Intracutaneous tests with recombinant allergens in cystic fibrosis patients with allergic bronchopulmonary aspergillosis and Aspergillus allergy.
Allergic bronchopulmonary aspergillosis (ABPA), an intensive inflammatory reaction to Aspergillus fumigatus, can cause irreversible lung damage in patients with cystic fibrosis (CF). The aim of this study was to assess if intracutaneous testing with recombinant A. fumigatus allergens (rAsp f ) allowed a reliable diagnosis of ABPA. Fifty patients with CF were tested, 12 suffering from ABPA, 21 with allergy to A. fumigatus, and 17 CF control patients not sensitized to A. fumigatus. All patients with ABPA reacted to at least one of the two intracellular A. fumigatus allergens rAsp f 4, a 30-kD protein of unknown biologic function, and rAsp f 6, a 23-kD manganese superoxide dismutase, at a concentration of 10(-2) microg/ml. The intracutaneous tests were negative or only marginally positive in the patients with allergy to A. fumigatus and completely negative in the CF control patients. The differential responses to the recombinant A. fumigatus allergens were in perfect agreement with our previous serologic results, so that rAsp f 4 and rAsp f 6 can be considered specific markers for ABPA. Early diagnosis of the disease might help to prevent irreversible lung damage and minimize possible steroid-mediated side effects as a consequence of an optimized control of the disease.
Nikolaizik
Wilfried H
WH
Department of Paediatrics, University Hospital, Essen, Germany. wilfried.nikolaizik@uni-essen.de
Weichel
Michael
M
Blaser
Kurt
K
Crameri
Reto
R
D000293:Adolescent; D000328:Adult; D000485:Allergens; D000908:Antibodies, Fungal / Q000032:analysis; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000150:complications / Q000175:diagnosis*; D001232:Aspergillus fumigatus / Q000276:immunology*; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications*; D005260:Female; D005656:Fungal Proteins / Q000276:immunology*; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D007428:Intradermal Tests; D008297:Male; D011852:Radioallergosorbent Test; D011994:Recombinant Proteins / Q000276:immunology
D000485:Allergens; D000908:Antibodies, Fungal; D005656:Fungal Proteins; D007074:Immunoglobulin G; D011994:Recombinant Proteins; D007073:Immunoglobulin E