Development of immune responses to Aspergillus at an early age in children with cystic fibrosis.

Abstract

Although the ability of Aspergillus organisms to colonize the respiratory tract in patients with cystic fibrosis (CF) is well recognized, the contribution of Aspergillus to the disease process is poorly understood. Using sera from 147 CF patients (age 5 to 43 yr), we measured IgE antibody (ab) to Aspergillus fumigatus and five common inhalant allergens with a radioallergosorbent test (RAST). Total IgE levels and IgG ab to radio-labeled Asp f I, an allergen purified from A. fumigatus and a potent inhibitor of protein synthesis, were also measured. Thirty (20%) of the patients had IgE ab to A. fumigatus, and 22 (15%) of these patients had developed total IgE levels > or = 400 IU/ml, raising the consideration of a diagnosis of allergic bronchopulmonary aspergillosis (ABPA). Five of the 22 patients developed these IgE responses by age 5 yr and 14 by age 10 yr. The proportion of patients with IgE ab to one or more of the other allergens tested was not significantly different from that of control subjects without respiratory symptoms. A striking proportion (84%) of CF sera contained IgG ab to Asp f I, compared with 6% of sera from control patients and 20% of sera from allergic children with asthma (n = 25), only one of whom had IgE ab to A. fumigatus. In an examination of additional sera from young CF patients, IgG anti-Asp f I ab was detected in 41% of these sera from patients 5 yr of age or older, increasing to 98% of 89 sera from patients older than age 10.(ABSTRACT TRUNCATED AT 250 WORDS)

Use of Recombinant Mitogillin for Improved Serodiagnosis ofAspergillus fumigatus-Associated Diseases

“…These data obtained for the blood donors confirm the high degree of specificity (95.4%) of the mitogillin-based test system. Similar ratios were identified by Heymann and colleagues (10), who detected AspfI-reactive IgG antibodies in 6% of control patients. We tested serum samples of blood donors with an age range of from 19 to 65 years.…”

Quantification of IgG Antibodies to Aspergillus fumigatus and Pigeon Antigens by ImmunoCAP Technology: An Alternative to the Precipitation Technique?

“…Previous reports also described colonization with A. fumigatus in patients with cystic fibrosis (13,31,32 ), COPD, and pulmonary infection (33)(34)(35). All patient groups, except those with bronchial asthma, had substantially higher concentrations of specific IgG to A. fumigatus than did nondiseased controls but significantly lower concentrations than the aspergillosis and ABPA patient groups (Table 1).…”

“…Other immunodiffusion assays, such as counterimmunoelectrophoresis (5 ) and radioimmunoprecipitation (13,14 ), are more rapid tests with lower detection limits than the precipitation technique. Although ELISA was shown to be even more sensitive and reliable than immunodiffusion (9,10,15 ), its suboptimal specificity can lead to false-positive results, identifying clinically irrelevant IgG responses.…”

Vitamin D3 attenuates Th2 responses to Aspergillus fumigatus mounted by CD4+ T cells from cystic fibrosis patients with allergic bronchopulmonary aspergillosis

“…Among fungal organisms that colonize the respiratory tracts of patients with CF, the ubiquitous environmental mold Aspergillus fumigatus is the most prevalent. In fact, in one study, up to 80% of children with CF demonstrate IgG antibody to Asp f1, an immunodominant Aspergillus peptide antigen, by an early age (13). The presence of A. fumigatus in a patient's sputum and immune recognition may or may not manifest in overt clinical disease.…”