title: The basophil surface marker CD203c identifies Aspergillus species sensitization in patients with cystic fibrosis.
abstract: BACKGROUND
  Colonization by Aspergillus fumigatus in patients with cystic fibrosis (CF) can cause A fumigatus sensitization and/or allergic bronchopulmonary aspergillosis (ABPA), which affects pulmonary function and clinical outcomes. Recent studies show that specific allergens upregulate the surface-expressed basophil marker CD203c in sensitized subjects, a response that can be readily measured by using flow cytometry.
  
  
  OBJECTIVE
  We sought to identify A fumigatus sensitization in patients with CF by using the basophil activation test (BAT).
  
  
  METHODS
  Patients with CF attending Beaumont Hospital were screened for study inclusion. BAT was used to identify A fumigatus sensitization. Serologic (total and A fumigatus-specific IgE), pulmonary function, and body mass index measurements were performed.
  
  
  RESULTS
  The BAT discriminates A fumigatus-sensitized from nonsensitized patients with CF. Persistent isolation of A fumigatus in sputum is a significant risk factor for A fumigatus sensitization. Levels of the A fumigatus-stimulated basophil activation marker CD203c inversely correlated with pulmonary function and body mass index in A fumigatus-sensitized but not nonsensitized patients with CF. Total and A fumigatus-specific IgE, but not IgG, levels are increased in A fumigatus-sensitized patients with CF and ABPA when compared with those in A fumigatus-sensitized and nonsensitized patients with CF without ABPA. Itraconazole treatment did not affect A fumigatus sensitization.
  
  
  CONCLUSIONS
  Combining the BAT with routine serologic testing allows classification of patients with CF into 3 groups: nonsensitized, A fumigatus-sensitized, and ABPA. Accurate and prompt identification of A fumigatus-associated clinical status might allow early and targeted therapeutic intervention, potentially improving clinical outcomes.
authors.affiliation: Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
authors.forename: Bojana
authors.initials: B
authors.lastname: Mirković
authors.affiliation: Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Lavelle
authors.affiliation: Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
authors.forename: Ahmed Abdul
authors.initials: AA
authors.lastname: Azim
authors.affiliation: Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
authors.forename: Kristine
authors.initials: K
authors.lastname: Helma
authors.affiliation: Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
authors.forename: Fatma S
authors.initials: FS
authors.lastname: Gargoum
authors.affiliation: Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
authors.forename: Kevin
authors.initials: K
authors.lastname: Molloy
authors.affiliation: Department of Genetics, Stanford University School of Medicine, Stanford, Calif.
authors.forename: Yael
authors.initials: Y
authors.lastname: Gernez
authors.affiliation: Clinical Microbiology Department, Trinity College Dublin, the Adelaide and Meath Hospital incorporating the National Children's Hospital, Tallaght, Dublin, Ireland.
authors.forename: Katie
authors.initials: K
authors.lastname: Dunne
authors.affiliation: Clinical Microbiology Department, Trinity College Dublin, the Adelaide and Meath Hospital incorporating the National Children's Hospital, Tallaght, Dublin, Ireland.
authors.forename: Julie
authors.initials: J
authors.lastname: Renwick
authors.affiliation: Clinical Microbiology Department, Trinity College Dublin, the Adelaide and Meath Hospital incorporating the National Children's Hospital, Tallaght, Dublin, Ireland.
authors.forename: Philip
authors.initials: P
authors.lastname: Murphy
authors.affiliation: Center for Excellence in Pulmonary Biology, Department of Paediatrics, Stanford University School of Medicine, Stanford, Calif.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Moss
authors.affiliation: Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Greene
authors.affiliation: Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
authors.forename: Cedric
authors.initials: C
authors.lastname: Gunaratnam
authors.affiliation: Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. Electronic address: schotirmall@ntu.edu.sg.
authors.forename: Sanjay H
authors.initials: SH
authors.lastname: Chotirmall
authors.affiliation: Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
authors.forename: Noel G
authors.initials: NG
authors.lastname: McElvaney
mesh_terms: D000918:Antibody Specificity / Q000276:immunology; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use; D000946:Antigens, Fungal / Q000276:immunology; D000954:Antigens, Surface / Q000378:metabolism; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism*; D001230:Aspergillus / Q000276:immunology*; D001491:Basophils / Q000276:immunology / Q000378:metabolism*; D015415:Biomarkers; D015992:Body Mass Index; D003550:Cystic Fibrosis / Q000150:complications* / Q000503:physiopathology; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D016130:Immunophenotyping; D007958:Leukocyte Count; D008297:Male; D010727:Phosphoric Diester Hydrolases / Q000378:metabolism*; D011446:Prospective Studies; D011755:Pyrophosphatases / Q000378:metabolism*; D013183:Sputum / Q000276:immunology / Q000382:microbiology
chemical_list: D000935:Antifungal Agents; D000946:Antigens, Fungal; D000954:Antigens, Surface; D015415:Biomarkers; C427944:ENPP3 protein, human; D007074:Immunoglobulin G; D007073:Immunoglobulin E; D010727:Phosphoric Diester Hydrolases; D011755:Pyrophosphatases
keywords: Allergic bronchopulmonary aspergillosis; Aspergillus fumigatus; CD203c; FEV(1); basophil activation test; body mass index; cystic fibrosis; flow cytometry; itraconazole; sensitization