الفهرس 
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Abstract
Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. It is defined by the history of respiratory
symptoms such as wheeze, shortness of breath, chest tightness and
cough that vary over time and in intensity, together with variable
expiratory airflow limitation. Asthma results from interaction of many
genetic and environmental factors which influence on the tone or
reactivity of the airways. The World Health Organization recently
stated approximately 300 million people have asthma.
Moreover if remain uncontrolled, it leads to poor quality of life
and increased economic threat to the family and the society
It is thought that up to 10% of people with asthma have poorly
controlled disease with major life impact despite guideline-based
combination high-dose inhaled corticosteroid/long-acting
bronchodilator therapy, i.e. severe asthma. One-third to one-half of
these severe asthmatics has atopic sensitization to filamentous fungi,
most prominently to Aspergillus fumigatus.
Allergic bronchopulmonary aspergillosis (ABPA) occurs almost
exclusively in people with asthma. It results from atopic sensitization
to hypha antigens of filamentous fungi (A. fumigatus in 90% of
cases), which provokes a florid innate and adaptive immuneinflammatory.
The aim of this study was to evaluate the role of Aspergillus
fumigatus infection in patients with uncontrolled asthma.
The present study was conducted on 80 patients known to be
uncontrolled bronchial asthma according GINA guidelines
(GINA2014); they were selected from El- Mahalla Chest Hospital
from September 2014 to December 2015.They were 27 males and 53
females, their ages ranged from 23 years to 52 years ( 36.763±7.889).
All subjects were subjected to the following:
1. Medical history taking.
2. Physical examination (general and local examination).
3- Radiographic study:
a) Plain chest X ray (posterior-anterior and lateral view).
b) High resolution computed tomography (HRCT) of the chest.
4- Laboratory investigation:
a) Serum total IgE levels.
b) Complete blood count (Eosinophilic count).
c) Specific IgE for Aspergillus fumigatus.
5- Sputum examination of Aspergillus fumigatus.
6- Pulmonary function tests (before and after bronchodilator).
The results of the present study showed that, the prevalence of ABPA
was 15% in patients with uncontrolled asthma; higher prevalence of
ABPA might be due to improved diagnostic methods and awareness
that have led to recent reports of higher prevalence of ABPA.
In our study we found that elevated level of specific antibodies
to Aspergillus fumigatus is considered the hallmark of ABPA.
In the present study, we founfound that 12 patients (15%) of patients
had central bronchiectasis on HRCT which is usually the most
common finding in ABPA with asthma.
In our study, there were significant inverse correlations between
FEV1% on one side and serum total IgE, peripheral blood
eosinophilia, HRCT, sputum culture for A. fumigatus and A.
fumigatus specific IgE test.
In our study there were significant positive correlations between
A. fumigatus specific IgE test and duration of asthma.
In our study there were significant positive correlations between
serum total IgE and peripheral blood eosinophilia.