Optimal Aspergillus fumigatus and Asp f 1 serum IgG cut-offs for the diagnosis of allergic bronchopulmonary aspergillosis
Optimal Aspergillus fumigatus and Asp f 1 serum IgG cut-offs for the diagnosis of allergic bronchopulmonary aspergillosis
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DOI：
10.1016/j.alit.2020.07.006
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发表时间：
2021-01-01
影响因子：
6.8
通讯作者：
Taniguchi, Masami
中科院分区：
文献类型：
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作者：
Hamada, Yuto;Fukutomi, Yuma;Taniguchi, Masami
背景资料：抗烟曲霉IgG抗体（Abs）的存在是过敏性支气管肺曲霉病（ABPA）的重要诊断标准。虽然沉淀传统上用于记录IgG抗体，但抗Af血清IgG水平也可通过酶免疫测定法（EIA）测量。然而，关于评估EIA方法诊断性能的最佳临界值的数据不足。本研究旨在确定IgG结合Af粗提物或重组Aspf 1（ImmunoCAP（R））的临界水平，并比较它们与Af沉淀Ab诊断ABPA的功效。方法：使用694名健康对照（HC）的血清建立Af粗提物（Af-IgG）和重组Aspf 1（Aspf 1-IgG）的IgG水平的年龄分布。对306例（包括49例ABPA）Af致敏哮喘患者的Af-IgG和Aspf 1-IgG水平进行受试者操作特征分析，并确定其诊断界值。因此，对于年龄≥ 55岁的患者，按年龄分别确定Af-IgG水平的临界值为60 mg/L。对于Asp f 1-IgG，无论年龄如何，均将6.6 mg/L设定为临界值。虽然这样的IgG检测EIA允许足够好的诊断性能，AF沉淀抗体有更好的诊断适用性ABPA.Conclusions：我们确定了截止值为AF-IgG和天冬氨酸f 1-IgG测定EIA，这可能是有用的沉淀抗体不可用的临床环境。日本过敏学会版权所有（C）2020。制作和主办：Elsevier B. V.
Background: The presence of IgG antibodies (Abs) to Aspergillus fumigatus (Af) is a crucial diagnostic criterion for allergic bronchopulmonary aspergillosis (ABPA). Although precipitation is traditionally used to document IgG Abs, anti-Af serum IgG levels can also be measured by enzyme immunoassay (EIA). However, there are insufficient data on the optimal cut-offs to assess diagnostic performance of the EIA method. This study aimed to determine cut-off levels of IgG binding crude Af extracts or recombinant Asp f 1 (by ImmunoCAP (R)) and to compare their efficacy for ABPA diagnosis with Af-precipitating Abs.Methods: The age distribution of levels of IgG to crude extracts of Af (Af-IgG) and recombinant Asp f 1 (Asp f 1-IgG) was established using sera from 694 healthy controls (HC). Receiver operating characteristic analysis for Af-IgG and Asp f 1-IgG levels for the purpose of ABPA diagnosis was performed in 306 Af-sensitized asthma patients (including 49 ABPA), and cut-offs were determined.Results: An age-dependent decline in the levels of Af-IgG was observed in HC. Thus, cut-offs for Af-IgG levels were determined separately by age as 60 mg/L for patients aged = 55 years. For Asp f 1-IgG, 6.6 mg/L was set as the cut-off regardless of age. Although such IgG testing by EIA allowed a sufficiently good diagnostic performance, Af-precipitating Abs had better diagnostic applicability for ABPA.Conclusions: We determined cut-offs for Af-IgG and Asp f 1-IgG measured by EIA, which can be useful in clinical settings where precipitating Abs are unavailable. Copyright (C) 2020, Japanese Society of Allergology. Production and hosting by Elsevier B.V.