Leser C, Kauffman H F, Virchow C, Menz G
Hochgebirgsklinik Davos-Wolfgang, Asthma- and Allergy Clinic, Switzerland.
J Allergy Clin Immunol. 1992 Oct;90(4 Pt 1):589-99. doi: 10.1016/0091-6749(92)90131-k.
Immunoblotting, radioallergosorbent test (RAST), and enzyme-linked immunosorbent assay (ELISA) were performed to determine specific IgE and IgG responses to Aspergillus fumigatus (Af) allergens (IgE-Af; IgG-Af). Serology results were compared in patients with allergic bronchopulmonary aspergillosis (ABPA) (n = 43), patients with Aspergillus fumigatus-associated asthma (Af-asthma) (n = 26), and healthy individuals (n = 3). In patients with different clinical phases of ABPA, three specific immunopatterns were found by immunoblotting. It is proposed to classify ABPA into the active, intermediate, and remission phase with respect to the specific immunoresponse to Af-allergens and asthma symptoms. First, the active phase of ABPA is characterized by a fully developed specific immunoresponse to Af-allergens and severe asthma. Second, the intermediate phase includes patients with elevated specific immunologic findings without asthma symptoms. Third, the remission phase is characterized by a weak specific immunoresponse to Af-allergens after a long-term asymptomatic period. No correlation occurred between specific immunopatterns and irreversible brochopulmonary lesions. The IgE-Af RAST and IgG-Af ELISA titers of patients with ABPA in the active and intermediate phase were significantly higher compared with patients with ABPA in remission phase and with patients with Af-asthma. In particular, the demonstration of positive IgG-Af ELISA titer generally allows the serologic discrimination of patients with asthma and ABPA from patients with Af-asthma in clinical practice. The present study revealed that immunoblots of most patients with Af-asthma were negative. Immunoblotting demonstrated an IgG reactivity exclusively to low molecular weight (MW) Af-allergens in 8 out of 26 patients with Af-asthma and in the three healthy individuals, and this IgG response may reflect naturally occurring antibodies.
进行免疫印迹法、放射变应原吸附试验（RAST）和酶联免疫吸附测定（ELISA），以确定对烟曲霉（Af）变应原的特异性IgE和IgG反应（IgE-Af；IgG-Af）。比较了变应性支气管肺曲霉病（ABPA）患者（n = 43）、烟曲霉相关性哮喘（Af-哮喘）患者（n = 26）和健康个体（n = 3）的血清学结果。在ABPA不同临床阶段的患者中，通过免疫印迹法发现了三种特异性免疫模式。建议根据对Af变应原的特异性免疫反应和哮喘症状，将ABPA分为活动期、中间期和缓解期。首先，ABPA的活动期特征为对Af变应原产生充分发展的特异性免疫反应和严重哮喘。其次，中间期包括特异性免疫学检查结果升高但无哮喘症状的患者。第三，缓解期的特征是在长期无症状期后对Af变应原的特异性免疫反应较弱。特异性免疫模式与不可逆的支气管肺病变之间无相关性。活动期和中间期ABPA患者的IgE-Af RAST和IgG-Af ELISA滴度显著高于缓解期ABPA患者和Af-哮喘患者。特别是，在临床实践中，IgG-Af ELISA滴度呈阳性通常有助于从Af-哮喘患者中血清学鉴别哮喘和ABPA患者。本研究显示，大多数Af-哮喘患者的免疫印迹为阴性。免疫印迹显示，26例Af-哮喘患者中的8例以及3名健康个体中，IgG仅对低分子量（MW）Af变应原产生反应，这种IgG反应可能反映自然产生的抗体。
