Serum levels of IgG antibodies against Aspergillus fumigatus and the risk of hypersensitivity pneumonitis and other interstitial lung diseases

Abstract Background Coronavirus disease COVID-19 has become a public health emergency of international concern. Together with the quest for an effective treatment, the question of the post-infectious evolution of affected patients in healing process remains uncertain. Krebs von den Lungen 6 (KL-6) is a high molecular weight mucin-like glycoprotein produced by type II pneumocytes and bronchial epithelial cells. Its production is raised during epithelial lesions and cellular regeneration. In COVID-19 infection, KL-6 serum levels could therefore be of interest for diagnosis, prognosis and therapeutic response evaluation. Materials and methods Our study retrospectively compared KL-6 levels between a cohort of 83 COVID-19 infected patients and two other groups: healthy subjects (n = 70) on one hand, and a heterogenous group of patients suffering from interstitial lung diseases (n = 31; composed of 16 IPF, 4 sarcoidosis, 11 others) on the other hand. Demographical, clinical and laboratory indexes were collected. Our study aims to compare KL-6 levels between a COVID-19 population and healthy subjects or patients suffering from interstitial lung diseases (ILDs). Ultimately, we ought to determine whether KL-6 could be a marker of disease severity and bad prognosis. Results Our results showed that serum KL-6 levels in COVID-19 patients were increased compared to healthy subjects, but to a lesser extent than in patients suffering from ILD. Increased levels of KL-6 in COVID-19 patients were associated with a more severe lung disease. Discussion and conclusion Our results suggest that KL-6 could be a good biomarker to assess ILD severity in COVID-19 infection. Concerning the therapeutic response prediction, more studies are necessary.

Download Full-text

CA 19-9 serum levels in patients with end-stage idiopathic pulmonary fibrosis (IPF) and other interstitial lung diseases (ILDs): Correlation with functional decline

Chronic Respiratory Disease ◽

10.1177/1479973120958428 ◽

2020 ◽

Vol 17 ◽

pp. 147997312095842

Author(s):

Elisabetta Balestro ◽

Gioele Castelli ◽

Nicol Bernardinello ◽

Elisabetta Cocconcelli ◽

Davide Biondini ◽

...

Keyword(s):

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Lung Diseases ◽

Lung Transplant ◽

Functional Decline ◽

Serum Levels ◽

Interstitial Lung Diseases ◽

Disease Course ◽

Rapid Progressors ◽

End Stage

Idiopathic pulmonary fibrosis presents a progressive and heterogeneous functional decline. CA 19-9 has been proposed as biomarker to predict disease course, but its role remains unclear. We assessed CA 19-9 levels and clinical data in end-stage ILD patients (48 IPF and 20 non-IPF ILD) evaluated for lung transplant, to correlate these levels with functional decline. Patients were categorized based on their rate of functional decline as slow (n = 20; ΔFVC%pred ≤ 10%/year) or rapid progressors (n = 28; ΔFVC%pred ≥ 10%/year). Nearly half of the entire patients (n = 32; 47%) had CA 19-9 levels ≥37kU/L. CA 19-9 levels in IPF were not different from non-IPF ILD populations, however, the latter group had a median CA 19-9 level above the normal cut-off value of 37 KU/l (60 [17–247] kU/L). Among IPF patients, CA 19-9 was higher in slow than in rapid progressors with a trend toward significance (33vs17kU/L; p = 0.055). In the whole population, CA19-9 levels were inversely related with ΔFVC/year (r = −0.261; p = 0.03), this correlation remained in IPF patients, particularly in rapid progressors (r = −0.51; p = 0.005), but not in non. Moreover, IPF rapid progressors with normal CA 19-9 levels showed the greater ΔFVC/year compared to those with abnormal CA 19-9 (0.95 vs. 0.65 L/year; p = 0.03). In patients with end-stage ILD, CA 19-9 may represent a marker of disease severity, whereas its level is inversely correlated with functional decline, particularly among IPF rapid progressors.

Download Full-text

Presentation, diagnosis and clinical course of the spectrum of progressive-fibrosing interstitial lung diseases

European Respiratory Review ◽

10.1183/16000617.0076-2018 ◽

2018 ◽

Vol 27 (150) ◽

pp. 180076 ◽

Cited By ~ 72

Author(s):

Vincent Cottin ◽

Nikhil A. Hirani ◽

David L. Hotchkin ◽

Anoop M. Nambiar ◽

Takashi Ogura ◽

...

Keyword(s):

Interstitial Pneumonia ◽

Lung Diseases ◽

Hypersensitivity Pneumonitis ◽

Early Death ◽

Occupational Exposures ◽

Interstitial Lung Diseases ◽

Lung Function Decline ◽

Nonspecific Interstitial Pneumonia ◽

Immunomodulatory Therapies

Although these conditions are rare, a proportion of patients with interstitial lung diseases (ILDs) may develop a progressive-fibrosing phenotype. Progressive fibrosis is associated with worsening respiratory symptoms, lung function decline, limited response to immunomodulatory therapies, decreased quality of life and, potentially, early death. Idiopathic pulmonary fibrosis may be regarded as a model for other progressive-fibrosing ILDs. Here we focus on other ILDs that may present a progressive-fibrosing phenotype, namely idiopathic nonspecific interstitial pneumonia, unclassifiable idiopathic interstitial pneumonia, connective tissue disease-associated ILDs (e.g.rheumatoid arthritis-related ILD), fibrotic chronic hypersensitivity pneumonitis, fibrotic chronic sarcoidosis and ILDs related to other occupational exposures. Differential diagnosis of these ILDs can be challenging, and requires detailed consideration of clinical, radiological and histopathological features. Accurate and early diagnosis is crucial to ensure that patients are treated optimally.

Download Full-text

Transforming growth factor β1polymorphism and serum levels in Egyptian patients with interstitial lung diseases

Egyptian Journal of Chest Diseases and Tuberculosis ◽

10.1016/j.ejcdt.2015.12.001 ◽

2017 ◽

Vol 66 (3) ◽

pp. 487-495

Author(s):

Rania Mohammed Azmy ◽

Rana Helmy El Helbawy ◽

Ashraf Abd El Raouf Dawood ◽

Sami El Dahdaouh

Keyword(s):

Growth Factor ◽

Lung Diseases ◽

Transforming Growth Factor ◽

Serum Levels ◽

Interstitial Lung Diseases ◽

Egyptian Patients

Download Full-text

Radioallergosorbent test (RAST) for measurement of IgG antibodies to Aspergillus fumigatus in sera of patients with different lung diseases

Journal of Immunological Methods ◽

10.1016/0022-1759(84)90231-x ◽

1984 ◽

Vol 75 (1) ◽

pp. 117-128 ◽

Cited By ~ 11

Author(s):

Mahmoud Dewair ◽

Xaver Baur

Keyword(s):

Aspergillus Fumigatus ◽

Lung Diseases ◽

Igg Antibodies ◽

Radioallergosorbent Test

Download Full-text

Quantification of IgG Antibodies to Aspergillus fumigatus and Pigeon Antigens by ImmunoCAP Technology: An Alternative to the Precipitation Technique?

Clinical Chemistry ◽

10.1373/clinchem.2006.067546 ◽

2006 ◽

Vol 52 (9) ◽

pp. 1785-1793 ◽

Cited By ~ 48

Author(s):

Erna Van Hoeyveld ◽

Lieven Dupont ◽

Xavier Bossuyt

Keyword(s):

Aspergillus Fumigatus ◽

Hypersensitivity Pneumonitis ◽

Allergic Bronchopulmonary Aspergillosis ◽

Important Variable ◽

Pulmonary Diseases ◽

Igg Antibodies ◽

Precipitation Technique ◽

Measuring Techniques ◽

Antibody Titers ◽

Specific Igg

Abstract Background: We evaluated the ImmunoCAP technique for measurement of IgG specific to Aspergillus fumigatus and pigeon antigens. Methods: We used ImmunoCAP and precipitation technique to measure concentrations of IgG to A. fumigatus or pigeon antigens in sera from 265 patients and 42 controls. We also evaluated linearity, interference, imprecision, concordance, and diagnostic accuracy of the measuring techniques. Results: The precipitation and ImmunoCAP technique showed moderate concordance (κ, 0.46 for both A. fumigatus and pigeon antibodies). Specific IgG results for A. fumigatus and pigeon were linear (r = 0.98 and 0.97, respectively), with interrun reproducibility rates of 23% and 14% and maximal interference of 36.5% and 8% by lipid and 24% and 21% by hemolysis, respectively. A. fumigatus antibody concentrations were higher in patients with aspergillosis and allergic bronchopulmonary aspergillosis (ABPA) (median, 103 and 70.1 mgA/L, respectively) than in patients with other pulmonary diseases (median, 18.15–33.40 mgA/L). Antibodies to pigeon antigens were high in patients with hypersensitivity pneumonitis (median, 1024 mgA/L) but also in patients with other pulmonary diseases (median, 445 mgA/L). Antibody titers were substantially higher in patients with other pulmonary diseases and contact with pigeons (median, 1060 mgA/L) than in patients without antigen contact (median, 27.35 mgA/L) (P <0.004). Conclusions: Agreement between the precipitation and ImmunoCAP technique was 86% for A. fumigatus and 70% for pigeon antigens. Highest concentrations of specific IgG to A. fumigatus were found in patients with aspergillosis and ABPA. Our results suggest that antigen contact was the most important variable affecting the presence of antibodies to pigeon antigen.

Download Full-text

Occupational Extrinsic Allergic Alveolitis in a poultry farmer

Romanian Journal of Occupational Medicine ◽

10.2478/rjom-2020-0010 ◽

2020 ◽

Vol 71 (1) ◽

pp. 69-73

Author(s):

Smărăndescu Raluca Andreea ◽

Mircea-Constantin Diaconu ◽

Claudia-Mariana Handra ◽

Agripina Rașcu

Keyword(s):

Lung Diseases ◽

Hypersensitivity Pneumonitis ◽

Chemical Compounds ◽

Interstitial Lung Diseases ◽

Risk Exposure ◽

Low Molecular Weight ◽

Organic Substances ◽

Extrinsic Allergic Alveolitis ◽

Allergic Alveolitis ◽

The One

AbstractHypersensitivity pneumonitis is a group of inflammatory interstitial lung diseases caused by hypersensitivity immune reactions to the inhalation of various antigens: fungal, bacterial, animal protein, or chemical sources, finely dispersed, with aerodynamic diameter <5μ, representing the respirable fraction. The national register for interstitial lung diseases records very few cases of hypersensitivity pneumonitis (extrinsec allergic alveolitis), a well defined occupational disease. Although not an eminently of occupational origin, the extrinsec allergic alveolitis can occur secondary to occupational exposure to organic substances (animal or insect proteins, bacteria, fungi) or inorganic (low molecular weight chemical compounds) and the occupational doctor is a key actor in the diagnosys. The disease has chronic evolution and exposure avoidance, as early as possible, has major prognostic influence. The occupational anamnesis remains the most important step and the occupational physician is the one in charge for monitoring and detection of the presence of respiratory symptoms in all employees with risk exposure. Next, we present the case of a farmer, without other comorbidities, who develops various respiratory and systemic diseases and manifestations due to repeated exposure to animal proteins and molds, in order to review the risk factors and the consequences of exposure in poultry farms.

Download Full-text

Update in Diagnosis and Management of Interstitial Lung Diseases

Medical Research Archives ◽

10.18103/mra.v9i7.2428 ◽

2021 ◽

Vol 9 (7) ◽

Author(s):

Mauricio Salinas ◽

Matias Florenzano

Keyword(s):

Lung Diseases ◽

Hypersensitivity Pneumonitis ◽

Connective Tissue Diseases ◽

Interstitial Lung Diseases ◽

Diverse Group ◽

Principal Characteristics ◽

Diagnosis And Management ◽

New Concepts ◽

Lung Abnormalities ◽

Diagnosis Approach

Interstitial lung diseases (ILD) are a complex and diverse group of disorders. ILD are more frequently diagnosed and prevalent now. In this article, diagnosis approach, including new bronchoscopy and genetic tools, and some recently added concepts are revisited, as progressive fibrosing interstitial lung diseases and interstitial lung abnormalities. Recently information relative to idiopathic pulmonary fibrosis is shown, including genetics and pathophysiology. We look over the dynamic world of interstitial lung diseases related to connective tissue diseases, principal characteristics of this group and the principles that define which of the various available therapies should be chosen. Finally new concepts and guidelines published about the diagnosis and management of hypersensitivity pneumonitis are reported. New data and treatments have changed our traditional vision of these lung diseases and we will new options in the next years.

Download Full-text