Lymphocyte sensitization to Aspergillus fumigatus in allergic bronchopulmonary aspergillosis

Peripheral blood mononuclear cell (PBMC) proliferation induced by an extract of Aspergillus fumigatus (AF) was examined in patients with allergic bronchopulmonary aspergillosis (ABPA), all of whom had an immediate skin prick test reaction (SPT) and increased RAST binding to AF, and, for comparison, in individuals without immediate SPT reactivity or increased RAST binding to AF. The proliferative responses of PBMC from the ABPA patients were greater than those from the comparison donors. A substantial proportion of the comparison group, however, showed evidence of a specific immune response to AF, with AF-specific IgG measured by ELISA and specific lymphoproliferative responses. AF-responsive T cell lines and T cell clones were established from both ABPA patients and IgE-negative individuals. These clones, of helper/inducer (CD4+) phenotype, showed antigenic specificity and MHC restriction. The stimulating antigen was determined for four of six clones derived from a skin-prick-test-negative individual, and found to be of Mr 18 kD, possibly the major allergen, 'Ag 3'. ABPA patients showed a marked diminution of the proliferative response during disease exacerbation.