The remaining variables when used in the analysis demonstrated significant discrimination between CF asthma, CF-ABPA, CF, and normal groups (Figure ?(Figure3).3). method (ImmunoCAP). We analyzed 17 patients each from cystic fibrosis with ABPA, and cystic fibrosis with asthma, 22 cystic fibrosis with no ABPA or asthma, and 11 age matched controls. Results The results indicate that no antigen, antibody or method Rabbit Polyclonal to OR1N1 is capable of differentiating cystic fibrosis (CF) with ABPA from other CF patients, although some allergens showed strong reaction or showed more prevalence among the patients studied. Conclusion When results of several allergens such 3-Methylglutaric acid as Asp f 1, f 2, f 3, f 4, and f 6 in their binding to IgA, IgG, and IgE 3-Methylglutaric acid antibodies were analyzed, a more strong discrimination of CF patients with ABPA was possible from your other groups studied. Background Allergic bronchopulmonary aspergillosis (ABPA) is usually a disabling allergic disease frequently seen in patients with asthma and cystic fibrosis [1,2]. The prevalence of ABPA has been estimated to be around 1 to 3-Methylglutaric acid 2% in asthmatics and up to 15% among patients with cystic fibrosis [3]. Over 60 percent of the patients with cystic fibrosis (CF) experienced atopy and the prevalence of ABPA among those patients have been reported to be over 20% compared to 2% in non-atopic CF patients. Immediate cutaneous reactivity to em A. fumigatus /em (Af) antigen was detected in 59% of patients, while enhanced IgG antibodies to Af was detected in 51%, and precipitating antibodies in 42% of ABPA-CF patients. Peripheral blood eosinophilia was obvious only in one-third of the patients [4]. The available information thus indicate that em Aspergillus /em -specific IgE and IgG are elevated in some patients, while in others no such elevation has been detected, and the values are frequently comparable to CF patients without ABPA. Similarly, total serum IgE and skin assessments with Af antigens, antigen-specific histamine release, and pulmonary function assessments all have limitations in the diagnosis of ABPA with CF [3,5]. Thus, it is obvious that the diagnosis of ABPA-CF is extremely difficult compared to ABPA without CF and the laboratory results are frequently inconclusive. Although a number of Af allergens have been cloned and expressed, most of them have not been evaluated simultaneously for their IgE binding and diagnostic significance. Most of the studies have been carried out using crude Af antigens or, less frequently, with recombinant allergens by ELISA and 3-Methylglutaric acid radioimmunoassays [6-9]. Recently, semi-automatic methods have been launched using recombinant allergens of em Aspergillus /em . In the present study, we employed both ELISA and ImmunoCAP (UniCAP, Pharmacia) utilizing some of the encouraging recombinant and crude extracts of Af to investigate specific IgE and other antibody isotypes in the sera of different groups of patients with CF and Af-induced allergy and normal controls. The results indicate that no single allergen specificity or antibody isotype specificity can reliably identify ABPA with CF, although majority of such patients showed significantly increased polyclonal response to multiple antigens. Materials and methods Human sera Sera from four different groups of subjects were studied for numerous antibodies to em Aspergillus /em allergens. All the 17 ABPA patients were diagnosed according to the criteria recommended by Stevens et al [3]. These include clinical deterioration (cough, wheeze, exercise intolerance, exercise induced asthma, decline of pulmonary function, increased sputum) not attributed to another etiology, total serum IgE over 1000 IU/ml (2400 ng/mL), immediate cutaneous reactivity to em Aspergillus /em or em in vitro /em presence 3-Methylglutaric acid of serum IgE antibody to Af and either precipitins to Af antigens or abnormal chest radiographs showing infiltrates or mucus-plugging. Included in the study was a set of17 CF patients with asthma and positive epicutaneous test responses to Af antigen but no other criteria of ABPA explained above. In addition, 22 subjects with CF but no atopy and 11 sera from apparently normal control subjects were also studied. The institutional human study committees of the respective institutions have approved this research. em Aspergillus fumigatus /em antigens em Aspergillus fumigatus /em extractThe crude culture filtrate extract was made as explained before [6,10]. In brief; the fungus was produced in a defined medium for up to.
