Fungal Infection Trust Aspergillus Newsletter Sept 2017
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Highlights of this month...

Immune Cells Trigger Spore Suicide, Stopping Fungal Infection

Researchers found that fungal spore cell-death is triggered by healthy immune cells in the lungs, partly explaining why most people don't get fungal infections despite inhaling around 1000 fungal spores each day.
 
The international group of researchers describe discovering the phenomenon in a paper titled 'Sterilizing immunity in the lung relies on targeting fungal apoptosis-like programmed cell death', which has been published in the journal 'Science' on the 8th September. 
 
The study showed that, in mice, neutrophil immune cells engulfed the Aspergillus fumigatus spores, trapping them before triggering the spores own self-destruct cell mechanism. 
 
The researchers also found a protein (AfBIR1) on the surface of A. fumigatus spores, which is thought to prolong fungal cell life. Mice exposed to spores with many instances of this protein were more likely to die from fungal infection.
 
When the researchers used a drug to stop the production of this protein, fungal cell death was increased and infected airways began to clear.

New understanding of proteins like AfBIR1, and of the mechanism by which host immune cells trigger spore suicide, could help researchers to develop new ways to treat aspergillosis patients.

Click here to watch a video illustrating the findings.
 
News
National Aspergillosis Centre Annual Report
 
Earlier this month the NAC Annual Report for 2016/17 was released. The report details the successes of the National Aspergillosis Centre over the last year, including papers published, awards won and funding secured. It also reviews patient numbers and treatment trials over the last year. 
 
 
Fundraising Success
 
The summer of 2017 has been a bumper season for fundraising, with contributors cycling, dancing and donating for the Fungal Infection Trust. Read on for details of ongoing collections.
 
Roger Ryder’s wife Ruth organised a collection in aid of the Fungal Infection Trust in memory of Roger who died in August 2017 of aspergillosis. Incredibly that collection has now exceeded £4500 which must serve as a reminder of how much Roger was loved by everyone he knew and missed by all. Ruth's Giving Page is still open for donations.

Dave MacIntyre’s wife Julie and son David have run a successful annual fundraiser in aid of the Fungal Infection Trust for several years and 2017 is no exception. The Appeal asks for £1 donations in memory of Dave MacIntyre senior who passed away from aspergillosis, they have a target of £500.

To donate £1 visit Julie and David's Giving Page 

Money raised for the Fungal Infection Trust goes towards combating life-threatening fungal diseases, so please give generously and share these campaigns with your friends and family.
 
8th Advances Against Aspergillosis
 
Plans are well under way for the next AAA in Lisbon, Portugal on 1-3 February 2018.  Having run bi-annually since 2004 AAA is established as the biggest and best forum for detailed and dedicated discussion of Aspergillus diagnosis, treatment, and research.
 

Organisers hope to hold another event at the conference for patients, this time providing translations to the host language for local participants, Portuguese.
Articles
Some of the highlights are:
 
This study investigated a technique that is sometimes used to diagnose or monitor invasive aspergillosis (IA), known as galactomannan detection. The authors looked at the effectiveness of this technique when used on patients whose IA was caused by Aspergillus flavus, compared with those whose disease was attributed to Aspergillus fumigatus.
 
116 samples of fluid were collected from possible IA patients. Of the 35 patients that were classified as IA, 28 tested positive for A. flavus and 7 for A. fumigatusThe researchers found that the galactomannan technique detected IA more readily in patients whose disease was linked to A. fumigatus, compared to those whose disease was linked to A. flavusThe sensitivity and specificity of a GM index >0.5 in cases with A. flavus were 86 and 88% and for A. fumigatus patients were 100 and 73%, respectively. 
 
This study set out to describe the outcomes of fungal keratitis (fungal eye infection) after treatment. This prospective study only studied patients with fungal keratitis - the diagnosis was based on risk factors and features of the cornea (part of the eye) that are characteristic of the disease. 1,130 patients were included in the study and followed up for 3 months. The patients were treated with antifungals, in addition to measures to address their symptoms.
 
After the treatment finished, 590 (52.21%) of the patients were still able to count fingers using their affected eye, but 126 (11.15%) patients lost their eye. Patients whose corneas remained opaque needed surgery.
Reviews
 
Examination under a microscope is required for definitive diagnosis of fungal infections, although this is technically difficult. The authors of this paper suggested that in situ hybridization (ISH), a diagnostic tool that doesn’t require fungi to be grown, could have advantages over traditional techniques.
 
This review discusses pre-treating tissue sections prior to hybridization to solve problems associated with ‘fixing’ tissues in a substance called formalin. The authors note that ISH complements conventional diagnoses in tissues that have been formalin-fixed and paraffin-embedded. Understanding the limits of formalin-fixation is essential to develop suitable ISH protocols for fungal identification.
Veterinary
This study investigated essential oils as an alternative preventative measure and treatment for aspergillosis in chickens. The authors compared the effect of the antifungal voriconazole with the essential oils carvacrol, thymol, eugenol and thymoquinone. The fungus A. fumigatus was introduced into the windpipes of chicks. The chicks were then fed a diet containing one of the treatment options.
 
Prolonged survival was seen in chicks treated with voriconazole (87.5% survival) or carvacrol (79.2%) compared with chicks in other treatment groups. The authors suggest that carvacrol has potential for both prevention and treatment of A. fumigatus in chickens, particularly in light of antifungal resistance due to widespread use of drugs like voriconazole for preventing and treating aspergillosis.
 
The "Nietoperek" bat reserve located in Western Poland is one of the largest bat hibernation sites in the European Union with nearly 38,000 bats from 12 species. The researchers aimed to investigate the fungal species present during the bats’ hibernation season and evaluate the potential threat of fungi for bats and humans visiting the complex. They found 34 species of airborne fungi, including various Aspergillus species and Pseudogymnoascus destructans, which has not previously been found at bat hibernation.
 
The researchers also found that the concentration of airborne fungi increased as the number of bats increased. Even though the concentrations of fungal spores did not exceed limits established as dangerous for human health, they could present a problem for immunocompromised people. 
Attention!
Contribute to clinical data on rare infections:
Patients & Carers
 
International Fungal Disease Awareness Week ran on 14-18th August (and will now be an annual event) so we published a variety of short video’s and a patient's daily diary to promote awareness in the UK. These pages were seen by at least 50 000 new people in the UK and abroad, both public and medical communities. You can still see all pages on www.fungalinfectiontrust.org which is the website of the Fungal Infection Trust (FIT), a Macclesfield based charity that contributes significantly to the National Aspergillosis Centre every week!
 
As a result of Awareness Week 100 new people joined our Facebook support groups and we saw 5 fold increase in the use of our support & information websites at FIT and significant increase in the use of  www.aspergillus.org.uk during the week. We will certainly be involving ourselves in Fungal Awareness Week in 2018. If you have any suggestions for what we can do please let us know at graham@fungalinfectiontrust.org.
 
This month’s Aspergillosis Community Meeting (September 1st) featured Matt Harris, one of our local Pharmacy staff who spoke about how we should best manage the use of antifungal drugs and what to do when experiencing side effects. Matt mentioned a very useful phone number hosted here at UHSM for people to use for any queries about medication - UHSM Pharmacy Patient Helpline (0161 291 3331).
 
You can examine the results of the NAC survey which are published as part of our Annual Report at http://www.nacpatients.org.uk/nac-reports
 
The meeting was recorded, so you can catch up by watching the slides of the meeting on YouTube.

The Aspergillus community/patient group meeting normally meets on the first Friday of each month at the Altounyan Suite, North West Lung Centre, Manchester at 1.30pm BST/GMT. If you can't make it in person, you are welcome to listen in to our live Facebook Broadcast

If you want a text reminder when each meeting is approaching (UK only) then send us an email at admin@aspergillus.org.uk with your mobile phone number.
 
For more details go to the Patients Community Newsletter

Skype Meetings

If you would like to listen or chat to fellow patients and a NAC staff member we are running a successful Skype meeting every week! We are a chatty group of 8 - 12 most weeks but we can accommodate up to 24. If you have a computer or smartphone you will be able to join in - just click on https://join.skype.com/nbubWMUM8teC and you will be asked to register, then taken to the group. The Skype meeting is at 11am BST every Thursday
 
Join our Facebook Groups
 
Our Aspergillosis Support Facebook Group has over 1000 members, and is a safe place to meet and talk to other people with aspergillosis.
 
We also have a Facebook group for those who are caring for someone who is affected by the disease - join here
Fungal Infection Trust, PO Box 482, Macclesfield, Cheshire SK10 9AR