The validity of specific IgG and IgG4 in fungal disease diagnosis

Author:

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

Author address:

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

Full conference title:

European Academy of Allergy and Clinical Immunology Congress 2015

Date: 5 August 2020

Abstract:

Background: In allergic disease, specific IgG is used as a marker for exposure in some lung diseases including allergic alveolitis, aspergilloma and aspergillosis. Aspergilloma is mainly seen in patients with cavitary lung disease, while allergic bronchopulmonary aspergillosis is described in patients with hypersensitivity to Aspergillus antigens. Diagnose of fungal disease is often be difficult. Thus a serological method that could help clinicians in diagnose fungal disease is desirable. Our aim was to assess the validity of specific IgG and IgG4 in pulmonary fungal disease diagnosis.

Method: 217 patients with a possible pulmonary aspegillosis were evaluated at the IRCCS San Matteo Hospital in Pavia (Italy) from January 2010 to January 2014. Serum levels of IgG and IgG4 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; 9 of them were a risk and 23 with a probable sensitization. Aspergillus Niger (AN) was isolated in other 36 patients; 10 of them were a risk and 15 with a probable sensitization. Serum galactomannan was checked in 25 patients only.

Results: IgG levels show a significant difference between positive and negative coltures of Aspergillus Fumigatus (r p = 0.0062) but not for Aspergillus Niger (p = 0.059). Also IgG4 are significantly different between positive and negative coltures of Aspergillus Fumigatus (p = 0.0015) but not for Aspergillus Niger (p = 0.1241). Moreover IgG and IgG4 values showed a significant difference between AF and AN in positive (respectively p = 0.0074) and negative coltures (p < 0.0001), with higher values of AF. Also IgG4 are significantly different between AF and AN in positive (p = 0.0001) and negative coltures (p < 0.0001), with higher values of AF. Furthermore, in positive culture, specific IgG and IgG4 levels resulted statistically significant also when serum galactomannan was negative (respectively p = 0.0115 and p = 0.0017).

Conclusion: Specific IgG and IgG4 serum levels seem to be serologic tests that could potentially predict the pulmonary fungal disease.

Abstract Number: 1248

Link to conference website:

Link Conference abstract: 

EAACI 2015

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