Serological diagnosis of allergic bronchopulmonary mycosis: Progress and challenges

Prompt diagnosis of allergic bronchopulmonary mycosis (ABPM) is an important clinical issue in preventing irreversible lung damage. Therefore, a good serological marker for the diagnosis of ABPM is desired in clinical practice. The measurement of IgE antibody to crude Aspergillus fumigatus allergen...

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Main Authors: Yuma Fukutomi, Hidenori Tanimoto, Hiroshi Yasueda, Masami Taniguchi
Format: Article
Language:English
Published: Elsevier 2016-01-01
Series:Allergology International
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S132389301500177X
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author Yuma Fukutomi
Hidenori Tanimoto
Hiroshi Yasueda
Masami Taniguchi
author_facet Yuma Fukutomi
Hidenori Tanimoto
Hiroshi Yasueda
Masami Taniguchi
author_sort Yuma Fukutomi
collection DOAJ
description Prompt diagnosis of allergic bronchopulmonary mycosis (ABPM) is an important clinical issue in preventing irreversible lung damage. Therefore, a good serological marker for the diagnosis of ABPM is desired in clinical practice. The measurement of IgE antibody to crude Aspergillus fumigatus allergen is considered the first step in screening asthmatic patients for allergic bronchopulmonary aspergillosis (ABPA). However, presence of IgE to A. fumigatus does not always indicate genuine sensitization to A. fumigatus because of cross-reactivity between crude extracts from different fungal sources. The application of molecular-based allergy diagnosis can solve this problem. The specificity of testing can be greatly improved by measuring the IgE antibody to Asp f 1 and f 2, specific allergen components for genuine A. fumigatus allergy. The problem of cross-reactivity between crude fungal extracts is also true for the identification of genuine causal fungi in each ABPM patient. Some patients with ABPM induced by fungi other than Aspergillus may be consistent with ABPA diagnostic criteria because current criteria depend on IgE/IgG reactivity to crude extracts. Accurate identification of genuine causal fungi for ABPM is of clinical importance, considering that clinical presentation, anti-fungal treatment strategies and disease prognosis can be influenced by different causal fungi. The diagnosis of causal fungi can be robustly validated by the confirmation of genuine sensitization to fungi after measuring IgE to specific allergen components, as well as repeated microbiological isolation of the fungi from their airway.
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spelling doaj.art-c9b6c7c6982941659fd9d5f1272231932022-12-22T01:50:36ZengElsevierAllergology International1323-89302016-01-01651303610.1016/j.alit.2015.08.004Serological diagnosis of allergic bronchopulmonary mycosis: Progress and challengesYuma FukutomiHidenori TanimotoHiroshi YasuedaMasami TaniguchiPrompt diagnosis of allergic bronchopulmonary mycosis (ABPM) is an important clinical issue in preventing irreversible lung damage. Therefore, a good serological marker for the diagnosis of ABPM is desired in clinical practice. The measurement of IgE antibody to crude Aspergillus fumigatus allergen is considered the first step in screening asthmatic patients for allergic bronchopulmonary aspergillosis (ABPA). However, presence of IgE to A. fumigatus does not always indicate genuine sensitization to A. fumigatus because of cross-reactivity between crude extracts from different fungal sources. The application of molecular-based allergy diagnosis can solve this problem. The specificity of testing can be greatly improved by measuring the IgE antibody to Asp f 1 and f 2, specific allergen components for genuine A. fumigatus allergy. The problem of cross-reactivity between crude fungal extracts is also true for the identification of genuine causal fungi in each ABPM patient. Some patients with ABPM induced by fungi other than Aspergillus may be consistent with ABPA diagnostic criteria because current criteria depend on IgE/IgG reactivity to crude extracts. Accurate identification of genuine causal fungi for ABPM is of clinical importance, considering that clinical presentation, anti-fungal treatment strategies and disease prognosis can be influenced by different causal fungi. The diagnosis of causal fungi can be robustly validated by the confirmation of genuine sensitization to fungi after measuring IgE to specific allergen components, as well as repeated microbiological isolation of the fungi from their airway.http://www.sciencedirect.com/science/article/pii/S132389301500177XAllergic bronchopulmonary mycosisAllergyAspergillus fumigatusFungiMolecular-based allergy diagnostics
spellingShingle Yuma Fukutomi
Hidenori Tanimoto
Hiroshi Yasueda
Masami Taniguchi
Serological diagnosis of allergic bronchopulmonary mycosis: Progress and challenges
Allergology International
Allergic bronchopulmonary mycosis
Allergy
Aspergillus fumigatus
Fungi
Molecular-based allergy diagnostics
title Serological diagnosis of allergic bronchopulmonary mycosis: Progress and challenges
title_full Serological diagnosis of allergic bronchopulmonary mycosis: Progress and challenges
title_fullStr Serological diagnosis of allergic bronchopulmonary mycosis: Progress and challenges
title_full_unstemmed Serological diagnosis of allergic bronchopulmonary mycosis: Progress and challenges
title_short Serological diagnosis of allergic bronchopulmonary mycosis: Progress and challenges
title_sort serological diagnosis of allergic bronchopulmonary mycosis progress and challenges
topic Allergic bronchopulmonary mycosis
Allergy
Aspergillus fumigatus
Fungi
Molecular-based allergy diagnostics
url http://www.sciencedirect.com/science/article/pii/S132389301500177X
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AT hidenoritanimoto serologicaldiagnosisofallergicbronchopulmonarymycosisprogressandchallenges
AT hiroshiyasueda serologicaldiagnosisofallergicbronchopulmonarymycosisprogressandchallenges
AT masamitaniguchi serologicaldiagnosisofallergicbronchopulmonarymycosisprogressandchallenges