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There is a proposal for a seperately identifiable clinical entity where patients have clear signs of respiratory infection (cough, voluminous sputum, recurrent chest infections) and have a positive culture or PCR results for the presence of Aspergillus in their airways. Many have bronchiectasis and high MRC dyspnea scores. Most have high IgG and precipitans to Aspergillus. Despite all this these patients did not fulfill the criteria for allergic, chronic or invasive aspergillosisbut do respond strongly to antifungal treatment.
This paper proposes that these observations constitute a group of patients that can be diagnosed as having Aspergillus bronchitis.
Another noteworthy publication in December is a major review of pathogenic fungal diseases entitled 'Hidden Killers, Human Fungal Infections'. This review takes a worldwide perspective of most of the major fungal infections that occur globally, making the point that many of these diseases are not widely appreciated to be the major killers that they are. There is good awareness of the more superficial infections such as athletes foot, ringworm and nail infections but did you know that the former affects 20% of the world population while the latter affects up to 50% of the population of the world amongst those aged over 70!? This review contains many such surprising statistics for a range of fungal infections.
Most readers will be aware that Aspergillus infections are usually caused by inhaling spores and that we all generally inhale spores all of the time as spores of this genus (and a few others e.g. Penicillium) are present in our air all of the time. We also know that these spores can only grow if an individual is immunocompromised and/or has some lung damage that allows spores to gain a foothold in otherwise healthy tissue. But did you know that there are 200 000 recorded cases of Invasive Aspergillosis (IA) every year worldwide? The majority of these affect people who have leukemia or emphysema (COPD) and mortality rates are >50% and higher if diagnosis is delayed. More at risk groups are emerging e.g. TB.
Worryingly for research funding most victims of aspergillosis will be recorded as deaths due to cancer or smoking respectively (and 50-60% are not recorded as IA at all so the true numbers of infections are more likely to be approaching 400 000 per year), leading to a lack of awareness that reduces research funding.
If we were able to quickly and accurately diagnose aspergillosis we could save many more lives. The only way to
discover and develop better diagnostic technology is to dedicate funding for the research. For this to happen much more awareness of serious fungal infections is needed!
Latest Website News and Articles
Over 700 new articles added to our collection this month!
We have been adding to our collection of articles in two ways. Professor Denning has been digitising his collection of articles (thanks to our dedicated data team Michael Clarke and James Hughes) and we have been adding all the articles that are currently listed in the reference lists for our treatment
Selected articles: (729 new articles added,
45 are reviews and 529 precede the year 2000, 70 historic)
Posaconazole after previous antifungal therapy with voriconazole for therapy of invasive aspergillus disease, a retrospective analysis Posaconazole is confirmed as a highly effective salvage treatment for invasive aspergillus disease, with response rates exceeding 70% in a retrospective examination of 36 patients in 4 German hospitals.
Aspergillus fumigatus activates thrombocytes by secretion of soluble compounds A. fumigatus secretes two factors that induce platelet response to fungal infection, strengthening the host immune response. The factors are named as gliotoxin and a fungal serine protease. Some harmful effects of platelert activation are suspected, namely excessive inflammation and thrombosis. The authors suggest that platelet activation might be a useful diagnostic aid.
Inter-Laboratory and Inter-Study Reproducibility of a Novel Lateral-Flow Device and the Influence of Antifungal Therapy on the Detection of Invasive Pulmonary Aspergillosis Lateral-Flow devices have potentialas point-of-care assays for the detection of microbial infection. Once such device has been shown to be effective in an animal model of invasive pulmonary aspergillosis. Here the authors demonstrate its effectiveness using a Guinea Pig model system using samples from blood serum and BAL. Serum sensitivity is reduced when antifungal therapy is in use but BAL samples remain unchanged.
Primordial enemies: fungal pathogens in thrips societies Microbial pathogens are ancient selective agents that have driven many aspects of multicellular evolution, including genetic, behavioural, chemical and immune defence systems. It appears that fungi specialised to attack insects were already present in the environments in which social insects first evolved and we hypothesise that if the early stages of social evolution required antifungal defences, then covariance between levels of sociality and antifungal defences might be evident in extant lineages, the defences becoming stronger with group size and increasing social organisation.
Aspergillus meningitis: A rare clinical manifestation of central nervous system aspergillosis. Case report and review of 92 cases Objectives: To describe the pathogenesis, clinical presentation, cerebrospinal
ﬂuid ﬁndings and outcome of Aspergillus meningitis, meningoencephalitis and arachnoiditis. Methods: A case of Aspergillus meningitis is described. A comprehensive review of the English language literature was conducted to identify all reported cases of Aspergillus meningitis described between January 1973 and December 2011.
Aspergillus serology, from yesterday to today for tomorrow (in French) Anti-Aspergillus antibody detection has been performed for over 50 years for the diagnosis of different chronic Aspergillus infections, starting with aspergilloma and later with chronic necrotizing pulmonary aspergillosis. It also enters into definition criteria for allergic broncho-pulmonary aspergillosis and contributes to the initial diagnosis of the aspergillosis, to the follow-up under treatment or to the detection of exacerbations. For the acute invasive aspergillosis, antibody detection has low interest compared to galactomannan antigen detection. Serology results have to be interpreted together with other clinical, radiological and biological, mycological criteria. This review describes the origins, the technical evolutions and the current place of Aspergillus serology in France. Finally, future improvements are discussed.
Regulation of fungal secondary metabolism Fungi produce a multitude of low-molecular-mass compounds known as secondary metabolites, which have roles in a range of cellular processes such as transcription, development and intercellular communication. In addition, many of these compounds now have important applications, for instance, as antibiotics or immunosuppressants. Genome mining efforts indicate that the capability of fungi to produce secondary metabolites has been substantially underestimated because many of the fungal secondary metabolite biosynthesis gene clusters are silent under standard cultivation conditions.
Several historical articla have recently been added
Aspergillosis in parrots by Simpson VR, Euden PR (1991)
Pulmonary Aspergillosis in the calf by Griffin RM (1969)
Antifungals and their use in veterinary ophthalmology by Ford MM (2004)
You can now search all of our veterinary articles alongside all of the rest of our articles in the website Library
New Book: Infectious Diseases of Wild Mammals and Birds in Europe by Dolorés Gavier-Widen, Anna Meredith and J. Paul Duff (31 Aug 2012)
NOTE: Vets in the UK in need of assistance with acquiring antifungals please contact us 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.
Clinical Training for developing countries
Public Health and Tropical Medicine Fellowships. It has come to our attention that there are a series of Fellowships funded by the Wellcome Trust available to applicants for low and middle income countries. We would like to encourage medical mycology applicants and would be happy to provide facilities and expertise for training at the National Aspergillosis Centre for applicants. We would like to identify applicants for these Fellowships and help facilitate application - please contact us at firstname.lastname@example.org
Research Grant Awards
Gilead UK and Ireland Fellowship Programme details of 2013 programme for fungal disease opens on 10th December 2012.
Aspergillosis Patients Meeting - New Format Successful
The Patients Support Meeting in December is taken over by a Christmas Quiz. Teams of three or four answer a series of 25 questions based on members of the NAC service and on the talks given during the previous year. The David Macintyre Memorial Trophy has been donated to present to the winning team. The aim is to have a fun couple of hours before the holidays and if last year is anything to go by it will be a lot of fun.
STOP PRESS! The David Macintyre Trophy was won by team DGW with an excellent score of 21 out of 25 - Well done team DGW.
The quiz will be available to watch at http://www.slideshare.net/GTAtherton
The next meeting will be at 1.30 on the 11th or 25th January 2013 (email email@example.com for final details in January). Everyone is welcome. You can pop in and out as you wish as
each talk will last 20 – 30mins and there will be time for you to ask staff any
questions that you wish. Light lunch, tea & coffee will be provided in the
Altounyan suite Atrium from around 1pm.
NOTE: To stay in touch of any changes at short notice we have a
mobile phone text-based update system that can provide instant updates and
reminders. If you wish to be added to the list we contact send your mobile
number to firstname.lastname@example.org.
You can see a listing of all
talks here (on the right)
Facebook community progress
Reaching new people is of fundamental importance to our need to reach people who may be living with aspergillosis and not be supported or even diagnosed correctly.
The Bristol and London groups seem to be preparing for meetings early in the New Year and there is a suggestion that we will be able to start a volunteer based peer group phone service to support those who don't have access to the internet or who are more comfortable chatting on the phone rather than typing! Watch this space! If you would like to volunteer to help us provide a a trial of this service please email me at email@example.com
Patient's Own Stories
So far we have collected 50
stories (78 members) which are being updated regularly, written by patients directly into the 'wiki' website at Patients with Aspergillosis.
More stories needed - join up and join in!
'A Fly on the Ward' by Mike Chapman: In the book he tries to takes a lighter look at life as a chronic patient. A proportion of sales will be donated to the Fungal Research Trust.
The Lady with the Aspergillus by Julie Michael is the story of her stuggle with aspergillosis. All profits go to the Fungal Research Trust.
Two new leaflets are now available:
Local Support Meetings
Several more meeting were successfully held over the summer, East and West Midlands, Liverpool and the group in Los Angeles, USA.
We always need new groups, particularly in the North East of England and Scotland, Southern and Eastern areas of the US so any volunteers would be welcome - all you need to do is arrange a venue (can be a pub/civic centre - we recommend NOT using your home at first) and a date and we will help publicising your group. How often you meet depends on you.
Contact firstname.lastname@example.org for details.
| Bristol: Facebook Email Group Leader
|USA: South Louisiana: Facebook Email Group Leader
|West Yorkshire: Facebook Email Group Leader
|Canada: Ontario. Facebook Email
|Liverpool: Next date to be announced, "Wetherspoons", Childwall Fiveways Hotel, Queens Drive, Liverpool, L15 6XS. Map Facebook Email
Next date to be announced, video conference available.
Belgrave House, 76 Buckingham Palace Road, London SW1W 9TQ. Map Facebook Email Group Leader
West Midlands: Next date to be announced at 1:30pm, Dudley Golf Club, Rowley Regis,
West Midlands B65 9DP. Map Facebook Email
East Midlands: Next date to be announced at Eat n' Enjoy Cafe, 4 Eaton Walk, Rushden Northants, NN10 9SH Map Facebook Email
|USA: San Francisco. Map Facebook Email Group Leader
|USA: Los Angeles. Met recently
(1:30pm) at Weiler's Deli.
22323 Sherman Way in West Hills. Map Facebook Email
|USA: Vermont. Map Facebook Email
Expert Patient Programme
Learn to manage long term illness better by taking part in a 6 week course. Originally designed at Stanford University, USA 20 years ago this programme has proven benefit for the patient, the carer and family. In the UK this is provided free of charge by the NHS.
Contact us for more information
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NOTE: Direct donations made through this page have raised £1650 so far this year - Many thanks for helping us run the Aspergillus Website.
Five positions are currently being advertised:
CLINICAL RESEARCH FELLOW, 2 year post at the National Aspergillosis Centre, Manchester, UK
An enthusiastic enquiring clinician is sought to undertake a 2 year (possible extension) clinical research post related to the interaction of fungus and the lung, in particular Aspergillus. There are several million patients with allergic aspergillosis in Europe, hundreds of thousands with chronic pulmonary aspergillosis and millions at risk of invasive aspergillosis. This post offers a unique opportunity to become one of the best of the best in this area.
Group Leader - Research Groups in Parasitology and Mycology
Institut Pasteur, Paris. The Institut Pasteur in Paris announces an international call for outstanding candidates to establish independent research groups at all levels in the Department of Parasitology and Mycology and to develop research programs on pathogenic eukaryotic microorganisms (parasites or fungi) and/or their insect vectors.
Infectious Disease Registrar
Adelaide Teaching Hospitals, Australia. This is an excellent opportunity to join South Australia largest teaching hospitals providing care to South Australians. You will have a fantastic opportunity to work closely with I/D physicians and clinical microbiologists, providing inpatient care, outpatient care and clinical consultative service to medical and surgical units in these teaching hospitals.
Postdoctoral Fellowship to Study Aspergillus Pathogenesis and Immune Activation
The Cramer Laboratory is located at the Geisel School of Medicine at Dartmouth in Hanover, New Hampshire in the Department of Microbiology and Immunology.
Research Fellowship at CIDM Westmead
Expression of interest are sought for a Fellowship position in the Centre for Infectious Diseases and Microbiology at Westmead Hospital in Sydney. The position is most suited to those who wish to undertake doctoral or postdoctoral training in bacterial genetics and with completed qualifications in Infectious Diseases
Advertise your vacancy
free of charge on the Aspergillus Website here. *Optional donation to the Fungal Research Trust to cover
costs incurred in providing this newsletter.
Conferences - coming up
39th EBMT Annual Meeting in 2013 London, UK. April 7 - 10 2013. Abstract submission deadline December 17th 2012.
CBS Spring Symposium, One Fungus : Which Gene(s) (1F = ?G) 2013 Amsterdam, The Netherlands. April 10-11
49th Annual Scientific Meeting of the BSMM Newcastle, UK. April 14 - 16
23rd ECCMID, Berlin, Germany. April 27 - 30. Abstract submission deadline November 30th 2012
31st Annual Meeting of the European Society for Paediatric Infectious Diseases Milan, Italy. Abstract Submission Deadline January 14. May 21 - June 1.
2nd Fungal Biofilms Meeting Glasgow, Scotland. May 20-21.
The European Society for Paediatric Infectious Diseases (ESPID). 31st Annual Meeting to be held in Milan, Italy, May 28-June 1, 2013.
Many more here...
Courses and Workshops
We keep a listing of courses and workshops including 'one off' events and courses that repeat regularly. Course subjects are wide ranging and include medical mycology, lab ID, young scientists symposia and much more. Those coming up next are:
FEBS advanced practical course State-of-the-art infection models for human pathogenic fungi Jena, Germany. February 17 - March 2nd 2013
Cystic Fibrosis Barcelona, Spain. April 18 - 20th 2013
Specialization Course in Medical MycologyKU Leuven Campus Gasthuisberg, Belgium. September 16 - 26th 2013
If you know of a course that should be added to this list please add it by contacting us here
View latest theses online. UK USA
Analyses of mitotic nuclear pore complex dynamics in Aspergillus nidulans, by Liu, Hui-Lin, Ohio State University, Ohio State University
Molecular detection of bloodstream pathogens in critical illness by Al griw, Huda Hm, University of Manchester , University of Manchester Link
NB Links to theses may require library membership.
We are always looking for more for our collection - please send your suggestions here
We have now moved this to our Aspergillus & Aspergillosis Group in LinkedIn were we have a membership of over 280 professionals from a variety of backgrounds. Once a member you can start discussions and ask questions.
Searching for Aspergillus Information
You can now receive notification of updates to the Aspergillus Website on your mobile phone via SMS texting free of charge. Go to http://twitter.com/AspergillusWeb and open a Twitter account. Follow AspergillusWeb. 262 already follow AspergillusWeb.
If your network does not support Twitter SMS and you have a smartphone you can still monitor our messages over 3G or Wifi via free software and apps installed on your phone
Join the Aspergillus & Aspergillosis group (286 members) to get in touch and keep in touch with your professional colleagues working in this field. Many jobs are advertised here too!
LinkedIn runs discussion forums in each group that all members can start up. Ask questions & debate with colleagues.
Thanks for reading!
Visit our website again soon.
The Aspergillus Team.