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Aspergillosis and HIV
Acute aspergillosis infections are overwhelmingly found in patients that are immunocompromised. Famously the HIV virus that causes AIDS gradually renders its victims vulnerable to infection by slowly reducing the effectiveness of their immune system over time, so it might
follow that someone with active AIDS would eventually become vulnerable to aspergillosis.
Surprisingly we find that this is not so. Aspergillosis isn't common in HIV patients and as a consequence this infection has been little studied in this context. This new study presents an analysis of a case series of 19 people with HIV and attempts to identify the risk factors for aspergillosis and estimate prognosis for the different sites of infection.
The authors found that the most common risk factor (occuring in 70% of patients with aspergillosis) was CD4 levels of less than 200 (normal value 500 - 1200cells/mm3) but that this was usually accompanied by at least one more risk factor, mostly corticosteroid therapy. Aspergillosis was also commonly accompanied by other infections that had the potential to delay diagnosis. Prognosis of invasive aspergillosis in an HIV patients was poor with mortality rate of 70% but pulmonary aspergilloma and sinus fungal balls fared better.
Latest Website News and Articles
We have a new website section. The study of Geomicrobiology is a new area of research looking into how microbes interact with our subterrenean environment and in particular rocks. Metal and mineral transformation and bioremediation are important for human well being with fungi and bacteria being most important for reclamation, immobilization or detoxification of metallic and radionuclide pollutants.
We provide a searchable library of 72 articles that involve Aspergillus including several recent reviews from leaders in this field of research.
We have also been adding to our collection of articles
by adding all the articles that are currently listed in the reference lists for our treatment section. We hope this makes our collection of seminal and important papers more complete. This task is not yet complete but is ongoing and has contributed over 1500 new articles over the last 4 months.
Our Patients Support group in Yahoo! has reached a major milestone. It now has a membership exceeding 1000 patients & carers.
Selected articles: (163 new articles added,
33 are reviews and 131 precede the year 2000)
The Mycotic Ulcer Treatment Trial: A Randomized Trial Comparing Natamycin vs Voriconazole Natamycin treatment was associated with
significantly better clinical and microbiological outcomes
than voriconazole treatment for smear-positive filamentous
fungal keratitis, with much of the difference attributable
to improved results in Fusarium cases.
Application to Clinical Practice: Voriconazole should
not be used as monotherapy in filamentous keratitis.
Validity and reliability of the St. George's Respiratory Questionnaire in assessing health status in patients with chronic pulmonary aspergillosis The St Georges respiratory questionnaire for quality of life assessment is reported to be a valid tool for the assessment of the health of chronic pulmonary aspergillosis (CPA) patients, comparing well with clinician ratings of health status. This finding should lead to further use of SGRQ for future research into attempts to improve health status in this group of patients..
The Β-glucan receptor dectin-1 promotes lung immunopathology during fungal allergy via IL-22 Sensitivity to fungi is increasingly being linked with severity of asthma. This paper strongly suggests that lung inflammation is at least partly controlled by the Β-globin receptor Dectin-1 (a c-lectin that binds fungal cell wall material)
which stimulates the production of IL-22. In a mouse model. Absence of either improved lung function.
Dectin-1 and IL-17A suppress murine asthma induced by Aspergillus versicolor but not Cladosporium cladosporioides due to differences in Β-glucan surface exposure The previous paper listed here showed that Dectin-1 expression causes deterioration in lung function in mice. This suggests that as Dectin-1 very specifically recognised fungi then fungi must be intimately involved in the development of asthma symptons in a mouse model for human asthma. This paper suggests that the interaction is more specific than that - only the presence of Aspergillus spores had this effect via Dectin-1 when tested alongside Cladosporium spores.
Hypoxia enhances innate immune activation to Aspergillus fumigatus through cell wall modulationInfection by the human fungal pathogen Aspergillus fumigatus induces hypoxic microenvironments within the lung that can alter the course of fungal pathogenesis. How hypoxic microenvironments shape the composition and immune activating potential of the fungal cell wall remains undefined. Herein we demonstrate that hypoxic conditions increase the hyphal cell wall thickness and alter its composition particularly by augmenting total and surface-exposed Β-glucan content. In addition, hypoxia-induced cell wall alterations increase macrophage and neutrophil responsiveness and antifungal activity as judged by inflammatory cytokine production and ability to induce hyphal damage. We observe that these effects are largely dependent on the mammalian Β-glucan receptor dectin-1. In a corticosteroid model of invasive pulmonary aspergillosis, A. fumigatus Β-glucan exposure correlates with the presence of hypoxia in situ. Our data suggest that hypoxia-induced fungal cell wall changes influence the activation of innate effector cells at sites of hyphal tissue invasion, which has potential implications for therapeutic outcomes of invasive pulmonary aspergillosis.
Have novel serum markers supplanted tissue diagnosis for invasive fungal infections in acute leukemia and transplantation? Invasive fungal infections (IFIs) are difficult to diagnose, especially early in the course of infection when antifungal therapy is most effective. There are two commercially available biomarker assays useful for detection of the IFIs most commonly seen in patients with hematologic malignancies, the galactomannan and beta glucan assays. The former is specific for aspergillosis, the latter positive for not only Aspergillus and Candida species, but several other clinically relevant fungal pathogens as well. Both have good assay performance characteristics, provide rapid test results, are widely available, can be assayed non-invasively, and are positive early in the course of infection, often before onset of signs and symptoms of infection. Adoption of these assays into clinical practice has led to reduced need to perform invasive procedures to obtain deep tissue to establish the diagnosis of invasive fungal infections. Improved survival rates from aspergillosis are, in part, due to earlier detection of infection and earlier therapy.
Modelling hyphal networks The indeterminate growth habit of fungal mycelial can produce massive organisms spanning kilometres, whereas the hypha, the modular building block of these structures, is only a few microns in diameter. The qualitative and quantitative relationship between these scales is difﬁcult to establish using experimental methods alone and a large number of mathematical models have been constructed to assist in the investigation of the multi-scale form and function of ﬁlamentous fungi. Many such models operate at the colony-scale, representing the hyphal network as either a regular lattice or as a geometrically-unconstrained structure that changes according to a minimal set of speciﬁed rules focussed on the fundamental processes responsible for growth and function. In this review we discuss the historical development and recent applications of such models and suggest some future directions.
Corneal stromal abscessation in two horses treated with intracorneal and subconjunctival injection of 1% voriconazole solution This procedure may be an effective technique to treat refractory or relapsing DSA in horses. Intracorneal and subconjunctival voriconazole administration results in a visual and cosmetically acceptable globe. In equine DSA cases, the advantages of this technique compared with other medical and surgical approaches to this disease include shortened anesthesia times, minimal resultant scarring and shorter healing times, and lower cost of therapy.
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
Videos have now been added to the powerpoint slides from the Masterclass in "Management of chronic and allergic pulmonary aspergillosis" by Prof David Denning. As presented at the 5th AAA meeting in Istanbul 25th January 2012.
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.
Merck International Grants (Non-US) requests are now submitted online via Merck Support
See also Jobs for PhD Studenships, Fellowships
Yahoo! Aspergillosis Support Group - Milestone Passed
This group celebrated its 10 year anniversary in December 2012 by signing in its 1000th member virtually to the very day the group opened in 2002. This is our oldest and most active group and unlike Facebook is completely private and members only. It continues to grow at around 100 new members per year.
Aspergillosis Patients Meeting - New Format Successful
The Patients Support Meeting on January 25th will be as follows:
1.30 Debbie Kennedy Oral fungals and TDM
2.00 Khaled Al-Shair- 4 things we have learned from QOL
2.30 Phil Langridge- Correct use of inhalers
2.50 Graham Atherton Short story on some recent research/discuss social support via phone
3.10 Q & A
Follow the meeting online here
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 is available to watch at http://www.slideshare.net/GTAtherton/aspergillosis-patients-meeting-christmas-quiz-december-2012
The next meeting will be at 1.30 on the 22nd February 2013. 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 email@example.com.
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 occasionally even diagnosed correctly.
We have a new Local Support Group in Wigan and the West Midlands and London groups are preparing for meetings early in the New Year. 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 firstname.lastname@example.org
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 email@example.com for details.
|NEW Wigan Group: FacebookEmail Group Leader
| Bristol: Raised £415 for Fungal Infection Trust! 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
|London: February 3rd, video conference available.
Belgrave House, 76 Buckingham Palace Road, London SW1W 9TQ. Map Facebook Email Group Leader
West Midlands: 29th January at 11.00am (bring your clubs if you are a lady golfer) , 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
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!
Two new leaflets are now available:
Will you donate just £1 (or $1 or €1) per newsletter to help us
deliver the Aspergillus website and sustain research into Aspergillus
related illnesses? That is just £12 for a year of newsletters.
We need your help to continue providing up to date information and
resources for patients and Doctors through the Aspergillus website.
You can donate through Virgin Money Giving. Through this organisation all of your donations goes straight to our charity. If you are a UK taxpayer we can reclaim the tax on your donation.
NOTE: Direct donations made through this page have raised £1700 in 2012- Many thanks for helping us run the Aspergillus Website.
Eight positions are currently being advertised:
CLINICAL SENIOR LECTURER OR READER IN MEDICAL MYCOLOGY /FUNGAL IMMUNOLOGY An exciting opportunity has arisen for a Clinical Senior Lecturer or Reader in Medical Mycology to join the Aberdeen Fungal Group. This position is aimed at individuals at Consultant level within medical mycology or fungal immunology or a closely connected speciality, with a strong applied research background and an ambition to pursue an academic career in this speciality.
CLINICAL RESEARCH FELLOW,
at the National Aspergillosis Centre, Manchester, UK
Over the next 2 years at least 2 vacancies will be available for Clinical Research Fellows at the National Aspergillosis Centre. The precise area of research has not been decided and will depend partly on the experience and interest of any successful candidate. Major areas of interest now include the genetics of chronic pulmonary aspergillosis, ABPA and other chronic lung infections (bronchiectasis, cystic fibrosis etc), azole resistance and epidemiology of fungal lung infection worldwide.
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
PROJECT GRANTS FOR CROSS-DISCIPLINARY PDRA PROJECTS
Applications are invited for projects that will start in October 2014. Applications are invited for projects. A project grant will support a PDRA and research expenses for 3 years. 6 grants are available.
3-YEAR CLINICAL PHD FELLOWSHIP Applications are invited for this exciting new PhD programme to train a new generation of clinicians in medical mycology. The scheme is open to clinicians who wish to develop a long term career in academic medicine specialising in medical mycology.
INTERNATIONAL RESEARCH SCHOLARSHIP (1-YEAR MRES + 3-YEAR PHD) Applications are invited for these prestigious International Research Scholarships. Prospective students will be expected to complete a 12-month MRes in Medical Mycology and Fungal Immunology at the University of Aberdeen, followed by a 3-year PhD at a UK university or research institution in the network.
PROJECT GRANTS FOR PHD PROJECTS Applications are invited for projects that will start in October 2014. PhD candidates will be selected from our cohort of international students completing the MRes stage of the International Research Scholarship. A project grant includes; stipend, home/EU tuition fees and research expenses for 3 years. Host institutions must agree to waive foreign tuition fees.
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.
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
Conferences - coming up
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.
asm2013 113th General Meeting Denver,Colorado May 18-21.
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
Bioconversion of biodiesel by-products to value-added chemicals by Salakkam, Apilak, University of Manchester.
Molecular detection of bloodstream pathogens in critical illness by Al_griw, Huda Hm, University of Manchester
Fungal communities on flooded building materials by Skrobot, Frederick. Mississippi State University
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 300 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. 294 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 (300 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.