Michel Moïse, Sereme Youssouf, Mankouri Farid, Gouitaa Marion, Gautier Clarisse, Mège Jean-Louis, Cassagne Carole, Ranque Stéphane, Reynaud-Gaubert Martine, Vitte Joana
Laboratoire d'Immunologie, CHU Carémeau Nîmes, Nîmes, France.
Aix-Marseille Université, APHM, IRD, MEPHI, Marseille, France.
Front Allergy. 2022 Jun 22;3:898731. doi: 10.3389/falgy.2022.898731. eCollection 2022.
Allergic bronchopulmonary aspergillosis (ABPA) is an underestimated allergic disease due to (AF). The main diagnostic criteria for ABPA rely on the evaluation of immunoglobulin (Ig) E and IgG responses to AF extracts, although these cannot discriminate AF-sensitization from ABPA.
To evaluate the performance of cellular functional assays with extract and molecular AF allergens in ABPA.
A prospective cohort of 67 patients (6 ABPA) was investigated with basophil activation test (BAT) with AF extract. Twelve patients were further investigated for BAT responses to molecular AF components: Asp f 1, Asp f 2, Asp f 3, Asp f 4, and Asp f 6.
BAT with AF extract with an optimized cutoff displayed 100% sensitivity and 77.6% specificity for ABPA diagnosis. Among patients with positive BAT to AF, BAT with Asp f 4 was significantly higher in ABPA patients at 10 ng/mL (mean basophil stimulation index 10.56 in ABPA vs. 1.24 in non-ABPA patients, = 0.0002).
BAT with AF is a promising diagnostic biomarker in the context of suspected ABPA, which can be further improved with AF molecular allergens, especially Asp f 4.
变应性支气管肺曲霉病（ABPA）是一种因曲霉属真菌（AF）而被低估的变应性疾病。ABPA的主要诊断标准依赖于对AF提取物的免疫球蛋白（Ig）E和IgG反应的评估，尽管这些评估无法区分AF致敏与ABPA。
评估在ABPA中使用提取物和AF分子变应原进行细胞功能检测的性能。
对67例患者（6例ABPA）的前瞻性队列进行了AF提取物嗜碱性粒细胞活化试验（BAT）。另外12例患者进一步接受了针对AF分子成分（Asp f 1、Asp f 2、Asp f 3、Asp f 4和Asp f 6）的BAT反应检测。
采用优化临界值的AF提取物BAT对ABPA诊断的敏感性为100%，特异性为77.6%。在对AF的BAT呈阳性的患者中，ABPA患者对10 ng/mL的Asp f 4的BAT显著更高（ABPA患者的平均嗜碱性粒细胞刺激指数为10.56，非ABPA患者为1.24，P = 0.0002）。
在疑似ABPA的情况下，AF的BAT是一种有前景的诊断生物标志物，使用AF分子变应原，尤其是Asp f 4可进一步改善诊断效果。
