Clinical applications of immunoglobulin G against different individual Aspergillus species for the diagnosis of chronic pulmonary aspergillosis among at-risk populations.

IF 4.9 4区 医学 Q1 PARASITOLOGY Pathogens and Global Health Pub Date : 2024-11-06 DOI:10.1080/20477724.2024.2424489
Li-Ta Keng, Chen-Chieh Lin, Chang-Wei Wu, Chia-Jung Liu, Lih-Yu Chang, Meng-Rui Lee, Jung-Yueh Chen, Jann-Yuan Wang
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Abstract

Aspergillus fumigatus-specific IgG is often used as a diagnostic test for chronic pulmonary aspergillosis (CPA), but few studies have evaluated the performance and serology of IgGs from species other than A. fumigatus. In this study, we evaluated the serology and performance of different Aspergillus species-specific IgG antibodies in patients with CPA and at-risk populations and whether different Aspergillus species-specific IgGs could be of clinical utility and aid in the diagnosis of CPA caused by all Aspergillus species. A total of 187 participants were included between 2020 and 2022 (12 with CPA, 75 with old tuberculosis [TB], 45 with active TB and 55 with bronchiectasis). We measured the serum Aspergillus fumigatus, flavus, terreus, niger-specific, and mixed Aspergillus IgG levels (Phadia ImmunoCap). The correlation was the strongest between A. fumigatus and A. niger (Spearman's rank: 0.940), followed by A. niger and A. flavus (Spearman's rank: 0.915). A. terreus-specific IgG was less strongly correlated with the other three Aspergillus species-specific IgG (Spearman's rank: 0.828-0.849). A. flavus (4 of 6, 67%) was the dominant species. Using the at-least-one-positive approach, the highest performance was obtained when A. fumigatus and A. flavus IgGs were used (sensitivity, 0.75; specificity, 0.84). Significant cross-reactivity exists among different Aspergillus-species IgGs although the correlation may be less significant for A. terreus. In addition to the commonly used A. fumigatus IgG test, IgGs specific to local prevalent Aspergillus species may provide additional clinical utility.

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针对不同曲霉菌种的免疫球蛋白 G 在诊断高危人群慢性肺曲霉菌病中的临床应用。
烟曲霉菌特异性 IgG 常被用作慢性肺曲霉菌病(CPA)的诊断检测,但很少有研究对烟曲霉菌以外的其他菌种的 IgG 的性能和血清学进行评估。在这项研究中,我们评估了不同曲霉菌种特异性 IgG 抗体在 CPA 患者和高危人群中的血清学表现,以及不同曲霉菌种特异性 IgG 是否具有临床实用性并有助于诊断由所有曲霉菌种引起的 CPA。我们在 2020 年至 2022 年间共纳入了 187 名参与者(其中 12 人患有 CPA,75 人患有陈旧性肺结核 [TB],45 人患有活动性肺结核,55 人患有支气管扩张症)。我们测量了血清曲霉菌、黄曲霉菌、赤曲霉菌、黑曲霉菌特异性和混合曲霉菌 IgG 水平(Phadia ImmunoCap)。烟曲霉和黑曲霉之间的相关性最强(Spearman's rank:0.940),其次是黑曲霉和黄曲霉(Spearman's rank:0.915)。赤霉菌特异性 IgG 与其他三种曲霉菌特异性 IgG 的相关性较弱(Spearman's rank:0.828-0.849)。黄曲霉(6 种中的 4 种,占 67%)是主要菌种。采用至少一阳性的方法,使用烟曲霉和黄曲霉的 IgG 性能最高(灵敏度为 0.75;特异性为 0.84)。不同曲霉菌种的 IgG 之间存在显著的交叉反应性,但对于赤曲霉来说,相关性可能不那么明显。除了常用的烟曲霉 IgG 检测外,当地流行曲霉菌种的特异性 IgG 可能会提供更多的临床用途。
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来源期刊
Pathogens and Global Health
Pathogens and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-PARASITOLOGY
CiteScore
6.00
自引率
0.00%
发文量
60
审稿时长
6-12 weeks
期刊介绍: Pathogens and Global Health is a journal of infectious disease and public health that focuses on the translation of molecular, immunological, genomics and epidemiological knowledge into control measures for global health threat. The journal publishes original innovative research papers, reviews articles and interviews policy makers and opinion leaders on health subjects of international relevance. It provides a forum for scientific, ethical and political discussion of new innovative solutions for controlling and eradicating infectious diseases, with particular emphasis on those diseases affecting the poorest regions of the world.
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