochem 2009; 24:131-6. [PMID: 23105821 DOI: 10.1007/s12291-009-0024-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Aspergillus fumigatus a fungal pathogen is implicated in a spectrum of allergic and invasive disorders in humans. Validation of transcriptome of pathogen is essential for understanding its virulence mechanism and to identify new therapeutic targets/diagnostic markers. In order to rapidly identify genes of Aspergillus fumigatus we adopted sequencing of cDNA clones. Our earlier effort has lead to identification of 68 expressed sequence tags of Aspergillus fumigatus. Present study describes 52 more expressed sequence tags generated by sequencing 200 phage clones of a non-normalized cDNA library. One of the cDNA clones comprised of the complete coding region for tetratricopeptide repeat domain protein gene. Various homology search algorithms were employed to assign functions to expressed sequence tags coding for hypothetical proteins, and relevance of these expressed sequence tags or their protein products as drug targets/diagnostic markers was examined by searching for homologues in fungi and human.
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Affiliation(s)
- Santosh Kumar Upadhyay
- Institute of Genomics and Integrative Biology, Mall road, Delhi, 110007 India ; Department of Biosciences, Jamia Millia Islamia, New Delhi, 110025 India
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Abstract
PURPOSE OF REVIEW Allergic bronchopulmonary aspergillosis is an immunologically mediated lung disease that is caused by hypersensitivity to antigens of the genus Aspergillus. This review summarizes the clinical presentation, radiologic profile, lung functions and immunologic studies on allergic bronchopulmonary aspergillosis from India. Data regarding Aspergillus sensitization in asthmatics are presented. The association of allergic bronchopulmonary aspergillosis with allergic Aspergillus sinusitis and aspergilloma is also highlighted. RECENT FINDINGS Allergic bronchopulmonary aspergillosis is now an emerging disease in India. Sensitization to Aspergillus antigens is not uncommon in our patients with asthma. Although asthma commenced in these subjects in their early 20s, allergic bronchopulmonary aspergillosis was recognized more than a decade later. Allergic bronchopulmonary aspergillosis can also occur in patients without clinical asthma. Radiology is crucial to the diagnosis of allergic bronchopulmonary aspergillosis. The remarkable radiological similarity to pulmonary tuberculosis has important clinical implications in our country as patients with allergic bronchopulmonary aspergillosis often receive antituberculous therapy for a long time. Although oral corticosteroids still remain the cornerstone for management, itraconazole has emerged as an adjunct therapy in appropriate situations. Concomitant occurrence of allergic bronchopulmonary aspergillosis and allergic Aspergillus sinusitis is now being increasingly recognized. SUMMARY All asthmatic subjects with a positive skin prick test to Aspergillus antigens must be evaluated for allergic bronchopulmonary aspergillosis and allergic Aspergillus sinusitis should be excluded.
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Affiliation(s)
- Ashok Shah
- Department of Respiratory Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India.
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Kamal N, Chowdhury S, Madan T, Sharma D, Attreyi M, Haq W, Katti SB, Kumar A, Sarma PU. Tryptophan residue is essential for immunoreactivity of a diagnostically relevant peptide epitope of A. fumigatus. Mol Cell Biochem 2005; 275:223-31. [PMID: 16335802 DOI: 10.1007/s11010-005-2056-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The role of tryptophan (Trp17) in immunoreactivity of P1, the diagnostically relevant peptide from a major allergen/antigen of Aspergillus fumigatus, was evaluated by chemically modifying tryptophanyl residue of P1. In BIAcore kinetic studies, unmodified P1 showed a 100-fold higher binding with ABPA (Allergic Bronchopulmonary Aspergillosis) patients' IgG [KD (equilibrium dissociation constant) = 2.74 e(-8) +/- 0.13 M] than the controls' IgG (KD = 2.97 e(-6) +/- 0.14 M), whereas chemically-modified P1 showed similar binding [KD patients' IgG = 3.25 e(-7) +/- 0.16 M, KD controls' IgG = 3.86 e(-7) +/- 0.19 M] indicating loss of specific immunoreactivity of P1 on tryptophan modification. Modified P1 showed loss of specific binding to IgE and IgG antibodies of ABPA patients in ELISA (Enzyme-Linked Immunosorbent Assay). The study infers that tryptophan residue (Trp17) is essential for immunoreactivity of P1.
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Affiliation(s)
- Neel Kamal
- Institute of Genomics and Integrative Biology, Mall Road, Delhi, India
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Shankar J, Nigam S, Saxena S, Madan T, Sarma PU. Identification and Assignment of Function to the Genes of Aspergillus fumigatus Expressed at 37 oC. J Eukaryot Microbiol 2004; 51:428-32. [PMID: 15352325 DOI: 10.1111/j.1550-7408.2004.tb00390.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Aspergillus fumigatus, a fungal pathogen, causes a spectrum of allergic and invasive disorders. In order to rapidly identify genes of this fungus relevant for pathogenesis and as potential antifungal drug targets, 125 expressed sequence tags (ESTs) were generated from 200 phage clones of a non-normalized cDNA library. Out of a novel 68 ESTs, 45 were assigned putative functions based on the sequence similarity. The identities of some of these genes suggest that they may be involved in pathogenesis or autoimmune reactions. Additional genes were identified that are possible targets for the development of antifungal drugs or that may be of use in diagnosing fungal infections.
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Affiliation(s)
- Jata Shankar
- Molecular Biochemistry and Diagnostics Division, Institute of Genomics and Integrative Biology, Council for Scientific and Industrial Research, Mall Road, Delhi 110007, India
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Priyadarsiny P, Swain PK, Sarma PU. Expression and characterization of Asp fI, an immunodominant allergen/antigen of A. fumigatus in insect cell. Mol Cell Biochem 2004; 252:157-63. [PMID: 14577589 DOI: 10.1023/a:1025594620152] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Asp fI is a major allergen/antigen/cytotoxin of Aspergillus fumigatus and exhibits ribonuclease activity. This allergen plays a role in allergic and invasive Aspergillosis and reported as a major cytotoxin with ribonuclease activity. To express the protein in large quantity and to characterize the multifunctional nature of Asp fI, we have generated recombinant baculovirus by introducing the gene in pFastBac HTa expression vector and expressed in insect cell. The baculovirus expression vector system has been used as a versatile system for the efficient expression of proteins with most eukaryotic posttranslational modification. Recombinant Asp fI was expressed as approximately 1% of the total cellular protein in infected Sf9 insect cells. The protein was purified using Ni2+ affinity column chromatography and the yield of purified protein was approximately 10 mg/l g of total cellular protein. Immunoreactivity of the protein was determined by immunoblot analysis using both poly His monoclonal antibody, IgG and IgE antibodies present in the sera of ABPA patients. The protein was glycosylated as revealed by the glycoprotein staining and was observed to retain both ribonuclease and cytotoxic activities. These results suggest that Asp fI expressed in insect cell was post translationally modified and biologically active that can be used as a diagnostic marker for biochemical studies.
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Saxena S, Madan T, Muralidhar K, Sarma PU. cDNA cloning, expression and characterization of an allergenic L3 ribosomal protein of Aspergillus fumigatus. Clin Exp Immunol 2003; 134:86-91. [PMID: 12974759 PMCID: PMC1808839 DOI: 10.1046/j.1365-2249.2003.02257.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aspergillus fumigatus (Afu) is an important fungal pathogen causing allergic and invasive respiratory disorders. A plethora of multi-functional allergens/antigens secreted by Afu have been implicated in pathogenesis. The present study was undertaken to identify and characterize novel Afu allergen/antigen by cDNA library approach. cDNA library of Afu was immunoscreened with pooled sera of allergic bronchopulmonary aspergillosis (ABPA) patients. The cDNA clone, TS1, reacting significantly with specific IgG antibodies, was selected. cDNA was subcloned and expressed in Escherichia coli. Sequencing of the cDNA revealed an open reading frame (ORF) of 1179 bases coding for a protein with an approximate molecular weight of 44 kDa. Immunoreactivity of the recombinant TS1 protein (rTS1) was evaluated by ELISA and Western blot analysis using pooled sera of ABPA patients. The rTS1 exhibited binding to specific IgG and IgE antibodies present in sera of ABPA patients. The deduced amino acid sequence showed homology to 60S ribosomal protein L3 (RpL3) of Aspergillus nidulans, Saccharomyces cerevisiae and Homo sapiens. The RpL3 of S. cerevesiae, tcm1, to which TS1 sequence shows significant homology (72% identity), is known to be responsible for conferring resistance against trichodermin (antibiotic, inhibiting protein synthesis). The present study has led to identification, cloning and expression of a 44-kDa novel allergen/antigen of Afu with sequence homology to L3 ribosomal protein with a probable role in resistance of Afu to antifungal drugs. Sixty-four per cent sequence identity of Afu RpL3 with human RpL3 and common regions in their predicted epitopes suggest a possibility of involvement of Afu RpL3 in autoimmune reactions due to molecular mimicry.
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Affiliation(s)
- S Saxena
- Institute of Genomics and Integrative Biology, Delhi, India
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Shah A, Panjabi C. Allergic bronchopulmonary aspergillosis: a review of a disease with a worldwide distribution. J Asthma 2002; 39:273-89. [PMID: 12095177 DOI: 10.1081/jas-120002284] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Allergic bronchopulmonary aspergillosis (ABPA), an immunologically mediated lung disease, occurs predominantly in patients with asthma. This chronic relapsing disorder ranges clinically from mild asthma to fatal destructive lung disease and is caused by hypersensitivity to colonized Aspergillus fumigatus (Af). The immunopathogenesis of the disease is yet to be understood clearly. Specific IgE-Af and IgG-Af, the serological markers, contribute to the diagnosis. Radiologically, ABPA is characterized by fleeting pulmonary infiltrates often confused with pulmonary tuberculosis. However, central bronchiectasis on computed tomography is considered to be the hallmark of the disease. Early diagnosis and therapy with prednisolone, the cornerstone of management, could alter the course of the disease and prevent the development of end-stage lung fibrosis.
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Affiliation(s)
- Ashok Shah
- Department of Respiratory Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, India.
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Svirshchevskaya EV, Alekseeva L, Marchenko A, Viskova N, Andronova TM, Benevolenskii SV, Kurup VP. Immune response modulation by recombinant peptides expressed in virus-like particles. Clin Exp Immunol 2002; 127:199-205. [PMID: 11876740 PMCID: PMC1906341 DOI: 10.1046/j.1365-2249.2002.01776.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aspergillus fumigatus, a ubiquitous fungus, is implicated in the pathogenesis of a number of clinically different allergic diseases in man, including allergic bronchopulmonary aspergillosis. Peptide-based immunotherapy may offer an alternative treatment strategy for the management of allergic disease. The objective of this study was to alter the allergen-specific immune response using dominant T cell epitopes of a major A. fumigatus allergen, Asp f2, expressed in yeast as virus-like particles (VLP). The T cell epitopes of Asp f2, recognized in mice with an H-2d background, were determined by producing T-cell hybridomas. Two dominant T cell epitopes, aa60--71 and aa235--249, were identified and expressed in a yeast VLP system. To induce tolerance VLP-peptides were injected subcutaneously into mice previously immunized with recombinant Asp f2. The T cell immune response was abrogated totally in 3 weeks following a single injection of VLP but was restored 2 months later following intranasal antigen exposure. T-cell depletion resulted in the reduction of 20-30% of all antigen-specific immunoglobulin classes. Thus, recombinant peptides expressed in the VLP system can be used successfully in the modulation of Asp f2-induced immune response in mice, although a single administration is not sufficient to maintain a state of tolerance for a long period of time.
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Affiliation(s)
- E V Svirshchevskaya
- Shemyakin and Ovchinnikov Institute of Bioorganic Chemistry, RAS, Moscow, Russia.
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Sarma PU, Sarma PVGK, Madan T. Challenges in prevention, diagnosis and therapy of emerging fungal diseases. Aspergillosis: A case study. Indian J Clin Biochem 2000; 15:43-50. [PMID: 23105267 PMCID: PMC3454083 DOI: 10.1007/bf02867543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Diseases caused by pathogenic filamentous fungi, are an emerging threat to public health in the wake of increasing incidence of HIV and tuberculosis. At this point, discovery and development of fungal therapeutics and diagnostics are serious challenges for biomedical researchers. Recent technological advances in genomics and proteomics offer great scope for development of preventive and therapeutic measures for fungal diseases.Aspergillus, one of the medically important filamentous pathogenic fungi causes a wide spectrum of clinical disorders ranging from allergic aspergillosis to systemic invasive aspergillosis. Increase in incidence of drug resistance and the cytotoxic effects are two serious limitations of the antifungal drugs presently in use. This is primarily due to lack of understanding of biological mechanisms operative in these fungi. Today, it is possible to understand the biological mechanisms of the fungus for its colonisation, survival and invasion of the host. Future developments based on such leads can result in development of precise and specific diagnostic, therapeutic and preventive measures for a wide clinical spectrum of fungal diseases.
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Affiliation(s)
- P. Usha Sarma
- Centre for Biochemical Technology, Mall Road, 110007 Delhi, India
| | - P V G K Sarma
- Department of Biochemical Technology, Sri Venkateswara College, Dhaula Kuan, 21 New Delhi
| | - Taruna Madan
- Centre for Biochemical Technology, Mall Road, 110007 Delhi, India
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