title: Molecular-based allergy diagnosis of allergic bronchopulmonary aspergillosis in Aspergillus fumigatus-sensitized Japanese patients.
abstract: BACKGROUND
  Distinguishing between patients with allergic bronchopulmonary aspergillosis (ABPA) and Aspergillus fumigatus (Af)-sensitized asthmatic patients without ABPA is sometimes difficult owing to the IgE-cross-reactivity between Af and other fungal allergens.
  
  
  OBJECTIVE
  To establish the usefulness of molecular-based allergy diagnostics using allergen components from Af in distinguishing ABPA from Af-sensitized asthma without ABPA.
  
  
  METHODS
  Sera from Japanese patients with ABPA (n = 53) and Af-sensitized asthma without ABPA (n = 253) were studied. The levels of IgE and IgG antibodies to allergen components from Af and IgE antibodies to different fugal allergen extracts were measured by ImmunoCAP. Comorbid atopic dermatitis (AD) was taken into consideration in the sensitization profile analysis.
  
  
  RESULTS
  Patients with ABPA possessed significantly higher levels of IgE antibodies to Asp f 1, and Asp f 2 than asthmatic patients without ABPA. The areas under the receiver operating characteristic curves for the levels of IgE to Asp f 1 and Asp f 2 as diagnostic markers of ABPA were 0.75 and 0.78, respectively. The presence of IgE positivity to Asp f 1 and/or Asp f 2 resulted in increased sensitivity while losing little specificity. Comorbid AD was associated with higher levels of IgE to Asp f 6 (manganese superoxide dismutase from Af, a ubiquitous pan-allergen in fungi) and low but positive levels of IgE to other Af-components, which hampered the serological discrimination of ABPA.
  
  
  CONCLUSIONS
  The levels of IgE to Asp f 1 and/or Asp f 2 can effectively differentiate ABPA from Af-sensitized asthma, suggesting that the amounts of IgE specific for these molecules are markers for genuine Af-sensitization in ABPA. However, comorbid AD must be taken into consideration in the interpretation of high IgE to Asp f 6. Establishing of IgE-sensitization profiles using panel of Af-allergen components provides valuable information for distinguishing genuine vs. cross-reactive sensitization in Af-sensitized patients.
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Kanagawa, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Tanimoto
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Kanagawa, Japan.
authors.forename: Y
authors.identifier: http://orcid.org/0000-0001-9913-4524
authors.initials: Y
authors.lastname: Fukutomi
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Kanagawa, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Yasueda
authors.affiliation: Division of Respiratory Medicine and Clinical Allergy, Fujita Health University, Toyoake, Aichi, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Takeuchi
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Kanagawa, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Saito
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Kanagawa, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Watai
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Kanagawa, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Sekiya
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Kanagawa, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Tsuburai
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Asano
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Kanagawa, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Taniguchi
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Kanagawa, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Akiyama
mesh_terms: D000328:Adult; D000368:Aged; D000485:Allergens / Q000276:immunology; D000908:Antibodies, Fungal / Q000276:immunology; D000946:Antigens, Fungal / Q000276:immunology; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000175:diagnosis* / Q000276:immunology* / Q000382:microbiology / Q000503:physiopathology; D001232:Aspergillus fumigatus / Q000276:immunology; D001249:Asthma / Q000175:diagnosis* / Q000276:immunology* / Q000503:physiopathology; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007114:Immunization; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007564:Japan; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D013902:Radiography, Thoracic; D012129:Respiratory Function Tests; D055815:Young Adult
chemical_list: D000485:Allergens; D000908:Antibodies, Fungal; D000946:Antigens, Fungal; D007074:Immunoglobulin G; D007073:Immunoglobulin E
keywords: Aspergillus fumigatus; allergen components; allergic bronchopulmonary aspergillosis; asthma; atopic dermatitis; component-resolved diagnostics; molecular-based allergy diagnostics; receiver operating characteristic analysis