Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan.
Allergol Int. 2021 Apr;70(2):208-214. doi: 10.1016/j.alit.2020.09.003. Epub 2020 Oct 8.
Bird antigens are some of the most relevant antigens in hypersensitivity pneumonitis (HP). Possible sources of bird antigens are bird breeding, feather products and fertilizer with fowl droppings. For the screening and diagnosis of HP, the measurement of bird-specific antibodies should be standardized. The aim of this study was to clarify the utility of serum IgG (sIgG) and IgA (sIgA) antibodies to bird antigens in screening and diagnosing acute/chronic bird-related HP with ImmunoCAP® in multi-centre clinical research.
We executed a clinical performance test by conducting a multi-institutional study to measure the levels of sIgG/sIgA against pigeon, parrot and budgerigar antigens by the ImmunoCAP® system in 29 acute and 46 chronic bird-related HP patients.
The levels of sIgG/sIgA against the bird antigens of the three species were significantly higher in subjects with acute bird-related HP and chronic bird-related HP with acute episodes (recurrent type) than in the control subjects. For sIgG, the optimal cutoff values by receiver operating characteristic (ROC) analysis were 24.6 mgA/L for pigeon, 14.0 mgA/L for parrot, and 8.7 mgA/L for budgerigar. By measuring multiple bird antigens and combining sIgG values of two species, the sensitivity and specificity for acute and recurrent-type chronic bird-related HP patients were 85-91% and 73-80%, respectively. For recurrent and insidious types of chronic bird-related HP, the sensitivity and specificity were 48-61% and 73-80%, respectively.
Measurement of the levels of sIgG/sIgA against pigeon, budgerigar and parrot antigens by ImmunoCAP® was useful for screening and diagnosis in bird-related HP.
鸟类抗原是过敏性肺炎（HP）中最相关的抗原之一。鸟类抗原的可能来源有鸟类养殖、羽毛产品和含有禽畜粪便的肥料。为了筛查和诊断 HP，应标准化对鸟类特异性抗体的测量。本研究旨在通过 ImmunoCAP® 在多中心临床研究中阐明针对血清 IgG（sIgG）和 IgA（sIgA）针对鸟类抗原在筛查和诊断急性/慢性与鸟类相关的 HP 中的作用。
我们通过进行多机构研究来执行临床性能测试，通过 ImmunoCAP®系统测量 29 例急性和 46 例慢性与鸟类相关的 HP 患者中针对鸽子、鹦鹉和虎皮鹦鹉抗原的 sIgG/sIgA 水平。
与对照组相比，急性与鸟类相关的 HP 和具有急性发作（复发性）的慢性与鸟类相关的 HP 患者的三种鸟类抗原的 sIgG/sIgA 水平显著更高。对于 sIgG，通过接受者操作特征（ROC）分析的最佳截断值分别为鸽子 24.6 mgA/L、鹦鹉 14.0 mgA/L 和虎皮鹦鹉 8.7 mgA/L。通过测量多种鸟类抗原并结合两种物种的 sIgG 值，急性和复发性慢性与鸟类相关的 HP 患者的敏感性和特异性分别为 85-91%和 73-80%。对于复发性和隐匿性慢性与鸟类相关的 HP，敏感性和特异性分别为 48-61%和 73-80%。
通过 ImmunoCAP® 测量针对鸽子、虎皮鹦鹉和鹦鹉抗原的 sIgG/sIgA 水平对与鸟类相关的 HP 的筛查和诊断有用。
