Specific IgE and IgG and pulmonary fungal disease

Author:

De Amici, M 1; Mariani, F 2; Corsico, AG 2; Piloni, D 2; Paracchini, E 2; Torre, C 1; Nigrisoli, S 1; Campo, I 2; Marseglia, GL 1

Author address:

1 Foundation IRCCS Policlinico San Matteo, Department of Pediatrics, Pavia, Italy; 2
Foundation IRCCS Policlinico San Matteo, Department of Pneumology, Pavia, Italy

Full conference title:

European Academy of Allergy and Clinical Immunology Congress 2015

Date: 5 August 2020

Abstract:

Background: Aspergillus may cause a variety of pulmonary diseases, depending on immune status and the presence of underlying lung disease. Aspergilloma is mainly seen in patients with cavitary lung disease, while allergic bronchopulmonary aspergillosis is described in patients with hypersensitivity to Aspergillus antigens. Definitive diagnosis of fungal disease is often difficult, when culture is negative. The detection of specific IgE may enable clinicians to select the best strategy for managing the disease. Therefore the detection of IgG and IgG4 is considered a marker for exposure in some lung diseases. Aim of this study is to demonstrate the validity of specific IgE and IgG in pulmonary fungal disease diagnosis.

Method: Two hundred and seventeen patients with a possible pulmonary aspegillosis have been evaluated. Serum levels of specific IgE were measured by immunofluorometric assay and expressed in kU/L. Values higher than 0.35 kU/L were considered positive. Serum levels of IgG were measured by immunofluorometric assay and expressed in mgA/L. Values higher than 25 mgA/L indicate a probable sensitization while values in the range 8–25 mgA/L indicate a risk. Aspergillus Fumigatus (AF) was isolated in 36 patients; 10 of them had positive specific IgE to AF. IgG to AF showed that 9 patients were a risk and 23 with a probable sensitization. Aspergillus Niger (AN) was isolated in other 36 patients; 6 of them had positive specific IgE to AN. IgG to AN showed that 10 patients were a risk and 15 with a probable sensitization.

Results: In our preliminary data, IgE specific antibodies level are significantly different between positive and negative coltures of Aspergillus Fumigatus (p = 0.045) and Aspergillus Niger (p = 0.048). IgG and IgG4 levels show a significant difference between positive and negative coltures of Aspergillus Fumigatus (respectively p = 0.0062 and p = 0.0015) but not for Aspergillus Niger (respectively p = 0.059 and p = 0.1241). Moreover specific IgE levels resulted significantly different also comparing A. Fumigatus with A. Niger in positive(p = 0.0001)and in negative coltures (p < 0.0001), with higher values of AF. Also IgG and IgG4 values showed a significant difference between AF and AN in positive (respectively p = 0.0074 and p = 0.0001) and negative coltures (both p < 0.0001), with higher values of AF.

Conclusion: Specific IgE serum levels and IgG serum levels seem to be serologic tests that could potentially predict the pulmonary fungal disease.

Abstract Number: 1247

Link to conference website:

Link Conference abstract: 

EAACI 2015

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