Steroids and aspergillosis ?

[Chrisf100]

Hi, my question is as follows.

Can seretide or any corticosteroids inhaled or taken orally encourage the growth of aspergillus in the lungs .

I have a poor immune system and know that steroids can further weaken our defences.

I take itraconazol long term for the aspergillosis and have a bad flare up at the moment and can't help but wonder if the steroids could contribute to this.

[GAtherton Administrator Fungal Infection Trust]

There have been a few papers that associate people who are severely asthmatic and those who are on steroid treatment tend to have a higher fungal load (as a proportion of their whole microbiome) in their lungs eg jacionline.org/article/S009... - study that took place at the UK National Aspergillosis Centre in Manchester.

This does not necessarily mean that the steroid is causing a higher fungal load as it could be that the higher fungal load is causing the use of the steroid for example. It is really difficult to differentiate between these possibilities convincingly.

Use of an antifungal medication at the same time as taking steroids has been shown to be effective for some patients, reducing frequency and severity of symptoms. It also appears to reduce fungal load, though this does not correlate well with symptoms.

In short this study (one of the first of its type) offers some highly intriguing insights into the impact of corticosteroids and antifungal medication on the amount of fungus in a patients lungs, and the impact that that fungus has on symptoms, but the data is a little too variable to make strong conclusions. We need to do similar work on larger patient populations.