Fungal Infection Trust Aspergillus Newsletter Jan 2018
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Jill Fairweather has helped to raise over £1000 this year by making Christmas cards, ribbons and car stickers
 
Thanks to our brilliant fundraisers the Fungal Infection Trust has raised over £12000 from individual donors and events in 2017. This money forms a vital extra fund that supports our research and educational projects.
 
Thank you all our fundraising heroes!!

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Highlights of this month...

The action of Mesenchymal Stromal Cells in Response to Aspergillus fumigatus

Mesenchymal stromal cells (MSCs; cells that can change into a variety of different cell types) can be used as immunotherapy in hematopoietic stem cell transplant (HSCT) recipients with refractory graft-versus-host disease (GvHD). However, there is some concern that this treatment might interfere with immune responses, increasing the likelihood of infection. In this study, Schmidt and colleagues aimed to investigate the effect of human MSCs on Aspergillus fumigatus and on the host response to this species in vitro.
 
The researchers found that co-incubation of A. fumigatus hyphae with human MSCs resulted in increased gene expression of IL-6, but did not alter other pro- or ant- inflammatory molecules. Additionally, MSCs did not appear to affect activation and function of A. fumigatus specific CD4+ T cells, or the oxidative burst activity of phagocytes.
 
A. fumigatus conidia did not affect protein release of any of the investigated molecules, but human MSCs did appear to be able to phagocytose conidia (the authors suggest that further research is needed to identify this mechanism in vivo). The direct antifungal effect of human MSCs on A. fumigatus hyphae was not investigated.
 
In summary, the researchers found no negative effect of human MSCs on the host response against A. fumigatus. Additionally the fungus does not appear to stimulate MSCs to increase the release of the cytokines associated with GvHD pathophysiology.
News
 
The first World Aspergillosis Day will focus on the impact that carers have on aspergillosis patients' health and wellbeing. The aim is to make carers feel valued and supported.
 
We're asking both patients and clinicians to invite carers to join the dedicated 'Carers, Family & Friends: Aspergillosis' Facebook group. We're also asking clinicians to think about the ways they might support carers more, including encouraging them to come to appointments with patients, providing written information when possible, and addressing the carer as well as the patient when both are present.
 
8th Advances Against Aspergillosis

The 8th AAA conference takes place 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. The 8th AAA program has been published.
Look out for highlights from the conference in the next Aspergillus Website newsletter (February 18)
 

We can reveal that 2017 was another very successful year for fundraising through our Virgin Money Giving page. Over £10 500 in donations has been collected through the page in the last 12 months. These donations support the work of the Fungal Infection Trust, which supports fungal disease research, education, awareness and patient support.
To keep up to date with the latest fundraising successes, visit our fundraising site - www.fit.care
Articles

Although the fungal microbiome (mycobiome) has been explored previously, this study by Fraczek et al is the first to characterize the mycobiome of individuals with respiratory fungal disease.
 
They found that the mycobiome varied considerably between individuals suffering from different respiratory fungal diseases. The highest fungal loads could be found in patients with severe asthma (although there was no statistically significant difference in fungal load between groups). The most common fungus identified was Aspergillus fumigatus, which accounted for much of the increased fungal burden in individuals with high fungal loads.
 
The authors found a significant association between corticosteroid treatment and fungal load, but cautioned that this association could be confounded by antifungal therapy. It is not yet known if this association is causal.
 
Between 1997 and 2013, investment into infectious disease research totalled £2.4 billion in the UK, in the form of 5685 grants from research councils and charities. Researchers from the University of Southampton compared grant data against estimated costs of infectious disease to the UK.
 
Relative to the disease burden they cause, apparently well-funded diseases included measles, hepatitis C, HIV, TB and enterotoxigenic E. coli. The disease receiving the most funding was HIV (16%) and the disease area receiving the most was respiratory infections (19%). Relatively neglected diseases included some sexually-transmitted infections (syphilis, gonorrhoea) and pneumonia. Funding was largely tilted towards pre-clinical research (69%) rather than clinical trials or public health studies.
 

Researchers have described an outbreak of invasive aspergillosis (IA) in heart transplant recipients. The paper describes seven cases seen over a ten month period, and discusses screening strategies used at a hospital in Canada.
 
The researchers note that the patients diagnosed with IA via screening achieved full response to treatment at 12 weeks, whereas those diagnosed after presentation of symptoms achieved only partial response in the same time frame, or failed to respond to treatment. However, this apparent difference could be due to differences in the patients, their respective infections, or their treatment, rather than early diagnosis.
 
The researchers conclude that CT scans of the chest might help to detect IA earlier in heart transplant recipients, which could improve outcomes for these patients. But the best strategies for screening and prophylaxis remain unclear.
Reviews

Researchers from Johann Wolfgang Goethe-University in Germany evaluated the role of natural killer cells in antifungal immunity in a review for the journal Frontiers in Immunology. The paper suggests that it is critical to improve understanding of the interaction between fungal pathogens and the immune response, so that new therapeutic approaches (including adoptive immunotherapy) might be developed. 
 
Host response to fungal infections is associated with both innate immunity and adaptive immunity. The authors state that the role of natural killer cells has been underestimated in this regard –studies have shown that these cells are able to attack various fungal species in vitro. It has also been shown that some fungi are able to suppress the action of natural killer cells. The review summarises data on the interaction between fungal pathogens and natural killer cells, from clinical, animal and in vitro studies. 
 
Veterinary
 
This study evaluated the use of a commercial immunoblot kit (Aspergillus Western Blot IgG kit; developed for the serological diagnosis of chronic aspergillosis in humans) for the diagnosis of aspergillosis in common bottlenose dolphins. Researchers compared results from a novel enzyme-linked immunosorbent assay (ELISA) test and the immunoblot on 32 ‘proven’ or ‘probable’ aspergillosis samples, and 55 negative controls.
 
The two tests were highly correlated in terms of diagnostic performance, but immunoblot showed higher specificity (92.7%) and lower sensitivity (65.6%) than the ELISA (69.1% and 90.6% respectively). The authors suggest that both tests could help to diagnose aspergillosis in dolphins. Aspergillosis appears to be relatively common in captive dolphins, but the incidence of fungal infection in captive cetaceans compared to wild cetaceans is, as of yet, unknown.  
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Patients & Carers
Patient Meetings

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 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.
 
N.B. The next patients' meeting will be held in Portugal at the AAA conference on the 1st February - visit the AAA website to learn more and book.
 
For more details see the Patients Community Newsletter

Skype Meetings

If you would like to listen or chat with 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 GMT every Thursday
 
We have recently started running a USA/Worldwide Skype group at 5pm GMT every Thursday, which can be accessed using this link: https://join.skype.com/ffp8FM6UysGf 
 
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 carers, friends and family of someone who is affected by the disease - join here
 
To find our regional and international groups, search the following terms within Facebook: 'aspergillosis'; 'aspergillus'; 'ABPA'
Fungal Infection Trust, PO Box 482, Macclesfield, Cheshire SK10 9AR