Pulmonary eosinophilia may indicate onset stage of allergic bronchopulmonary aspergillosis

Abstract Background Allergic bronchopulmonary aspergillosis (ABPA) and chronic eosinophilic pneumonia (CEP) both display peripheral eosinophilia as well as pulmonary infiltration, together described as pulmonary eosinophilia, and differentiation is sometimes problematic. This study therefore examined the distinctions between ABPA with and without CEP-like shadows. Methods This retrospective cohort study from a single center included 25 outpatients (median age, 65 years) with ABPA diagnosed between April 2015 and March 2019, using criteria proposed by the International Society of Human and Animal Mycology (ISHAM), which focuses on positive specific IgE for Aspergillus fumigatus. Patients were assigned to either the eosinophilic pneumonia (EP) group or Non-EP group, defined according to findings on high-resolution computed tomography (HRCT). The EP group included patients with HRCT findings compatible with CEP; i.e., the presence of peripheral consolidation (p-consolidation) or ground-glass opacities (GGO), with no evidence of high-attenuation mucus. The Non-EP group comprised the remaining patients, who showed classical findings of ABPA such as mucoid impaction. Differences between the groups were analyzed. Results Baseline characteristics, frequency of a history of CEP (EP, 50% vs. Non-EP, 26%) and tentative diagnosis of CEP before diagnosis of ABPA (67% vs. 16%) did not differ significantly between groups. Although elevated absolute eosinophil count and Aspergillus-specific immunoglobulin E titers did not differ significantly between groups, the Non-EP group showed a strong positive correlation between these values (R = 0.7878, p = 0.0003). The Non-EP group displayed significantly higher levels of the fungal marker beta-D glucan (median, 11.7 pg/ml; interquartile range, 6.7–18.4 pg/ml) than the EP group (median, 6.6 pg/ml; interquartile range, 5.2–9.3 pg/ml). Both groups exhibited frequent recurrence of shadows on X-rays but no cases in the EP group had progressed to the Non-EP group at the time of relapse. Conclusions The ABPA subgroup with imaging findings resembling CEP experienced frequent recurrences, as in typical ABPA. In pulmonary eosinophilia, even if there are no shadows indicating apparent mucous change, the Aspergillus-specific immunoglobulin E level is important in obtaining an accurate diagnosis and in the selection of appropriate therapies for this type of ABPA.

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Pulmonary eosinophilia may indicate onset stage of allergic bronchopulmonary aspergillosis

10.21203/rs.3.rs-729308/v1 ◽

2021 ◽

Author(s):

mari miki ◽

Kazuyuki Tsujino ◽

Takahiro Kawasaki ◽

Tomoki Kuge ◽

Yuji Yamamoto ◽

...

Keyword(s):

Immunoglobulin E ◽

Allergic Bronchopulmonary Aspergillosis ◽

Eosinophilic Pneumonia ◽

Interquartile Range ◽

Pulmonary Eosinophilia ◽

Strong Positive Correlation ◽

X Rays ◽

High Attenuation ◽

Specific Immunoglobulin E ◽

Specific Immunoglobulin

Abstract Background Allergic bronchopulmonary aspergillosis (ABPA) and chronic eosinophilic pneumonia (CEP) both display peripheral eosinophilia and pulmonary infiltration, a condition described as pulmonary eosinophilia, and differentiation is sometimes problematic. This study therefore examined the distinctions between ABPA with and without CEP-like shadows. Methods This retrospective cohort study from a single center included 25 outpatients (median age, 65 years) with ABPA diagnosed between April 2015 and March 2019 using criteria proposed by the International Society of Human and Animal Mycology (ISHAM). Patients were assigned to either the eosinophilic pneumonia (EP) group or Non-EP group, defined according to findings on high-resolution computed tomography (HRCT). The EP group included patients with HRCT findings compatible with CEP; i.e., the presence of peripheral consolidation (p-consolidation) or ground-glass opacities (GGO), with no evidence of high-attenuation mucus. The Non-EP group comprised the remaining patients, who showed classical findings of ABPA such as mucoid impaction. Differences between the groups were analyzed. Results Baseline characteristics, frequency of a history of CEP (EP, 50% vs. Non-EP, 26%) and tentative diagnosis of CEP (67% vs. 16%) did not differ significantly between groups. Although elevated absolute eosinophil count and Aspergillus-specific immunoglobulin E titers did not differ significantly between groups, the Non-EP group showed a strong positive correlation between these values (R = 0.7878, p = 0.0003). The Non-EP group displayed significantly higher levels of the fungal marker beta-D glucan (median, 11.7 pg/ml; interquartile range, 6.7–18.4 pg/ml) than the EP group (median, 6.6 pg/ml; interquartile range, 5.2–9.3 pg/ml). Both groups exhibited frequent recurrence of shadows on X-rays but no cases in the EP group had progressed to the Non-EP group at the time of relapse. Conclusions The ABPA subgroup with imaging findings resembling CEP experienced frequent recurrences, as in typical ABPA. In pulmonary eosinophilia, even if there are no shadows indicating apparent mucous change, the Aspergillus-specific immunoglobulin E level is important in obtaining an accurate diagnosis and in the selection of appropriate therapies for this type of ABPA.

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Optimal cutoff values of allergen-specific immunoglobulin E to house dust mites and animal dander based on skin-prick test results: Analysis in 16,209 patients with allergic rhinitis

American Journal of Rhinology and Allergy ◽

10.2500/ajra.2017.31.4483 ◽

2017 ◽

Author(s):

S. D. Hong ◽

G. Ryu ◽

M. Y. Seo ◽

J. I. Jeong ◽

H. Y. Kim ◽

...

Keyword(s):

Allergic Rhinitis ◽

Immunoglobulin E ◽

House Dust Mites ◽

Test Results ◽

Dust Mites ◽

Optimal Cutoff ◽

Prick Test ◽

Specific Immunoglobulin E ◽

Specific Immunoglobulin ◽

Animal Dander

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Allergic diseases attributable to atopy in a population sample of Asian children

Scientific Reports ◽

10.1038/s41598-021-95579-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Chao-Yi Wu ◽

Hsin-Yi Huang ◽

Wen-Chi Pan ◽

Sui-Ling Liao ◽

Man-Chin Hua ◽

...

Keyword(s):

Immunoglobulin E ◽

Population Attributable Risk ◽

Population Sample ◽

International Study ◽

Allergic Diseases ◽

Population Based ◽

School Age Children ◽

Specific Immunoglobulin E ◽

Asian Children ◽

Specific Immunoglobulin

AbstractThe proportion of allergic diseases attributable to atopy remains a subject of controversy. This study aimed to estimate the population risk of physician-diagnosed asthma, rhinitis and eczema attributed to atopy among a population sample of Asian school-age children. Asian children aged 5–18 years (n = 1321) in the Prediction of Allergies in Taiwanese CHildren (PATCH) study were tested for serum allergen-specific immunoglobulin E. Physician-diagnosed asthma, rhinitis and eczema were assessed by a modified International Study of Asthma and Allergies in Childhood questionnaire. Atopy was defined as the presence of serum allergen-specific immunoglobulin E. In this population-based study, 50.4% of the subjects with asthma, 46.3% with rhinitis, and 46.7% with eczema were attributable to atopy. The population attributable risk (PAR) of atopy for three allergic diseases was higher in adolescents (asthma, 54.4%; rhinitis, 59.6%; eczema, 49.5%) than younger children aged less than 10 years (asthma, 46.9%; rhinitis, 39.5%; eczema, 41.9%). Among the seven allergen categories, sensitization to mites had the highest PARs for all three allergic diseases (51.3 to 64.1%), followed by sensitization to foods (asthma, 7.1%; rhinitis, 10.4%; eczema 27.7%). In conclusion, approximately half (46.3 to 50.4%) of Asian children in Taiwan with allergic diseases are attributable to atopy.

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Effect of Specific Immunoglobulin E Response and Comorbidities on Effectiveness of MP-AzeFlu in a Real-Life Study

International Archives of Allergy and Immunology ◽

10.1159/000508749 ◽

2020 ◽

Vol 181 (10) ◽

pp. 754-764

Author(s):

Ludger Klimek ◽

David Price ◽

Gabriella Gálffy ◽

Melanie Emmeluth ◽

Arkady Koltun ◽

...

Keyword(s):

Immunoglobulin E ◽

Real Life ◽

Life Study ◽

Specific Immunoglobulin E ◽

Specific Immunoglobulin ◽

Real Life Study

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Total and Specific Immunoglobulin E and Their Relationship to Respiratory Symptoms in Quebec Children and Adolescents

Canadian Respiratory Journal ◽

10.1155/2005/248714 ◽

2005 ◽

Vol 12 (8) ◽

pp. 426-432 ◽

Cited By ~ 6

Author(s):

Benoît Levesque ◽

Jean-François Duchesne ◽

Suzanne Gingras ◽

Pierre Allard ◽

Edgar Delvin ◽

...

Keyword(s):

Children And Adolescents ◽

Respiratory Symptoms ◽

Immunoglobulin E ◽

Geometric Mean ◽

Allergic Sensitization ◽

Population Sample ◽

Ethnic Origin ◽

Total Ige ◽

Specific Immunoglobulin E ◽

Specific Immunoglobulin

BACKGROUND: Respiratory disease is a major cause of morbidity in young people. It is now recognized that atopy plays an important role in the development of chronic respiratory symptoms in children.OBJECTIVE: To examine the determinants and consequences of serum total and specific immunoglobulin E (IgE) in a general population sample of Québec children and adolescents.METHODS: In 1999, 2349 children and adolescents (nine, 13 or 16 years of age) who had participated in a respiratory symptom and disease questionnaire had their total IgE measured. Of these participants, a subsample of 451 children and adolescents was analyzed to detect antibodies to eight specific allergens (ie, allergens of dust mites [Dermatophagoides farinae and Dermatophagoides pteronyssinus], cat, dog, ragweed, Timothy grass, mould [alternaria] and cockroach).RESULTS: The geometric mean of the total IgE was 44.4 U/mL among all participants. Concentrations were higher in boys and increased with age. More than 41% of the participants were sensitized to at least one specific allergen. Such sensitization was strongly associated with the occurrence of respiratory conditions and symptoms, namely asthma, wheezing and rhinitis. Family history, school location and ethnic origin had an impact on the prevalence of atopy and total IgE levels.CONCLUSIONS: Allergic sensitization is a major determinant in the development of asthma, wheezing and rhinitis in children and adolescents in the province of Québec.

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A Simple and Rapid Light-Initiated Chemiluminescence Assay for Quantitation of Artemisia-Specific Immunoglobulin E

International Archives of Allergy and Immunology ◽

10.1159/000520511 ◽

2021 ◽

pp. 1-8

Author(s):

Dandan Liu ◽

Bei Zhang ◽

Lina Zhu ◽

Lisheng Zheng ◽

Shaoshen Li ◽

...

Keyword(s):

Food Allergen ◽

Clinical Guideline ◽

Immunoglobulin E ◽

Limit Of Detection ◽

Enzyme Linked Immunosorbent Assay ◽

Serum Samples ◽

Chemiluminescence Assay ◽

Limit Of Quantitation ◽

Specific Immunoglobulin E ◽

Specific Immunoglobulin

Background: Light-initiated chemiluminescence assay (LICA) is a homogeneous assay that has been successfully used for the quantitation of food allergen-specific immunoglobulin E (sIgE), but not inhaled allergen-sIgE. Simultaneously, current assays used to detect allergen-sIgE are serum consuming and/or time consuming. Hence, we established a method for the quantitation of Artemisia-sIgE based on LICA and verified its performance according to the clinical guideline documents, laying a foundation for the quantitation of inhaled and food allergen-sIgE in parallel on LICA. Methods: The assay was established after optimizing the first incubation time and the dilutions of Artemisia-coated chemibeads, biotinylated goat anti-human IgE, and serum. In order to quantitate Artemisia-sIgE, the calibration curve was established with a high positive serum of known concentration. The assay performance was confirmed per the clinical guideline documents. In addition, the correlation between the results of LICA and capture enzyme-linked immunosorbent assay was evaluated. Results: The developed LICA’s coefficients of variation of repeatability and intermediate precision were 3.20%, 2.14%, and 3.85% and 4.30%, 4.00%, and 4.40%, respectively. The limit of detection was 0.10 kUA/L, and the limit of quantitation was 0.11 kUA/L. The range of linearity was from 0.27 kUA/L to 97.53 kUA/L (r = 0.9968). The correlation coefficient (r) for the correlation analysis between results of LICA and capture ELISA was 0.9087. This assay was successfully applied in 64 human serum samples, showing good sensitivity (82.20%) and specificity (100%). Conclusion: An Artemisia-sIgE quantitation assay based on LICA was successfully established. Its performance satisfied the clinical requirements and could be widely used in clinical laboratories.

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