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

Fricker‐Hidalgo, Hélène; Coltey, Bérangère; Llerena, C.; Renversez, Jean‐Charles; Grillot, R.; Pin, Isabelle; Pelloux, Hervé; Pinel, Claudine

doi:10.1128/cvi.00200-10

Cited by 42 publications

(38 citation statements)

References 25 publications

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“…Our study confirmed the high specificity (84.7%) of the IPD, based on in-house antigens that we have been using for Ͼ20 years, which was even greater (96.6%) when equivocal results were treated as negative (19). However, it was not significantly higher than that of the Bordier assay or the Bio-Rad assay, probably due to the loss of statistical power in the smaller sample size.…”

Section: Discussionsupporting

confidence: 68%

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Prospective Evaluation of a New Aspergillus IgG Enzyme Immunoassay Kit for Diagnosis of Chronic and Allergic Pulmonary Aspergillosis

et al. 2016

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j Anti-Aspergillus IgG antibodies are important biomarkers for the diagnosis of chronic pulmonary aspergillosis (CPA) and allergic bronchopulmonary aspergillosis (ABPA). We compared the performance of a new commercial enzyme immunoassay (EIA) (Bordier Affinity Products) with that of the Bio-Rad and Virion‫گ‬Serion EIAs. This assay is novel in its association of two recombinant antigens with somatic and metabolic antigens of Aspergillus fumigatus. In a prospective multicenter study, 436 serum samples from 147 patients diagnosed with CPA (136 samples/104 patients) or ABPA (94 samples/43 patients) and from 205 controls (206 samples) were tested. We obtained sensitivities of 97%, 91.7%, and 86.1%, and specificities of 90.3%, 91.3%, and 81.5% for the Bordier, Bio-Rad, and Virion‫گ‬Serion tests, respectively. The Bordier kit was more sensitive than the Bio-Rad kit (P < 0.01), which was itself more sensitive than the Virion‫گ‬Serion kit (P ‫؍‬ 0.04). The Bordier and Bio-Rad kits had similar specificity (P ‫؍‬ 0.8), both higher than that of the Virion‫گ‬Serion kit (P ‫؍‬ 0.02). The area under the receiver operating characteristic (ROC) curves confirmed the superiority of the Bordier kit over the Bio-Rad and the Virion‫گ‬Serion kits (0.977, 0.951, and 0.897, respectively; P < 0.01 for each comparison). In a subset analysis of 279 serum samples tested with the Bordier and Bio-Rad kits and an in-house immunoprecipitin assay (IPD), the Bordier kit had the highest sensitivity (97.7%), but the IPD tended to be more specific (71.2 and 84.7%, respectively; P ‫؍‬ 0.10). The use of recombinant, somatic, and metabolic antigens in a single EIA improved the balance of sensitivity and specificity, resulting in an assay highly suitable for use in the diagnosis of chronic and allergic aspergillosis.

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Section: Discussionsupporting

confidence: 68%

“…This assay is novel in terms of its antigen composition, because it combines two recombinant antigens with somatic and metabolic antigens from A. fumigatus. We compared this assay with two other commercial EIAs, the Platelia Aspergillus IgG (Bio-Rad) and the ELISA classic Aspergillus IgG (Virion‫گ‬Serion), and an in-house IPD method (19).…”

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confidence: 99%

Prospective Evaluation of a New Aspergillus IgG Enzyme Immunoassay Kit for Diagnosis of Chronic and Allergic Pulmonary Aspergillosis

et al. 2016

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“…assumption arises from several lines of investigation. First, serological studies in patients with ABPA and SAFS demonstrate IgE responses to fungal products derived from in vivo germination of inhaled conidia into hyphae, as these antibodies exist as a response to fungal exoproducts, hyphal cell wall components expressed during growth phase and cytoplasmic antigens [21,22]. Secondly, there is mounting evidence that fungal hyphal products, including b-glucan and proteases, activate epithelial cells to secrete proinflammatory and Th2-polarising cytokines and chemokines directly via Toll-like receptor-induced signalling, via other innate sensors or via protease-activated receptors [23][24][25][26].…”

Section: Antifungal Therapy In Abpa and Safsmentioning

confidence: 99%

Treatment options in severe fungal asthma and allergic bronchopulmonary aspergillosis

Moss

2013

Eur Respir J

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Severe asthma with fungal sensitisation and allergic bronchopulmonary aspergillosis encompass two closely related subgroups of patients with severe allergic asthma. Pulmonary disease is due to pronounced host inflammatory responses to noninvasive subclinical endobronchial infection with filamentous fungi, usually Aspergillus fumigatus. These patients usually do not achieve satisfactory disease control with conventional treatment of severe asthma, i.e. high-dose inhaled corticosteroids and long-acting bronchodilators. Although prolonged systemic corticosteroids are effective, they carry a substantial toxicity profile. Supplementary or alternative therapies have primarily focused on use of antifungal agents including oral triazoles and inhaled amphotericin B. Immunomodulation with omalizumab, a humanised anti-IgE monoclonal antibody, or "pulse" monthly high-dose intravenous corticosteroid, has also been employed. This article considers the experience with these approaches, with emphasis on recent clinical trials. @ERSpublications Treatment of fungal asthma includes glucocorticoids, azoles, amphotericin and anti-IgE. Trial validation is needed.

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“…ABPA is a severe complication related to A. fumigatus sensitisation and colonisation in the lung that affects patients with severe asthma (35,39,88,89). It is a frequent complication in cystic fi brosis patients (90). ABPA patients showed a marked increase in IgG and IgE antibodies against special A. fumigatus allergens (35).…”

Section: Health Effects Of Mouldsmentioning

confidence: 99%

Indoor Exposure to Mould Allergens

Prester

2011

Archives of Industrial Hygiene and Toxicology

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Indoor Exposure to Mould AllergensHumid indoor environments may be colonised by allergenic filamentous microfungi (moulds),Aspergillusspp.,Penicilliumspp.,Cladosporiumspp., andAlternariaspp. in particular. Mould-induced respiratory diseases are a worldwide problem. In the last two decades, mould allergens and glucans have been used as markers of indoor exposure to moulds. Recently, mould allergens Alt a 1 (Alternaria alternata) and Asp f 1 (Aspergillus fumigatus) have been analysed in various environments (residential and occupational) with enzyme-linked immunosorbent assays, which use monoclonal or polyclonal antibodies. Household Alt a 1 and Asp f 1 levels were usually under the limit of the method detection. By contrast, higher levels of mould allergens were found in environments with high levels of bioaerosols such as poultry farms and sawmills. Data on allergen Alt a 1 and Asp f 1 levels in agricultural settings may provide information on possible colonisation of respective moulds and point out to mould-related diseases in occupants.

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

Cited by 42 publications

References 25 publications

Prospective Evaluation of a New Aspergillus IgG Enzyme Immunoassay Kit for Diagnosis of Chronic and Allergic Pulmonary Aspergillosis

Prospective Evaluation of a New Aspergillus IgG Enzyme Immunoassay Kit for Diagnosis of Chronic and Allergic Pulmonary Aspergillosis

Treatment options in severe fungal asthma and allergic bronchopulmonary aspergillosis

Indoor Exposure to Mould Allergens

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