One health approach to management of antifungal resistance in allergic bronchopulmonary aspergillosis.

Allergic bronchopulmonary aspergillosis (ABPA) is defined as a type I hypersensitivity reaction against allergens derived from Aspergillus spp., ubiquitous fungi present in various environments. Annually, the disease contributes a significant proportion to global morbidity and mortality, relative to other fungal diseases. Although known to affect populations worldwide, the exact pathogenesis of the disease from environmental to clinically-pertinent isolates and the basis for the emergence of antifungal resistance, a known by-product of unregulated prescription and use of drugs targeted at specific factors involved in forming fungal structural elements (i.e., ergosterol, chitin) and mediating survival mechanisms (i.e., fungal metabolism, DNA/RNA synthesis), remains poorly understood. Here, we focus on the role of the one health approach in combating the environment-host transition and mitigating the emergence of antifungal resistance. This includes the synthesis of current literature relevant to the subsequent insights on strategies to control the spread of the disease. From the findings of the present review, novel approaches to manage the incidence of ABPA and reduce the overall disease burden can be developed on a global scale. Perspectives utilizing the One Health approach has emerged as a prominent future direction for health programs worldwide, geared towards reducing the incidence and overall burden of fungal respiratory infections, such as ABPA.