Studies of the dual antibody response in allergic bronchopulmonary aspergillosis

Abstract

Bronchopulmonary aspergillosis was diagnosed in a 22-year-old man with pulmonary infiltrates and peripheral eosinophilia on the basis of precipitating antibody to A. fumigatus in serum and characteristic type I and type III responses following intradermal skin testing with the mold. The antibody was eluted from a DEAE-cellulose column, and the activity was shown to be IgG as demonstrated by gel diffusion analysis. These antibodies could be specifically absorbed from the serum by A. fumigatus but not by other members of the Aspergillus genus. Serum reagins were found in the IgE class of immunoglobulins and were developed against determinants common to several Aspergillus molds. However, both in vivo and in vitro absorption experiments established the majority of skin-sensitizing activity to be specific for determinants peculiar to A. fumigatus. Attempts were made to fractionate the allergenic material, and three peaks were obtained by application to a Sephadex G-200 column. The fractions obtained varied in capacity to precipitate with the patient's serum in gel diffusion and to evoke wheal and flare responses at P-K sites sensitized with the patient's serum.