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Clinical relevance of Aspergillus fumigatus sensitization in cystic fibrosis
- Rationale: The clinical relevance of sensitization to Aspergillus (A) fumigatus in cystic fibrosis (CF) is unclear. Some researchers propose that specific A fumigatus IgE is an innocent bystander, whereas others describe it as the major cause of TH‐2‐driven asthma‐like disease. Objectives: Lung function parameters in mild CF patients may be different in patients with and without A fumigatus sensitization. We aimed to ascertain whether allergen exposure to A fumigatus by bronchial allergen provocation (BAP) induces TH‐2 inflammation comparable to an asthma‐like disease. Methods: A total of 35 patients, aged 14.8 ± 8.5 years, and 20 healthy controls were investigated prospectively. The patients were divided into two groups: group 1 (n = 18): specific (s)IgE negative, and group 2 (n = 17): sIgE positive (≥0.7 KU/L) for A fumigatus. Lung function, exhaled NO, and induced sputum were analysed. All sensitized patients with an FEV1 > 75% (n = 13) underwent BAP with A fumigatus, and cell counts, and the expression of IL‐5, IL‐13, INF‐γ, and IL‐8 as well as transcription factors T‐bet, GATA‐3, and FoxP3, were measured. Results: Lung function parameters decreased significantly compared to controls, but not within the CF patient group. After BAP, 8 of 13 patients (61%) had a significant asthmatic response and increased eNO 24 hours later. In addition, marked TH‐2‐mediated inflammation involving eosinophils, IL‐5, IL‐13, and FoxP3 became apparent in induced sputum cells. Conclusion: Our study demonstrated the clinical relevance of A fumigatus for the majority of sensitized CF patients. A distinct IgE/TH‐2‐dominated inflammation was found in induced sputum after A fumigatus exposure.
Author: | Olaf EickmeierORCiDGND, Ulrich M. Zißler, Julia Wittschorek, Frederike Unger, Sabina Schmitt-Grohé, Ralf SchubertORCiDGND, Eva HerrmannORCiDGND, Stefan ZielenORCiDGND |
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URN: | urn:nbn:de:hebis:30:3-563110 |
DOI: | https://doi.org/10.1111/cea.13557 |
Parent Title (English): | Clinical & experimental allergy |
Publisher: | Wiley-Blackwell |
Place of publication: | Oxford |
Document Type: | Article |
Language: | English |
Date of Publication (online): | 2019/12/30 |
Date of first Publication: | 2019/12/30 |
Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
Release Date: | 2020/10/22 |
Tag: | Aspergillus fumigatus; IgE; basic mechanisms; bronchial allergen provocation; clinical immunology; cystic fibrosis |
Volume: | 50.2020 |
Page Number: | 9 |
First Page: | 325 |
Last Page: | 333 |
HeBIS-PPN: | 471418919 |
Institutes: | Medizin / Medizin |
Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Sammlungen: | Universitätspublikationen |
Licence (German): | Creative Commons - Namensnennung 4.0 |