The basophil surface marker CD203c identifies Aspergillus species sensitization in patients with cystic fibrosis

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:137

Article

Mirkovic, Bojana¹  Lavelle, Gillian M.¹  Azim, Ahmed Abdul¹  Helma, Kristine¹  Gargoum, Fatma S.¹  Molloy, Kevin¹  Gernez, Yael²  Dunne, Katie⁴  Renwick, Julie⁴  Murphy, Philip⁴  Moss, Richard B.³  Greene, Catherine M.¹  Gunaratnam, Cedric¹  Chotirmall, Sanjay H.⁵  McElvaney, Noel G.¹ 

[1] Beaumont Hosp, Royal Coll Surg Ireland, Dept Med, Resp Res Div, Dublin 9, Ireland

[2] Stanford Univ, Sch Med, Dept Genet, Stanford, CA 94305 USA

[3] Stanford Univ, Sch Med, Dept Paediat, Ctr Excellence Pulm Biol, Stanford, CA 94305 USA

[4] Trinity Coll Dublin, Dept Clin Microbiol, Dublin, Ireland

[5] Nanyang Technol Univ, Lee Kong Chian Sch Med, Singapore 639798, Singapore

关键词: Allergic bronchopulmonary aspergillosis;    Aspergillus fumigatus;    basophil activation test;    body mass index;    CD203c;    cystic fibrosis;    flow cytometry;    FEV1;    itraconazole;    sensitization;   

DOI  :  10.1016/j.jaci.2015.07.045

来源: Elsevier

【 摘 要 】

Background: Colonization by Aspergillus fumigatus in patients with cystic fibrosis (CF) can cause A fumigatus sensitization and/or allergic bronchopulmonary aspergillosis (ABPA), which affects pulmonary function and clinical outcomes. Recent studies show that specific allergens upregulate the surface-expressed basophil marker CD203c in sensitized subjects, a response that can be readily measured by using flow cytometry. Objective: We sought to identify A fumigatus sensitization in patients with CF by using the basophil activation test (BAT). Methods: Patients with CF attending Beaumont Hospital were screened for study inclusion. BAT was used to identify A fumigatus sensitization. Serologic (total and A fumigatus-specific IgE), pulmonary function, and body mass index measurements were performed. Results: The BAT discriminates A fumigatus-sensitized from nonsensitized patients with CF. Persistent isolation of A fumigatus in sputum is a significant risk factor for A fumigatus sensitization. Levels of the A fumigatus-stimulated basophil activation marker CD203c inversely correlated with pulmonary function and body mass index in A fumigatus-sensitized but not nonsensitized patients with CF. Total and A fumigatus-specific IgE, but not IgG, levels are increased in A fumigatus-sensitized patients with CF and ABPA when compared with those in A fumigatus-sensitized and nonsensitized patients with CF without ABPA. Itraconazole treatment did not affect A fumigatus sensitization. Conclusion: Combining the BAT with routine serologic testing allows classification of patients with CF into 3 groups: nonsensitized, A fumigatus-sensitized, and ABPA. Accurate and prompt identification of A fumigatus-associated clinical status might allow early and targeted therapeutic intervention, potentially improving clinical outcomes.

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