Serum Aspergillus fumigatus-Specific IgG as a Complementary Biomarker in Differentiating Endotypes of Chronic Rhinosinusitis: A Study on Its Role and Diagnostic Efficacy in Type 2 Inflammation.

IF 2.5 3区 医学 Q1 OTORHINOLARYNGOLOGY American Journal of Rhinology & Allergy Pub Date : 2024-09-01 Epub Date: 2024-05-15 DOI:10.1177/19458924241253937
Pei-Tzu Hung, Hsiang-Sheng Wang, Ta-Jen Lee, Chi-Che Huang, Po-Hung Chang, Yi-Wei Chen, Chia-Hsiang Fu
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Abstract

Background: Aspergillus is one of the most common pathogens causing fungal allergy in the respiratory tract. Serum Aspergillus fumigatus-specific immunoglobulin G (Af-sIgG) levels have been used as a biomarker for the diagnosis and treatment response monitoring in airway allergic diseases such as allergic bronchopulmonary aspergillosis and allergic fungal rhinosinusitis. However, its role in common primary chronic rhinosinusitis (CRS) was unclear.

Objective: This study aims to evaluate whether serum Af-sIgG level could serve as a biomarker for the disease presentation of primary CRS.

Methods: We obtained serum Af-sIgG levels from patients diagnosed as bilateral primary CRS refractory to medical treatment and evaluated the correlations between serum Af-sIgG levels and disease severity in patients with type 2 (T2) and non-T2 CRS.

Results: Patients with T2 CRS exhibited significantly higher serum Af-sIgG levels than non-T2 CRS patients. The cut-off value of serum Af-sIgG in T2 CRS was 20.9 mg/L, with an odds ratio of 3.8 (95% CI 1.17-12.20, P = .026). Furthermore, serum Af-sIgG levels were positively correlated with symptom scores evaluated by the Sino-Nasal Outcome Test-22 (SNOT-22) scores in T2 patients (P = .009). While stratified by SNOT-22 total scores, patients with severe disease had higher serum Af-sIgG levels only in T2 CRS (P = .034). In individual domains of SNOT-22 analysis, serum Af-sIgG levels showed a significant correlation with "ear/facial" symptom scores in the T2 group (P < .001).

Conclusions: Serum Af-sIgG levels may serve as a supplementary objective biomarker that correlates with identification and subjective measurements of T2 CRS, and may be associated with symptoms arising from Eustachian tube dysfunction.

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血清曲霉菌特异性 IgG 作为区分慢性鼻炎内型的补充生物标记物:关于其在2型炎症中的作用和诊断效力的研究。
背景:曲霉菌是导致呼吸道真菌过敏的最常见病原体之一。血清曲霉菌特异性免疫球蛋白 G(Af-sIgG)水平已被用作过敏性支气管肺曲霉菌病和过敏性真菌性鼻炎等气道过敏性疾病诊断和治疗反应监测的生物标志物。然而,它在普通原发性慢性鼻炎(CRS)中的作用尚不明确:本研究旨在评估血清 Af-sIgG 水平是否可作为原发性 CRS 疾病表现的生物标志物:我们采集了被诊断为药物治疗难治性双侧原发性CRS患者的血清Af-sIgG水平,并评估了2型(T2)和非T2型CRS患者血清Af-sIgG水平与疾病严重程度之间的相关性:结果:T2型CRS患者的血清Af-sIgG水平明显高于非T2型CRS患者。T2 CRS患者血清Af-sIgG的临界值为20.9 mg/L,几率比为3.8(95% CI 1.17-12.20,P = .026)。此外,在T2患者中,血清Af-sIgG水平与通过Sino-Nasal Outcome Test-22(SNOT-22)评分评估的症状评分呈正相关(P = .009)。根据 SNOT-22 总分进行分层,只有在 T2 CRS 患者中,重症患者的血清 Af-sIgG 水平较高(P = .034)。在 SNOT-22 分析的单个领域中,T2 组血清 Af-sIgG 水平与 "耳/面部 "症状评分有显著相关性(P = 0.009):血清 Af-sIgG 水平可作为一种补充性客观生物标志物,与 T2 CRS 的识别和主观测量结果相关,并可能与咽鼓管功能障碍引起的症状有关。
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来源期刊
CiteScore
5.60
自引率
11.50%
发文量
82
审稿时长
4-8 weeks
期刊介绍: The American Journal of Rhinology & Allergy is a peer-reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials, and review articles.
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