Pathogenesis

The presence of aspergillus in the bronchial wall results in an inflammatory process:

• mucus production is increased
• plugging of the airways causes distal collapse of the airways
• bronchiectasis occurs

The inhalation of Aspergillus fumigatus spores can elicit an acute allergic response:

• an immediate type I IgE response results in mast cell degranulation with bronchoconstriction and increased capillary permeability
• the leakage of anti-aspergillus antibodies into the bronchi results in a delayed type III response 4-6 hours after exposure

Reference

1. Gago S, Denning DW, Bowyer P. Pathophysiological aspects of Aspergillus colonization in disease. Med Mycol. 2019 Apr 1;57(supplement_2):S219-27.