+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Increasing Total Serum IgE, Allergic Bronchopulmonary Aspergillosis, and Lung Function in Cystic Fibrosis



Increasing Total Serum IgE, Allergic Bronchopulmonary Aspergillosis, and Lung Function in Cystic Fibrosis



Journal of Allergy and Clinical Immunology. in Practice 5(6): 1591-1598.E6



Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity disorder contributing to lung disease in cystic fibrosis (CF) and challenging to diagnose. This study analyzed the predictive value of increasing total IgE (t-IgE) levels in a CF cohort alongside with clinical and serologic data. A total of 387 children and young adults were followed from 2000 to 2006 and retrospectively classified into 6 groups. Patients with t-IgE levels < 95th percentile and without specific Aspergillus fumigatus (Af)-IgE were classified as "Naïve," those with Af-specific IgE (Af-sIgE) as "Sensitized." Patients with elevated t-IgE at entrance and Af-sIgE were labeled "Former ABPA," and those without, as "High t-IgE." Patients whose t-IgE values started normal and exceeded the 95th percentile during the study were labeled either "ABPA at risk" if Af-sIgE-positive or "Rising t-IgE" if not. Courses of t-IgE over time were divided into episodes with increasing IgE (ΔIgE) and related to pulmonary outcome. A total of 125 patients were classified Naïve (32%), 64 Sensitized (17%), 49 ABPA at risk (13%), 32 Rising t-IgE (8%), 102 Former ABPA (26%), and 15 High t-IgE (4%). A total of 874 ΔIgE episodes were accompanied by forced expiratory volume in 1 second (FEV1) declines (r = -0.21, P < .0001). Steroid treatment of severest ΔIgE episodes resulted in improved long-term pulmonary outcomes (P < .01). This FEV1 preservation effect was only detectable if t-IgE levels at least doubled within 3 months and exceeded the 95th age-specific percentile (P < .05). ΔIgE obtained from the course of t-IgE levels may be helpful in diagnosing treatment requiring ABPA and predicts the effect of systemic steroid treatment on pulmonary outcome.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 059851412

Download citation: RISBibTeXText

PMID: 28526275

DOI: 10.1016/j.jaip.2017.03.033


Related references

Effect of allergic bronchopulmonary aspergillosis on lung function in children with cystic fibrosis. American Journal of Respiratory and Critical Care Medicine 174(11): 1211-1220, 2006

Rise in total IgE as an indicator of allergic bronchopulmonary aspergillosis in cystic fibrosis. Thorax 49(10): 1002-1005, 1994

Allergic Bronchopulmonary Aspergillosis with Normal Serum IgE in a Child with Cystic Fibrosis. Pediatric Asthma Allergy & Immunology 18(1): 46-47, 2005

Comparison of serum markers for allergic bronchopulmonary aspergillosis in cystic fibrosis. European Respiratory Journal 31(1): 36-42, 2008

Allergic bronchopulmonary aspergillosis with low serum IgE levels in a child with cystic fibrosis. Journal of Allergy and Clinical Immunology 100(3): 431-432, 1997

Allergic bronchopulmonary aspergillosis with normal serum IgE in a child with cystic fibrosis. Pediatric Asthma Allergy and Immunology 17(2): 146-150, 2004

Serum markers for allergic bronchopulmonary aspergillosis in cystic fibrosis: State of the art and further challenges. Medical Mycology 48(Suppl. 1): S77-S87, 2010

Serum anti- antibodies by immunoblot and Elisa in cystic fibrosis with allergic bronchopulmonary aspergillosis. Journal of Allergy and Clinical Immunology 93(5): 926-931, 1994

Immune response, diagnosis and treatment of allergic bronchopulmonary aspergillosis in cystic fibrosis lung disease. Current Pharmaceutical Design 19(20): 3669-3678, 2013

Serum ige and igg anti aspergillus fumigatus antibody in cystic fibrosis patients with allergic bronchopulmonary aspergillosis. Journal of Allergy & Clinical Immunology 85(1 Part 2): 242, 1990

Serum immunoglobulins E and G anti-Aspergillus fumigatus antibody in patients with cystic fibrosis who have allergic bronchopulmonary aspergillosis. Journal of Laboratory and Clinical Medicine 116(5): 724-727, 1990

Serum anti-Aspergillus fumigatus antibodies by immunoblot and ELISA in cystic fibrosis with allergic bronchopulmonary aspergillosis. Journal of Allergy and Clinical Immunology 93(5): 926-931, 1994

Allergic bronchopulmonary aspergillosis in cystic fibrosis. A European epidemiological study. Epidemiologic Registry of Cystic Fibrosis. European Respiratory Journal 16(3): 464-471, 2000

Allergic bronchopulmonary aspergillosis in cystic fibrosis--state of the art: Cystic Fibrosis Foundation Consensus Conference. Clinical Infectious Diseases 37(Suppl. 3): S225-S264, 2003

Effect of allergic bronchopulmonary aspergillosis on FEV 1 in children and adolescents with cystic fibrosis: a European Cystic Fibrosis Society Patient Registry analysis. Archives of Disease in Childhood 102(8): 742-747, 2017