Serum total IgE may be a biomarker among chronic pulmonary aspergillosis patients with elevated serum total IgE levels: A cohort study with pathological evaluations
Serum total IgE may be a biomarker among chronic pulmonary aspergillosis patients with elevated serum total IgE levels: A cohort study with pathological evaluations
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血清总 IgE 可能是血清总 IgE 水平升高的慢性肺曲霉病患者的生物标志物：病理学评估的队列研究
DOI：
10.1093/mmy/myac006
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发表时间：
2022
期刊：
影响因子：
2.9
通讯作者：
Matsui Hirotoshi
中科院分区：
文献类型：
--
作者：
Watanabe Shizuka;Suzuki Junko;Suzukawa Maho;Takeda Keita;Imoto Sahoko;Kitani Masashi;Fukami Takeshi;Sasaki Yuka;Hebisawa Akira;Matsui Hirotoshi
据报道，慢性肺曲霉菌病(CPA)患者血清总免疫球蛋白E(IgE)水平升高。然而，研究人员还没有证实它们是否反映了疾病的活动。我们的目的是比较CPA患者急性加重期和稳定期血清总IgE水平，并通过免疫荧光染色检测皮损中IgE的表达模式。自2016年4月至2019年9月，我们根据美国传染病学会的标准，提取了血清总IgE水平升高的CPA病例。对血清总IgE水平等指标进行回顾性分析，最终抽取32例。急性加重期患者血清总IgE水平显著高于稳定期(P<；P<0.0001)。中位数变化率为1.76倍(四分位数为1.41~3.25)。另外，对血清总IgE水平升高的CPA患者、血清总IgE正常的CPA患者的手术标本和对照手术标本进行了IgE、肥大细胞类胰蛋白酶、CD138和4，6-二氨基-2-苯吲哚的免疫荧光染色。无论血清总IgE水平如何，CPA患者均可见多个肥大细胞和浆细胞。血清总IgE水平较高的CPA患者可见多个类胰蛋白酶阳性细胞。提示血清总IgE可作为判断病情严重程度的生物标志物。免疫荧光染色提示在慢性肺曲霉菌病中，血清总IgE水平升高的慢性肺曲霉菌病患者血清总IgE水平升高，可能通过交联性激活肥大细胞参与发病。这项新的研究表明，在上述情况下，血清总IgE可能是疾病活动性的一个生物标志物。免疫荧光染色提示IgE可能在疾病发病机制中起作用。
High serum total immunoglobulin E (IgE) levels have been reported in chronic pulmonary aspergillosis (CPA). However, researchers have not verified if they reflect the disease activity. We aimed to compare the serum total IgE levels in CPA cases with high serum IgE during an exacerbation or when stable and examined the IgE expression patterns in the lesions via immunofluorescence staining. From April 2016 to September 2019, we extracted CPA cases with elevated serum total IgE levels based on the criteria of the Infectious Diseases Society of America. We retrospectively analyzed serum total IgE levels and other parameters and eventually extracted 32 cases. The patients’ serum total IgE levels were significantly higher in the exacerbation period than in the stable period (P< .0001). The median rate of change was 1.76 times (quartile 1.41–3.25). In addition, we used surgical specimens of CPA cases with high serum total IgE levels, normal serum total IgE CPA cases, and control surgical specimens and performed immunofluorescence staining with IgE, mast cell tryptase, CD138, and 4,6-diamidino-2-phenylindole. We observed multiple mast cells and plasma cells in the CPA cases regardless of the serum total IgE level. In contrast, multiple IgE-positive cells co-stained with tryptase were observed in CPA cases with high serum total IgE levels. This finding suggested that serum total IgE could serve as a biomarker for evaluating disease severity. Immunofluorescence staining suggested that IgE may play a role in pathogenesis through activation of mast cells by cross-linking in cases of CPA with high serum total IgE levels.Lay summaryHigh serum total IgE levels are common in chronic pulmonary aspergillosis. This novel study indicated that serum total IgE is a possible biomarker of the disease activity in the aforementioned condition. Immunofluorescence staining indicated a possible role of IgE in disease pathogenesis.