{"doi":"10.2147/jir.s546322","title":"Asthma and Allergic Bronchopulmonary Aspergillosis: Understanding, Insights, and State-of-the-Art","abstract":null,"journal":"Journal of Inflammation Research","year":2026,"id":622798,"datarank":0.20794415416798362,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"self_citation_contribution":0.20794415416798362,"citation_network_contribution":0.0,"self_endowment_contribution":0.20794415416798362,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1609356,"name":"Valliappan Muthu","orcid":null,"position":1,"is_corresponding":false},{"id":1609357,"name":"Inderpaul Sehgal","orcid":null,"position":2,"is_corresponding":false},{"id":1609358,"name":"Ritesh Agarwal","orcid":"0000-0003-2547-7668","position":3,"is_corresponding":false},{"id":819879,"name":"Puneet Saxena","orcid":"0000-0003-1111-1008","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Asthma and Allergic Bronchopulmonary Aspergillosis: Understanding, Insights, and State-of-the-Art","abstract":"Abstract: Allergic bronchopulmonary aspergillosis (ABPA) is a severe asthma endotype arising from dysregulated immune responses to Aspergillus fumigatus in susceptible individuals. ABPA is characterized by exaggerated type 2 immune responses, markedly elevated serum total IgE and A. fumigatus -specific IgE and IgG levels, peripheral blood eosinophilia, and imaging abnormalities, including bronchiectasis and mucus impaction. Genetic predisposition involving HLA genotypes and immune-related polymorphisms contributes to disease susceptibility. The 2024 International Society of Human and Animal Mycology guidelines provide standardized criteria that integrate clinical, immunological, and radiological parameters to identify ABPA and distinguish it from overlapping diagnoses. Management employs a dual approach: anti-inflammatory therapy with systemic corticosteroids targets dysregulated immunity, while antifungal therapy with triazoles reduces airway fungal burden. The relapsing-remitting disease course necessitates systematic monitoring using clinical assessment, total IgE levels, and serial imaging to detect relapses, distinguish them from asthma exacerbations or infections, and optimize treatment intensity. Despite substantial progress in understanding the pathobiology of ABPA, high-quality evidence for optimal management strategies remains limited. Future research should focus on precision medicine approaches, novel biomarkers, and inhaled antifungal therapies to improve outcomes in this severe asthma phenotype. This review provides clinicians with comprehensive information on the pathobiology, diagnosis, classification, and evidence-based management strategies for ABPA, aiming to improve outcomes for patients with this severe asthma endotype. Plain Language Summary: Allergic bronchopulmonary aspergillosis (ABPA) is a serious lung condition that develops in some asthma patients when the common environmental mould Aspergillus fumigatus persists in the airways. The fungus is found everywhere in the environment, but most people tolerate exposure without problems. However, individuals with ABPA develop excessive immune responses to the fungus, causing severe asthma symptoms and progressive damage to the airways (bronchiectasis). ABPA affects approximately 11% of asthma patients worldwide and represents one of the most serious asthma phenotypes. Unlike typical asthma, which responds well to inhaled steroids, ABPA often requires treatment with oral corticosteroids or antifungal medications (or both) to control both the immune overreaction and the fungal burden in the lungs. Early diagnosis is crucial in preventing irreversible lung damage. Diagnosis requires demonstrating sensitization to the fungus by blood tests showing elevated total IgE levels and Aspergillus -specific antibodies, combined with elevated eosinophils and characteristic findings on lung imaging, such as bronchiectasis. Universal screening of all asthma patients for fungal sensitization enables early detection, timely treatment, and prevents disease progression. Early treatment with oral corticosteroids or antifungal medications can prevent progressive lung damage and improve long-term outcomes. Because ABPA tends to relapse, patients require regular monitoring with blood tests measuring IgE levels and periodic lung imaging to detect relapses early and adjust treatment intensity accordingly. This comprehensive approach ensures better disease control and quality of life for ABPA patients. Keywords: allergic bronchopulmonary aspergillosis, asthma, triazoles, bronchiectasis, Aspergillus","is_dataset_classified":null,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"41835114","pmcid":"PMC12988663","openalex_id":"https://openalex.org/W7134229027","authors":[],"funders":[],"total_grants":0,"fwci":22.9961,"citation_percentile":0.99405391,"influential_citations":0,"citation_trend":[{"year":2026,"count":3}],"oa_status":"gold","license":"cc-by-nc","oa_locations":[{"url":"https://www.dovepress.com/article/download/112851","host_type":"journal"},{"url":"https://www.dovepress.com/article/download/112851","host_type":"publisher"},{"url":"https://doi.org/10.2147/jir.s546322","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/41835114","host_type":"repository"},{"url":"https://www.dovepress.com/asthma-and-allergic-bronchopulmonary-aspergillosis-understanding-insig-peer-reviewed-fulltext-article-JIR","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12988663/","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC12988663","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC12988663?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Antifungal resistance and susceptibility","Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis","Asthma and respiratory diseases"],"mesh_terms":[],"keywords":["Asthma","Respiratory disease","Allergy","Immunopathology","Allergic asthma","Aspergillus","Bronchiectasis","Triazoles","Allergic Bronchopulmonary Aspergillosis"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Zero hunger"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"refsnp"},{"name":"doi"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-03T21:03:49.761000Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}