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回顾性比较两种曲霉 IgG 酶免疫分析法在诊断肺部曲霉病中的应用。

Retrospective Comparison of Two Aspergillus IgG Enzyme Immunoassays for Diagnosing Pulmonary Aspergillosis.

机构信息

Department of Respiratory Medicine and Infectious Diseases, Niigata University Medical & Dental Hospital.

出版信息

Med Mycol J. 2024;65(3):41-47. doi: 10.3314/mmj.24.00004.

Abstract

Aspergillus-specific antibodies are diagnostic indicators of allergic bronchopulmonary aspergillosis (ABPA) and chronic pulmonary aspergillosis (CPA). Tests for detecting Aspergillus-specific antibodies were not used clinically in Japan, and the production of the Aspergillus precipitin test was discontinued. Thus, alternative tests for diagnosing aspergillosis are urgently needed. We retrospectively evaluated 64 patients with suspected ABPA and CPA who underwent precipitin antibody testing. Serum Aspergillus IgG levels were measured and compared using the Bordier Aspergillus fumigatus ELISA and the Platelia Aspergillus IgG (Bio-Rad) kits. Of the participants, 18 were diagnosed with CPA, and 8 were diagnosed with ABPA. Both the Bordier and Bio-Rad kits showed high sensitivity and specificity for CPA and ABPA. The area under the receiver operating characteristic curves for the Bordier and Bio-Rad kits were 0.97 and 0.95, respectively, for CPA, and 0.89 and 0.91, respectively, for ABPA. In contrast to the Bordier kit, the Bio-Rad kit showed relatively low anti-Aspergillus IgG levels and lower sensitivity to non-fumigatus Aspergillus infections. The Aspergillus-specific IgG ELISA tests showed sufficient diagnostic accuracy. Therefore, these assays are recommended as alternatives to the precipitin kit for diagnosing aspergillosis in clinical settings in Japan.

摘要

曲霉特异性抗体是变应性支气管肺曲霉病(ABPA)和慢性肺曲霉病(CPA)的诊断指标。在日本,并未将检测曲霉特异性抗体的检测用于临床,并且也已停止生产曲霉沉淀试验。因此,迫切需要替代的曲霉病诊断检测方法。我们回顾性评估了 64 例疑似 ABPA 和 CPA 的患者,这些患者均进行了沉淀抗体检测。使用 Bordier 烟曲霉 ELISA 和 Platelia 曲霉 IgG(Bio-Rad)试剂盒测量并比较了血清曲霉 IgG 水平。在这些参与者中,18 例被诊断为 CPA,8 例被诊断为 ABPA。Bordier 和 Bio-Rad 试剂盒均对 CPA 和 ABPA 具有较高的灵敏度和特异性。Bordier 和 Bio-Rad 试剂盒的受试者工作特征曲线下面积分别为 0.97 和 0.95,用于 CPA,分别为 0.89 和 0.91,用于 ABPA。与 Bordier 试剂盒相比,Bio-Rad 试剂盒显示出相对较低的抗曲霉 IgG 水平和对非烟曲霉感染的较低灵敏度。曲霉特异性 IgG ELISA 检测具有足够的诊断准确性。因此,建议将这些检测方法作为日本临床环境中沉淀试剂盒的替代方法,用于诊断曲霉病。

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