Comparison of serum markers for allergic bronchopulmonary aspergillosis in cystic fibrosis

Latzin, Philipp; Hartl, Dominik; Regamey, Nicolas; Frey, U.; Schoeni, Martin H.; Casaulta, Carmen

doi:10.1183/09031936.00078107

Cited by 77 publications

(52 citation statements)

References 38 publications

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“…Kraemer et al (13) have shown that allergen-specific IgE against these two recombinants could be detected almost exclusively in the sera of patients with ABPA. rAspf4 sensitivity is usually higher than that of rAspf6 (6, 11), but not for Latzin et al (15). In comparison, the sensitivities obtained in our work were 92.3% for rAspf4 and 53.8% for rAspf6.…”

Section: Discussionmentioning

confidence: 42%

Recombinant Allergens Combined with Biological Markers in the Diagnosis of Allergic Bronchopulmonary Aspergillosis in Cystic Fibrosis Patients

Fricker‐Hidalgo

Coltey

Llerena

et al. 2010

Clin Vaccine Immunol

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Allergic bronchopulmonary aspergillosis (ABPA) is a frequent complication in cystic fibrosis patients. The diagnosis remains difficult and requires a combination of clinical, radiological, biological, and mycological criteria. The aim of this study was to analyze the added value of two recombinant antigens, rAspf4 and rAspf6, associated with the detection of specific IgG; precipitins; total IgE; and Aspergillus fumigatus in sputum for the diagnosis of ABPA. In a retrospective study, we determined the specific IgE responses to these recombinants in 133 sera of 65 cystic fibrosis patients. We selected an average of five serum samples from each of the 17 patients with ABPA (13 proven and 4 probable ABPA) and from 3 patients with Aspergillus bronchitis and rhinosinusitis. One serum sample for the 45 patients without ABPA was tested. The sensitivity of specific IgE detection against rAspf4 calculated per patient (92.3%) was significantly higher (P < 0.05) than that of rAspf6 (53.8%). When rAspf4 IgE detection was associated with anti-Aspergillus IgG enzyme-linked immunosorbent assay (ELISA) and precipitin detection, the sensitivity rose to 100%. The specificities of rAspf4 and rAspf6 IgE detection were 93.7% and 91.6%, respectively. Other diagnostic criteria had slightly lower specificities (87.5% for anti-Aspergillus IgG ELISA, 89.6% for precipitins, 84.4% for total IgE, and 85.0% for positive A. fumigatus culture in sputum). In conclusion, this retrospective study showed the relevance of rAspf4 IgE detection, in combination with other biological markers (Aspergillus IgG ELISA, precipitins, and total IgE), for improving the biological diagnosis of ABPA.

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Section: Discussionmentioning

confidence: 42%

Recombinant Allergens Combined with Biological Markers in the Diagnosis of Allergic Bronchopulmonary Aspergillosis in Cystic Fibrosis Patients

Fricker‐Hidalgo

Coltey

Llerena

et al. 2010

Clin Vaccine Immunol

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“…56 Some immunological manifestations include recurrent episodes of eosinophilic airways inflammation, peripheral blood eosinophilia, increased serum concentrations of IL-2 receptor, high total serum IgE levels, and increased circulating specific IgE and IgG against A. fumigatus antigen. 56,72,73 The pathophysiology of ABPA still remains largely speculative, nonetheless several predisposing factors have been proposed for ABPA development.…”

Section: Abpamentioning

confidence: 99%

Cystic fibrosis, atopy, asthma and ABPA

Antunes

Fernandes

Borrego

et al. 2010

Allergologia et Immunopathologia

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The role of atopy on cystic fibrosis (CF) progression remains unclear but evidence suggests that it may influence the appearance of co-morbid conditions such as CF asthma or allergic bronchopulmonary aspergillosis (ABPA). Recognising asthma in patients with CF is not always easy but the identification of atopic markers favours the diagnosis. Physicians should be aware of this fact in order to achieve a better control of respiratory symptoms in patients with CF. Bronchial mucosa inflammation and abnormal mucus predispose to mould colonisation. These patients are at higher risk of allergic sensitisation, especially when atopic susceptibility is present. In the particular case of A. fumigatus, allergic sensitisation precedes ABPA development, which occurs in up to 10% of CF patients. Progression of lung function deterioration is most strikingly pronounced in patients with ABPA. Therefore, sensitisation with A. fumigatus should be regularly tested in patients with CF, especially those at higher risk. Recombinant allergens constitute an important advance in differentiating Aspergillus sensitisation from ABPA itself.

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“…The addition of other tests, such as antigen detection tests for galactomannan, which is released during hyphal growth, can help confirm active organisms, although may be falsely positive because of antibiotic therapy. Other potential biomarkers such as basophil CD203c and thymus activation and regulated cytokine may also have roles in evaluating Aspergillus disease in CF [15].…”

Section: Methods Of Detection Of Aspergillusmentioning

confidence: 99%

What is the importance of classifyingAspergillusdisease in cystic fibrosis patients?

Jones

Horsley

Denning

2014

Expert Review of Respiratory Medicine

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Comparison of serum markers for allergic bronchopulmonary aspergillosis in cystic fibrosis

Cited by 77 publications

References 38 publications

Recombinant Allergens Combined with Biological Markers in the Diagnosis of Allergic Bronchopulmonary Aspergillosis in Cystic Fibrosis Patients

Recombinant Allergens Combined with Biological Markers in the Diagnosis of Allergic Bronchopulmonary Aspergillosis in Cystic Fibrosis Patients

Cystic fibrosis, atopy, asthma and ABPA

What is the importance of classifyingAspergillusdisease in cystic fibrosis patients?

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