Aspergillus Newsletter
December 2013

FDA Approves NOXAFIL Delayed Release Tablets - Posaconazole Dosing is Now Once Per Day!

A new form of posaconazole that will only have to be taken once per day and will then be slowly released into the bloodstream should make life easier for the patient as they can now take a dose at the most convenient time of day for them. It might also make it less likely that a dose will be forgotten. 
 
A slow and steady release of the drug in the new tablet increases absorption and reliability. Drug levels in the bloodstream are higher than with posaconazole liquid and so problems of low levels should be greatly minimised. Drug levels should be more predictable. Effective drug level management is known to have an impact on some outcomes when used to treat aspergillosis - this new drug formulation should be beneficial.
 
 
News
Death of Fred Sanger
 
Fred Sanger can reasonably be referred to as the 'Father of Genomics' as it was he who invented the method by which the world was able to read the sequence of bases in a strand of DNA. He also invented improvements ('shotgun sequencing') on his original technique which enabled us to read vast lengths of DNA and ultimately entire genomes.
 
Starting with a 5400base pair virus genome (sequenced by himself in 1977) Sanger's techniques were used to sequence the yeast genome (12.5 million base pairs in 1996) and then the achievement that may well benefit us all in the future, the Human Genome Project (3 billion base pairs completed in 2001).
 
Sanger was awarded his second Nobel Prize in 1980 for his work on DNA sequencing (the first awarded for the first sequencing of a protein in 1958). He is one of four people ever to have been awarded two Nobel Prizes and the only person to win it twice for chemistry.
 
The Human Genome Project has been run at The Sanger Institute in Cambridge, UK since 1992 and fittingly is one of the largest and most successful Genomic research centres in the world.
 
Genomic Research and the Human Genome Project are providing the tools to revolutionise medicine and research. Those advances have been built on the foundations provided by Fred Sanger.
 
Articles
 
NOTE access to all articles now requires registration
 
Here, we demonstrate that TLR4 is activated by airway proteinase activity to initiate both allergic airway disease and antifungal immunity. These outcomes were induced by proteinase cleavage of the clotting protein fibrinogen, yielding fibrinogen cleavage products that acted as TLR4 ligands on airway epithelial cells and macrophages. Thus, allergic airway inflammation represents an antifungal defensive strategy that is driven by fibrinogen cleavage and TLR4 activation. These findings clarify the molecular basis of allergic disease and suggest new therapeutic strategies.
 
CONCLUSION: CT-guided lung biopsy/FNAC can allow the definitive diagnosis of fungal pneumonia in selected patients with various hematological diseases and should be attempted whenever clinically indicated and radiologically feasible.
Related content: Also see A fine needle biopsy of the lung 
 
CONCLUSIONS/SIGNIFICANCE: We have developed and applied a fast, specific and efficient gene silencing approach for elucidating gene function in A. nidulans using d-siRNAs. We have also optimized an efficient A. tumefaciens-mediated transformation (AMT) in A. nidulans, which is useful for stable integration of transgenes.
 
Conclusions: Patients with ACLF and IPA have a high mortality rate. Patients with ACLF who present with encephalopathy should avoid steroids, as they increase the mortality rate. Azoles may prolong the survival time.
 
While fungal surveillance cultures are commonly performed for pediatric HSCT patients, they have limited utility for predicting invasive fungal disease.
Reviews/Overviews
Aspergillus fumigatus is a ubiquitous saprophytic fungus, responsible for organic material decomposition, and plays an important role in recycling environmental carbon and nitrogen. Besides its important role in the environment, this fungus has been reported as one of the most important fungal pathogens in immunocompromised patients. Due to changes of CO2 concentration that some pathogens face during the infection process, studies have been made to understand the pathogenic roles of the carbonic anhydrases (CAs), the well-known CO2 hydration catalytic enzymes. As a basis for a discussion on the possible CAs' roles in A. fumigatus pathogenicity, this review describes the main characteristics of the A. fumigatus infection, and the challenges for its treatment. In addition, it gathers findings from studies with CAs' inhibitor drugs as anti-infective agents in different pathogens.
 
Allergic bronchopulmonary aspergillosis (ABPA) complicating cystic fibrosis (CF) is treated with corticosteroids. Since elevated IgE is a cardinal abnormality, anti-IgE has been used sporadically as adjuvant treatment. In eight case reports, 13 children with CF and ABPA received anti-IgE resulting in improved FEV1 , fewer respiratory symptoms and decreased corticosteroid use.
Damp & Health
Indoor Environment Professionals
Join our LinkedIn group on Damp Building and Human Health.
 
Living in a damp home?
Please check out our LinkedIn group: Is my damp home making me ill? and read our new website pages
Conference Deadlines
CHEST World Congress (Madrid, Spain March 21-24) Early Registration Opportunity 30 August 2013 – 18 December 2013
 
12th European Conference on Fungal Genetics (Seville, Spain March 23-27) Opening of registration and abstract submission: October 2013, Deadline for fellowship application: 18 November 2013, Deadline for reduced registration & abstracts: 16 December 2013.
 
40th Annual Meeting of the European Society for Blood and Marrow Transfusions EBMT (Milan, Italy March 30 - April 2) Abstract submission deadline December 15th (Physicians) November 13 (Nurses)
 
16th International Congress on Infectious Diseases (Cape Town, South Africa April 2 - 5) Abstract submission deadline will be December 2013
 
24th ECCMID (Barcelona, Spain May 10th - 13th) Abstract submission deadline December 10th 2013
Courses
Bringing PK and PD in Fungal Infections into the Clinic July 4-6 2014, Nijmegen, The Netherlands. For more information check website in January 2014.
 
Online course, Start approximately July 2014
Mechanisms in Fungal Infections is a blended, e-learning resource with CME content developed by an expert, multidisciplinary group of specialists.

The content on this Web site is intended for oncologists, hematologists, and infectious disease specialists who treat transplant patients and other patient populations at risk for developing fungal infections.
 
Allergy Academy, King's College, London. Online resources for allergy education. Intended for all audiences including doctors & patients.
Veterinary
Standard methods for fungal brood disease research.
Chalkbrood and stonebrood are two fungal diseases associated with honey bee brood. Chalkbrood, caused by Ascosphaera apis, is a common and widespread disease that can result in severe reduction of emerging worker bees and thus overall colony productivity. Stonebrood is caused by Aspergillus spp. that are rarely observed, so the impact on colony health is not very well understood.
 
A major concern with the presence of Aspergillus in honey bees is the production of airborne conidia, which can lead to allergic bronchopulmonary aspergillosis, pulmonary aspergilloma, or even invasive aspergillosis in lung tissues upon inhalation by humans. In the current chapter we describe the honey bee disease symptoms of these fungal pathogens. In addition, we provide research methodologies and protocols for isolating and culturing, in vivo and in vitro assays that are commonly used to study these host pathogen interactions.
 
We give guidelines on the preferred methods used in current research and the application of molecular techniques. We have added photographs, drawings and illustrations to assist bee-extension personnel and bee scientists in the control of these two diseases.
Attention Clinicians & Scientists
Case Histories Database 212 aspergillosis cases already recorded and you can add yours too.
 
Information on mycetoma on the WHO List of Neglected Tropical Diseases can be found here, and see also the media briefing of the Mycetoma Consortium here.
 
 
The Joint Genome Institute (JGI) welcomes nominations of genomes to be sequences in its Community Sequencing Program. For procedures how to submit a proposal, see here. The current fungal program can be found here.
 
You may like to contribute to the following collaborative groups who are collecting clinical data on these rare infections:
 
Fungiscope is a global rare fungal infection registry, a working group of ISHAM.
 
International Pediatric Fungal Network (PFN) collating information on treatment of pediatric patients
 
AspICU2 is a web-based multicentre observational survey to assess the burden of aspergillosis and other fungi in critically ill patients.
Patients
 
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Also of interest...
6th TIMM:

 
 
 
 
 
 
 
Jobs:
 
European Academy of Allergy and Clinical Immunology (EAACI) RESEARCH FELLOWSHIPS 2014
 
European Academy of Allergy and Clinical Immunology (EAACI) Clinical Fellowships 2014

Clinical Research Fellow at the National Aspergillosis Centre, Manchester, UK
ow
Clinical Research Fellow
Conferences:
 
Courses:
 
Books:
Theses:
 
 
 
The Pharmacodynamics of Antifungal Agents Against Aspergillus by Jeans, Adam Rupert 2013 University of Manchester
Clinical Trials (35 Recruiting):
 
Research Grants:
 
Lab protocols:
 
Networking:
 
News blog:
 
 
 
 
Fungal Infection Trust, PO Box 482, Macclesfield, Cheshire SK10 9AR, UK,www.fungalinfectiontrust.org.uk