Abstract
BackgroundAspergillus fumigatus, a widely distributed fungus, has been implicated in causing life threatening infections as well as severe asthma and allergic diseases in man. Allergic affliction like allergic bronchopulmonary aspergillosis (ABPA) is a disabling lung disease frequently seen in patients with asthma and cystic fibrosis. Immunodiagnosis of the former is comparatively easier due to the availability of purified antigens and sensitive methods. However, this is not true with cystic fibrosis patients where the prevalence of ABPA is fairly high and the morbidity and mortality are significant.MethodsIn the present study, we have evaluated purified recombinant allergens from A. fumigatus, namely Asp f 1, f 2, f 3, f 4, and f 6 using ELISA and a semi-automated method (ImmunoCAP). We studied 17 patients each from cystic fibrosis with ABPA, and cystic fibrosis with asthma, 22 cystic fibrosis with no ABPA or asthma, and 11 age matched controls.ResultsThe results indicate that no antigen, antibody or method is capable of differentiating cystic fibrosis (CF) with ABPA from other CF patients, although some allergens showed strong reaction or showed more prevalence among the patients studied.ConclusionWhen results of several allergens such as Asp f 1, f 2, f 3, f 4, and f 6 in their binding to IgA, IgG, and IgE antibodies were analyzed, a more strong discrimination of CF patients with ABPA was possible from the other groups studied.
Highlights
Aspergillus fumigatus, a widely distributed fungus, has been implicated in causing life threatening infections as well as severe asthma and allergic diseases in man
The IgE antibody levels in the sera of cystic fibrosis (CF)-allergic bronchopulmonary aspergillosis (ABPA) against both recombinant A. fumigatus (Af) allergens as well as crude Af extract were higher than in CF with asthma, but due to similar reactivity of some patients in both groups, the usefulness of specific IgE for differential diagnosis is questionable as there were no significant differences in the response of specific IgE to Aspergillus allergens
The results presented here indicate that the demonstration of specific IgE, IgG, and IgA isotypes with recombinant Af allergens has less usefulness in the diagnosis of CF-ABPA than in non-CF-ABPA
Summary
Aspergillus fumigatus, a widely distributed fungus, has been implicated in causing life threatening infections as well as severe asthma and allergic diseases in man. Allergic affliction like allergic bronchopulmonary aspergillosis (ABPA) is a disabling lung disease frequently seen in patients with asthma and cystic fibrosis. Immunodiagnosis of the former is comparatively easier due to the availability of purified antigens and sensitive methods. This is not true with cystic fibrosis patients where the prevalence of ABPA is fairly high and the morbidity and mortality are significant. Allergic bronchopulmonary aspergillosis (ABPA) is a disabling allergic disease frequently seen in patients with asthma and cystic fibrosis [1,2]. The results indicate that no single allergen specificity or antibody isotype specificity can reliably identify ABPA with CF, majority of such patients showed significantly increased polyclonal response to multiple antigens
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