Abstract
Allergic bronchopulmonary aspergillosis (ABPA) is a condition characterized by an exaggerated response of the immune system to the fungus Aspergillus. This study aimed to assess the relationship between carcinoembryonic antigen (CEA) and eosinophils in ABPA patients. We describes a case of a 50-year-old patient who was diagnosed with ABPA presenting with high level of CEA and eosinophils. Besides,we used immunohistochemistry and immunofluorescence to identify eosinophils and CEA in sections which were obtained by Endobronchial ultrasound-guided transbronchial lung biopsy aspiration (EBUS-TBLB). The sections were then visualized using confocal microscopy. We also retrospectively analyzed a cohort of 37 ABPA patients between January 2013 and December 2019 in our hospital. We found the patient whose serum CEA levels were consistent with eosinophils during the follow-up (r = 0.929, P = 0.022). The positive expression of CEA and abnormal expression of eosinophils was higher in the ABPA tissue compared to the normal lung tissue. The co-localization was represented as pixels containing both red and green color in the image (with various shades of orange and yellow) which signified that eosinophils were immunohistochemically positive for CEA. Patients with higher levels of eosinophils had higher levels of CEA in the serum (P < 0.001). The results of Pearson correlation analysis showed that the levels of eosinophils were positively correlated with serum CEA levels (r = 0.459 and r = 0.506, P = 0.004 and P = 0.001). Serum CEA level is elevated in ABPA patients. The elevated serum CEA level was shown to be normalized after treatment. Increased CEA levels in ABPA patients may be positively correlated with eosinophil levels, and eosinophils may be served as CEA-secreting cells in patients with ABPA.
Highlights
Abbreviations ABPA Allergic bronchopulmonary aspergillosis carcinoembryonic antigen (CEA) Carcinoembryonic antigen EBUS-TBLB Endobronchial ultrasound-guided transbronchial lung biopsy aspiration acquired idiopathic generalized anhidrosis (AIGA) Acquired idiopathic generalized anhidrosis neutrophil extracellular traps (NETs) Neutrophil extracellular traps enzyme-linked immunosorbent assay (ELISA) Enzyme-linked immunosorbent assay IL-5 Interleukin-5 myelin basic protein (MBP) Myelin basic protein hematoxylin and eosin (H&E) Hematoxylin and eosin bovine serum albumin (BSA) Bovine serum albumin phosphate-buffered saline (PBS) Phosphate-buffered saline DAPI 4′,6-Diamidino-2-phenylindole ISHAM The International Society for Human and Animal Mycology positron emission tomographycomputed tomography (PET-CT) Positron emission tomography-computed tomography
Aim of the study was to assess whether eosinophils of allergic bronchopulmonary aspergillosis (ABPA) patients express carcinoembryonic antigen (CEA)
A 50-year-old female patient suffering from cough and dyspnea for 2 years was diagnosed with lung cancer because of high serum levels of CEA and lymphadenopathy before she was admitted to our hospital
Summary
Abbreviations ABPA Allergic bronchopulmonary aspergillosis CEA Carcinoembryonic antigen EBUS-TBLB Endobronchial ultrasound-guided transbronchial lung biopsy aspiration AIGA Acquired idiopathic generalized anhidrosis NETs Neutrophil extracellular traps ELISA Enzyme-linked immunosorbent assay IL-5 Interleukin-5 MBP Myelin basic protein H&E Hematoxylin and eosin BSA Bovine serum albumin PBS Phosphate-buffered saline DAPI 4′,6-Diamidino-2-phenylindole ISHAM The International Society for Human and Animal Mycology PET-CT Positron emission tomography-computed tomography. Allergic bronchopulmonary aspergillosis (ABPA) is characterized by an allergic inflammatory response to Aspergillus fumigatus colonized in the trachea[1]. It is manifested as poorly controlled asthma and affected approximately. People with high levels of serum CEA usually indicates the presence of malignant tumors. Japanese scholars have reported 13 patients with ABPA, in which 7 of them had elevated levels of CEA in the peripheral blood. In case of pulmonary consolidation, the serum CEA levels were gradually returned to normal level[7]. The study did not mention the precise source of CEA in ABPA patients. Aim of the study was to assess whether eosinophils of allergic bronchopulmonary aspergillosis (ABPA) patients express carcinoembryonic antigen (CEA). The first part of the manuscript describes a case study of a patient with high levels of CEA with a suspected diagnosis of ABPA, the second part describes a retrospective cohort study of 37 hospitalized ABPA patients
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