Severe asthma with fungal sensitization

Current Allergy and Asthma Reports

Volumn 11, Issue 5, 2011, Pages 403-413

  Agarwal, Ritesh ^a  

^a POSTGRADUATE INSTITUTE OF MEDICAL EDUCATION AND RESEARCH   (India)

Author keywords

ABPA; Allergic bronchopulmonary aspergillosis; Aspergillus; Asthma; Azoles; Itraconazole; Omalizumab; SAFS; Severe asthma with fungal sensitization

Indexed keywords

BETA 2 ADRENERGIC RECEPTOR STIMULATING AGENT; CORTICOSTEROID; FLUCONAZOLE; FUNGAL ENZYME; FUNGAL PROTEINASE; GLUCOCORTICOID; IMMUNOGLOBULIN E ANTIBODY; INTERLEUKIN 13; INTERLEUKIN 4; INTERLEUKIN 5; ITRACONAZOLE; LONG ACTING DRUG; OMALIZUMAB; PLACEBO; PYRROLE DERIVATIVE; UNCLASSIFIED DRUG;

ADRENAL INSUFFICIENCY; ALLERGENICITY; ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS; ALLERGIC REACTION; ANTIBODY PRODUCTION; ANTIFUNGAL ACTIVITY; ARTICLE; ASPERGILLUS FUMIGATUS; ASTHMA; CYTOKINE RELEASE; DIAGNOSTIC ACCURACY; DIFFERENTIAL DIAGNOSIS; DISEASE ASSOCIATION; DISEASE EXACERBATION; DISEASE SEVERITY; DRUG MEGADOSE; FUNGAL COLONIZATION; FUNGUS SPORE; GENETIC PREDISPOSITION; HUMAN; IMMUNE RESPONSE; PATHOGENESIS; PREVALENCE; SEVERE ASTHMA WITH FUNGAL SENSITIZATION; TRICHOPHYTON SENSITIVE ASTHMA;

ANIMALS; ANTI-ASTHMATIC AGENTS; ANTIBODIES, ANTI-IDIOTYPIC; ANTIBODIES, MONOCLONAL, HUMANIZED; ANTIFUNGAL AGENTS; ASPERGILLOSIS, ALLERGIC BRONCHOPULMONARY; ASTHMA; HUMANS; ITRACONAZOLE; SEVERITY OF ILLNESS INDEX;

EID: 81055157067     PISSN: 15297322     EISSN: 15346315     Source Type: Journal    
DOI: 10.1007/s11882-011-0217-4     Document Type: Article

References (110)

1. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Available at http://www.ginasthma.com/Guidelineitem. asp?l1=2&l2=1&intId=1561, 2009 update.
2. MooreWC, Bleecker ER, Curran-Everett D, et al. Characterization of the severe asthma phenotype by the National Heart, Lung, and Blood Institute's Severe Asthma Research Program. J Allergy Clin Immunol. 2007;119:405-13. (Pubitemid 46210080)
3. Antonicelli L, Bucca C, Neri M, et al. Asthma severity and medical resource utilisation. Eur Respir J. 2004;23:723-9. (Pubitemid 38618143)
4. Proceedings of the ATS workshop on refractory asthma: current understanding, recommendations, and unanswered questions. Am J Respir Crit Care Med. 2000;162:2341-51.
5. Langley SJ, Goldthorpe S, Craven M, et al. Exposure and sensitization to indoor allergens: association with lung function, bronchial reactivity, and exhaled nitric oxide measures in asthma. J Allergy Clin Immunol. 2003;112:362-8. (Pubitemid 36981377)
6. Kalliel JN, Goldstein BM, Braman SS, et al. High frequency of atopic asthma in a pulmonary clinic population. Chest. 1989;96:1336-40. (Pubitemid 20000832)
7. Miles J, Cayton R, Ayres J. Atopic status in patients with brittle and non-brittle asthma: a case-control study. Clin Exp Allergy. 1995;25:1074-82.
8. Denning DW, O'Driscoll BR, Hogaboam CM, et al. The link between fungi and severe asthma: a summary of the evidence. Eur Respir J. 2006;27:615-26. (Pubitemid 43372538)
9. Agarwal R, Gupta D. Severe asthma and fungi: current evidence. Med Mycol. 2011;49 Suppl 1:S150-7.
10. Salvaggio J, Seabury J, Schoenhardt FA. New Orleans asthma. V. Relationship between Charity Hospital asthma admission rates, semiquantitative pollen and fungal spore counts, and total particulate aerometric sampling data. J Allergy Clin Immunol. 1971;48:96-114.
11. Jenkins PF, Mullins JK, Davies BH, et al. The possible role of aero-allergens in the epidemic of asthma deaths. Clin Allergy. 1981;11:611-20. (Pubitemid 12172261)
12. Targonski PV, Persky VW, Ramekrishnan V. Effect of environmental molds on risk of death from asthma during the pollen season. J Allergy Clin Immunol. 1995;95:955-61.
13. Neas LM, Dockery DW, Burge H, et al. Fungus spores, air pollutants, and other determinants of peak expiratory flow rate in children. Am J Epidemiol. 1996;143:797-807. (Pubitemid 26119824)
14. Delfino RJ, Zeiger RS, Seltzer JM, et al. The effect of outdoor fungal spore concentrations on daily asthma severity. Environ Health Perspect. 1997;105:622-35. (Pubitemid 27405811)
15. Newson R, Strachan D, Corden J, et al. Fungal and other spore counts as predictors of admissions for asthma in the Trent region. Occup Environ Med. 2000;57:786-92.
16. Douwes J, Pearce N. Invited commentary: is indoor mold exposure a risk factor for asthma? Am J Epidemiol. 2003;158:203-6. (Pubitemid 36944412)
17. Schwartz HJ, Citron KM, Chester EH, et al. A comparison of the prevalence of sensitization to Aspergillus antigens among asthmatics in Cleveland and London. J Allergy Clin Immunol. 1978;62:9-14. (Pubitemid 8391441)
18. O'Hollaren M, Yunginger J, Offord K, et al. Exposure to an aeroallergen as a possible precipitating factor in respiratory arrest in young patients with asthma. N Engl J Med. 1991;324:359-63.
19. Peat JK, Tovey E, Mellis CM, et al. Importance of house dust mite and Alternaria allergens in childhood asthma: an epidemiological study in two climatic regions of Australia. Clin Exp Allergy. 1993;23:812-20. (Pubitemid 23327375)
20. Nelson HS, Szefler SJ, Jacobs J, et al. The relationships among environmental allergen sensitization, allergen exposure, pulmonary function, and bronchial hyperresponsiveness in the Childhood Asthma Management Program. J Allergy Clin Immunol. 1999;104:775-85. (Pubitemid 30249297)
21. Neukirch C, Henry C, Leynaert B, et al. Is sensitization to Alternaria alternata a risk factor for severe asthma? A populationbased study. J Allergy Clin Immunol. 1999;103:709-11. (Pubitemid 29295582)
22. Roux P, Smit M, Weinberg EG. Seasonal and recurrent intensive care unit admissions for acute severe asthma in children. S Afr Med J. 1993;83:177-9. (Pubitemid 23128748)
23. Niedoszytko M, Chelminska M, Jassem E, et al. Association between sensitization to Aureobasidium pullulans (Pullularia sp) and severity of asthma. Ann Allergy Asthma Immunol. 2007;98:153-6. (Pubitemid 46214220)
24. Matsuoka H, Niimi A, Matsumoto H, et al. Specific IgE response to trichophyton and asthma severity. Chest. 2009;135:898-903.
25. Fairs A, Agbetile J, Hargadon B, et al. IgE sensitisation to Aspergillus fumigatus is associated with reduced lung function in asthma. Am J Respir Crit Care Med. 2010;182:1362-8.
26. Agarwal R, Noel V, Aggarwal AN, et al. Clinical significance of Aspergillus sensitization in bronchial asthma. Mycoses. 2011; doi:10.1111/j.1439-0507.2010.01971.x.
27. Menzies D, Holmes L, McCumesky G, et al. Aspergillus sensitization is associated with airflow limitation and bronchiectasis in severe asthma. Allergy. 2011;66:679-85.
28. Maurya V, Gugnani HC, Sarma PU, et al. Sensitization to Aspergillus antigens and occurrence of allergic bronchopulmonary aspergillosis in patients with asthma. Chest. 2005;127:1252-9. (Pubitemid 46224288)
29. Zureik M, Neukirch C, Leynaert B, et al. Sensitisation to airborne moulds and severity of asthma: cross sectional study fromEuropean Community Respiratory Health Survey. BMJ. 2002;325:411-4. (Pubitemid 34969788)
30. O'Driscoll BR, Hopkinson LC, Denning DW. Mold sensitization is common amongst patients with severe asthma requiring multiple hospital admissions. BMC Pulm Med. 2005;5:4.
31. Black PN, Udy AA, Brodie SM. Sensitivity to fungal allergens is a risk factor for life-threatening asthma. Allergy. 2000;55:501-4. (Pubitemid 30230362)
32. Agarwal R, Nath A, Aggarwal AN, et al. Aspergillus hypersensitivity and allergic bronchopulmonary aspergillosis in patients with acute severe asthma in a respiratory intensive care unit in North India. Mycoses. 2010;53:138-43.
33. Agarwal R, Gupta D, Aggarwal AN, et al. Allergic bronchopulmonary aspergillosis: lessons from 126 patients attending a chest clinic in north India. Chest. 2006;130:442-8. (Pubitemid 44267011)
34. Agarwal R, Gupta D, Aggarwal AN, et al. Clinical significance of hyperattenuating mucoid impaction in allergic bronchopulmonary aspergillosis: an analysis of 155 patients. Chest. 2007;132:1183-90. (Pubitemid 47620991)
35. Agarwal R, Gupta D, Aggarwal AN, et al. Clinical significance of decline in serum IgE levels in allergic bronchopulmonary aspergillosis. Respir Med. 2010;104:204-10.
36. Agarwal R, Khan A, Gupta D, et al. An alternate method of classifying allergic bronchopulmonary aspergillosis based on high-attenuation mucus. PLoS One. 2010;5:e15346.
37. Akhunova AM. Infectious-allergic bronchopulmonary paecilomycosis. Ter Arkh. 1991;63:19-24.
38. Gondor M, Michaels MG, Finder JD. Non-aspergillus allergic bronchopulmonary mycosis in a pediatric patient with cystic fibrosis. Pediatrics. 1998;102:1480-2. (Pubitemid 28550845)
39. Agarwal R. Allergic bronchopulmonary aspergillosis. Chest. 2009;135:805-26.
40. Agarwal R, Chakrabarti A. Epidemiology of allergic bronchopulmonary aspergillosis. In: Pasqualotto AC, editor. Aspergillosis: from diagnosis to prevention. NewYork: Springer; 2009. p. 671-88.
41. Agarwal R, Aggarwal AN, Gupta D, et al. Aspergillus hypersensitivity and allergic bronchopulmonary aspergillosis in patients with bronchial asthma: systematic review and metaanalysis. Int J Tubercul Lung Dis. 2009;13:936-44.
42. Renz H, Smith HR, Henson JE, et al. Aerosolized antigen exposure without adjuvant causes increased IgE production and increased airway responsiveness in the mouse. J Allergy Clin Immunol. 1992;89:1127-38.
43. Gulbenkian AR, Egan RW, Fernandez X, et al. Interleukin-5 modulates eosinophil accumulation in allergic guinea pig lung. Am Rev Respir Dis. 1992;146:263-6.
44. Corry DB, Grunig G, Hadeiba H, et al. Requirements for allergen-induced airway hyperreactivity in T and B cell-deficient mice. Mol Med. 1998;4:344-55. (Pubitemid 28361658)
45. Agarwal R. Allergic bronchopulmonary aspergillosis: lessons learnt from genetics. Indian J Chest Dis Allied Sci. 2011;53:137-40.
46. Eaton TE, Weiner Miller P, Garrett JE, et al. Cystic fibrosis transmembrane conductance regulator gene mutations: do they play a role in the aetiology of allergic bronchopulmonary aspergillosis? Clin Exp Allergy. 2002;32:756-61. (Pubitemid 34534024)
47. Carvalho A, Pasqualotto AC, Pitzurra L, et al. Polymorphisms in Toll-like receptor genes and susceptibility to pulmonary aspergillosis. J Infect Dis. 2008;197:618-21. (Pubitemid 351321541)
48. Vicencio AG, Chupp GL, Tsirilakis K, et al. CHIT1 mutations: genetic risk factor for severe asthma with fungal sensitization? Pediatrics. 2010;126:e982-5.
49. Vicencio AG, Muzumdar H, Tsirilakis K, et al. Severe asthma with fungal sensitization in a child: response to itraconazole therapy. Pediatrics. 2010;125:e1255-8.
50. Chauhan B, Knutsen A, Hutcheson PS, et al. Tcell subsets, epitope mapping, and HLA-restriction in patients with allergic bronchopulmonary aspergillosis. J Clin Invest. 1996;97:2324-31. (Pubitemid 26165722)
51. Aron Y, Bienvenu T, Hubert D, et al. HLA-DR polymorphism in allergic bronchopulmonary aspergillosis. J Allergy Clin Immunol. 1999;104:891-2. (Pubitemid 30249316)
52. Chauhan B, Santiago L, Hutcheson PS, et al. Evidence for the involvement of two different MHC class II regions in susceptibility or protection in allergic bronchopulmonary aspergillosis. J Allergy Clin Immunol. 2000;106:723-9.
53. Knutsen AP, Vijay HM, Kumar V, et al. Mold-sensitivity in children with moderate-severe asthma is associated with HLADR and HLA-DQ. Allergy. 2010;65:1367-75.
54. Horner WE, Helbling A, Salvaggio JE, et al. Fungal allergens. Clin Microbiol Rev. 1995;8:161-79.
55. Crameri R, Glaser AG, Vilhelmsson M, et al. Overview of Aspergillus allergens. In: Pasqualotto AC, editor. Aspergillosis: from diagnosis to prevention. New York: Springer; 2009. p. 655-670
56. Kheradmand F, Kiss A, Xu J, et al. A protease-activated pathway underlying Th cell type 2 activation and allergic lung disease. J Immunol. 2002;169:5904-11. (Pubitemid 35291696)
57. Porter P, Susarla SC, Polikepahad S, et al. Link between allergic asthma and airway mucosal infection suggested by proteinasesecreting household fungi. Mucosal Immunol. 2009;2:504-17.
58. GudmundssonG, Hunninghake GW. Interferon-gamma is necessary for the expression of hypersensitivity pneumonitis. J Clin Invest. 1997;99:2386-90. (Pubitemid 27227715)
59. Tomee JF, Wierenga AT, Hiemstra PS, et al. Proteases from Aspergillus fumigatus induce release of proinflammatory cytokines and cell detachment in airway epithelial cell lines. J Infect Dis. 1997;176:300-3. (Pubitemid 27272890)
60. Tomee JF, Kauffman HF, Klimp AH, et al. Immunologic significance of a collagen-derived culture filtrate containing proteolytic activity in Aspergillus-related diseases. J Allergy Clin Immunol. 1994;93:768-78. (Pubitemid 24132433)
61. Hogaboam CM, Blease K, Schuh JM. Cytokines and chemokines in allergic bronchopulmonary aspergillosis (ABPA) and experimental Aspergillus-induced allergic airway or asthmatic disease. Front Biosci. 2003;8:e147-56.
62. Kauffman HK, Tomee JFC. Inflammatory cells and airway defense against Aspergillus fumigatus. Immunol Allergy Clin North Am. 1998;18:619-40. (Pubitemid 28369711)
63. Kauffman HF, Tomee JF, van de Riet MA, et al. Proteasedependent activation of epithelial cells by fungal allergens leads to morphologic changes and cytokine production. J Allergy Clin Immunol. 2000;105:1185-93. (Pubitemid 30418799)
64. British guideline on the management of asthma. Thorax. 2008;63 Suppl 4:iv1-121.
65. National Asthma Education and Prevention Program. Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma-Summary Report 2007. J Allergy Clin Immunol. 2007;120:S94-S138.
66. Liang KL, Su MC, Jiang RS. Comparison of the skin test and ImmunoCAP system in the evaluation of mold allergy. J Chin Med Assoc. 2006;69:3-6.
67. O'Driscoll BR, Powell G, Chew F, et al. Comparison of skin prick tests with specific serum immunoglobulin E in the diagnosis of fungal sensitization in patients with severe asthma. Clin Exp Allergy. 2009;39:1677-83.
68. Malo JL, Paquin R. Incidence of immediate sensitivity to Aspergillus fumigatus in a North American asthmatic population. Clin Allergy. 1979;9:377-84. (Pubitemid 9245434)
69. Behera D, Guleria R, Jindal SK, et al. Allergic bronchopulmonary aspergillosis: a retrospective study of 35 cases. Indian J Chest Dis Allied Sci. 1994;36:173-9.
70. Chakrabarti A, Sethi S, Raman DS, et al. Eight-year study of allergic bronchopulmonary aspergillosis in an Indian teaching hospital. Mycoses. 2002;45:295-9. (Pubitemid 35279060)
71. Agarwal R, Hazarika B, Gupta D, et al. Aspergillus hypersensitivity in patients with chronic obstructive pulmonary disease: COPD as a risk factor for ABPA? Med Mycol. 2010;48:988-94.
72. Wang JL, Patterson R, Rosenberg M, et al. Serum IgE and IgG antibody activity against Aspergillus fumigatus as a diagnostic aid in allergic bronchopulmonary aspergillosis. Am Rev Respir Dis. 1978;117:917-27. (Pubitemid 8329099)
73. Kurup VP, Banerjee B, Hemmann S, et al. Selected recombinant Aspergillus fumigatus allergens bind specifically to IgE in ABPA. Clin Exp Allergy. 2000;30:988-93. (Pubitemid 30427040)
74. Crameri R, Hemmann S, Ismail C, et al. Disease-specific recombinant allergens for the diagnosis of allergic bronchopulmonary aspergillosis. Int Immunol. 1998;10:1211-6. (Pubitemid 28362696)
75. Crameri R. Recombinant Aspergillus fumigatus allergens: from the nucleotide sequences to clinical applications. Int Arch Allergy Immunol. 1998;115:99-114. (Pubitemid 28048339)
76. Crameri R, Lidholm J, Gronlund H, et al. Automated specific IgE assay with recombinant allergens: evaluation of the recombinant Aspergillus fumigatus allergen I in the Pharmacia Cap System. Clin Exp Allergy. 1996;26:1411-9. (Pubitemid 27019797)
77. Bowyer P, Blightman O, Denning DW. Relative reactivity of Aspergillus allergens used in serological tests. Med Mycol. 2006;44 Suppl 1:23-8. (Pubitemid 44524081)
78. Bateman ED. A new look at the natural history of Aspergillus hypersensitivity in asthmatics. Respir Med. 1994;88:325-7. (Pubitemid 24167098)
79. Greenberger PA, Miller TP, Roberts M, et al. Allergic bronchopulmonary aspergillosis in patients with and without evidence of bronchiectasis. Ann Allergy. 1993;70:333-8. (Pubitemid 23110029)
80. Skov M, Main KM, Sillesen IB, et al. Iatrogenic adrenal insufficiency as a side-effect of combined treatment of itraconazole and budesonide. Eur Respir J. 2002;20:127-33. (Pubitemid 34822934)
81. Kim JH, Ahn YK. The effects of itraconazole on the immune responses in ICR mice. J Toxicol Sci. 1994;19:7-15. (Pubitemid 24104203)
82. Agarwal R, Khan A. ABPA or AFAA: that is the question? Am J Respir Crit Care Med 2011;183:1281.
83. Denning DW, Van Wye JE, Lewiston NJ, et al. Adjunctive therapy of allergic bronchopulmonary aspergillosis with itraconazole. Chest. 1991;100:813-9.
84. Agarwal R, Khan A, Aggarwal AN, et al. Is the SMART approach better than other treatment approaches for prevention of asthma exacerbations? A meta-analysis. Monaldi Arch Chest Dis. 2009;71:161-9.
85. Brusselle G, Michils A, Louis R, et al. "Real-life" effectiveness of omalizumab in patients with severe persistent allergic asthma: the PERSIST study. Respir Med. 2009;103:1633-42.
86. Walker S, Monteil M, Phelan K, et al. Anti-IgE for chronic asthma in adults and children. Cochrane Database Syst Rev. 2006:CD003559.
87. van der Ent CK, Hoekstra H, Rijkers GT. Successful treatment of allergic bronchopulmonary aspergillosis with recombinant anti- IgE antibody. Thorax. 2007;62:276-7. (Pubitemid 46579813)
88. Kanu A, Patel K. Treatment of allergic bronchopulmonary aspergillosis (ABPA) in CF with anti-IgE antibody (omalizumab). Pediatr Pulmonol. 2008;43:1249-51.
89. Zirbes JM, Milla CE. Steroid-sparing effect of omalizumab for allergic bronchopulmonary aspergillosis and cystic fibrosis. Pediatr Pulmonol. 2008;43:607-10. (Pubitemid 351813015)
90. Lebecque P, Leonard A, Pilette C. Omalizumab for treatment of ABPA exacerbations in CF patients. Pediatr Pulmonol. 2009;44:516.
91. Quintas Vazquez LM, Ortiz Piquer M, Perez de Llano LA. [Effective anti-immunoglobulin-E antibody treatment of a patient with allergic bronchopulmonary aspergillosis.]. Arch Bronconeumol. 2009;45:207.
92. Randhawa I, Chin T, Nussbaum E. Resolution of corticosteroidinduced diabetes in allergic bronchopulmonary aspergillosis with omalizumab therapy: a novel approach. J Asthma. 2009;46:445-7.
93. Thomas MF. Life-threatening allergic bronchopulomnary aspergillosis treated with methylprednisolone and anti-IgE monoclonal antibody. J R Soc Med. 2009;102 Suppl 1:49-53.
94. Brinkmann F, Schwerk N, Hansen G, et al. Steroid dependency despite omalizumab treatment of ABPA in cystic fibrosis. Allergy. 2010;65:134-5.
95. Lin RY, Sethi S, Bhargave GA. Measured immunoglobulin E in allergic bronchopulmonary aspergillosis treated with omalizumab. J Asthma. 2010;47:942-5.
96. Wark PA, Gibson PG, Wilson AJ. Azoles for allergic bronchopulmonary aspergillosis associated with asthma. Cochrane Database Syst Rev. 2003:CD001108.
97. Ward Jr GW, Woodfolk JA, Hayden ML, et al. Treatment of lateonset asthma with fluconazole. J Allergy Clin Immunol. 1999;104:541-6.
98. Denning DW, O'Driscoll BR, Powell G, et al. Randomized controlled trial of oral antifungal treatment for severe asthma with fungal sensitization: The Fungal Asthma Sensitization Trial (FAST) study. Am J Respir Crit Care Med. 2009;179:11-8.
99. Varis T, Kaukonen KM, Kivisto KT, et al. Plasma concentrations and effects of oral methylprednisolone are considerably increased by itraconazole. Clin Pharmacol Ther. 1998;64:363-8. (Pubitemid 28473761)
100. Varis T, Kivisto KT, Neuvonen PJ. The effect of itraconazole on the pharmacokinetics and pharmacodynamics of oral prednisolone. Eur J Clin Pharmacol. 2000;56:57-60. (Pubitemid 30317782)
101. Abruzzo GK, Fromtling RA, Turnbull TA, et al. Effects of bifonazole, fluconazole, itraconazole, and terbinafine on the chemiluminescence response of immune cells. J Antimicrob Chemother. 1987;20:61-8. (Pubitemid 17100057)
102. Pawelec G, Jaschonek K, Ehninger G. The anti-fungal agent itraconazole exerts immunosuppressive effects on alloreactivity but not on natural immunity in vitro. Int J Immunopharmacol. 1991;13:875-9.
103. Pawelec G, Ehninger G, Rehbein A, et al. Comparison of the immunosuppressive activities of the antimycotic agents itraconazole, fluconazole, ketoconazole and miconazole on human Tcells. Int J Immunopharmacol. 1991;13:299-304.
104. Kanda N, Enomoto U, Watanabe S. Anti-mycotics suppress interleukin-4 and interleukin-5 production in anti-CD3 plus anti- CD28-stimulated T cells from patients with atopic dermatitis. J Invest Dermatol. 2001;117:1635-46. (Pubitemid 34032798)
105. Ausaneya U, Kawada A, Aragane Y. Itraconazole suppresses an elicitation phase of a contact hypersensitivity reaction. J Invest Dermatol. 2006;126:1028-35.
106. Simitsopoulou M, Roilides E, Likartsis C, et al. Expression of immunomodulatory genes in human monocytes induced by voriconazole in the presence of Aspergillus fumigatus. Antimicrob Agents Chemother. 2007;51:1048-54. (Pubitemid 46355294)
107. Pasqualotto AC, Powell G, Niven R, et al. The effects of antifungal therapy on severe asthma with fungal sensitization and allergic bronchopulmonary aspergillosis. Respirology. 2009;14:1121-7.
108. Tucker RM, Haq Y, Denning DW, et al. Adverse events associated with itraconazole in 189 patients on chronic therapy. J Antimicrob Chemother. 1990;26:561-6. (Pubitemid 20346872)
109. Lebrun-Vignes B, Archer VC, Diquet B, et al. Effect of itraconazole on the pharmacokinetics of prednisolone and methylprednisolone and cortisol secretion in healthy subjects. Br J Clin Pharmacol. 2001;51:443-50. (Pubitemid 32852982)
110. Main KM, Skov M, Sillesen IB, et al. Cushing's syndrome due to pharmacological interaction in a cystic fibrosis patient. Acta Paediatr. 2002;91:1008-11. (Pubitemid 35168419)