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Serological Cross-Reactivity of Various Aspergillus spp. with Aspergillus fumigatus: A Diagnostic Blind Spot
Mattis Bertlich1,2, Saskia Freytag3, Patrick Huber1
1Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Ludwig-Maximilians University of Munich, Munich, Germany.
Introduction:
Aspergillus fumigatus is the most common airborne allergen of the Aspergillus family. However, allergies to Aspergillus spp. are increasing, and subsequently, allergies to Aspergillus species other than fumigatus are also on the rise. Commercial diagnostic tools are still limited to Aspergillus fumigatus. Hence, there is a need for improved tests. We decided to investigate the correlation between serological sensitization to A. fumigatus and other Aspergillus species.
Methods:
Hundred and seven patients with positive skin prick tests to A. fumigatus were included in this study. Immunoglobulin E (IgE) concentrations against A. fumigatus, A. terreus, A. niger, A. flavus, and A. versicolor were measured from specimens by fluorescent enzyme-linked immunoassays.
Results:
Patients showed considerably higher IgE concentrations against A. fumigatus (6.00 ± 15.05 kUA/L) than A. versicolor (0.30 ± 1.01 kUA/L), A. niger (0.62 ± 1.59 kUA/L), A. terreus (0.45 ± 1.12 kUA/L), or A. flavus (0.41 ± 0.97 kUA/L). Regression analysis yielded weak positive correlations for all Aspergillus spp., but low r2 values and heteroscedastic distribution indicate an overall poor fit of the calculated models.
Conclusion:
Serological sensitization against A. fumigatus does not correlate with sensitization against other Aspergillus spp. To detect sensitization against these, other diagnostic tools like a skin prick test solution of different Aspergillus spp. are needed.
Insights
Allergies to Aspergillus species beyond A. fumigatus are increasing, but current tests are limited. Serological sensitization to A. fumigatus does not reliably predict sensitization to other Aspergillus species, indicating a need for broader diagnostic tools.
Area of Science:
- Medical Mycology
- Allergology
- Immunology
Background:
- Aspergillus fumigatus is a common airborne allergen, but allergies to other Aspergillus species are rising.
- Current diagnostic tests for Aspergillus allergies primarily focus on A. fumigatus.
- There is a clinical need for improved diagnostic methods to detect sensitization to a broader range of Aspergillus species.
Purpose of the Study:
- To investigate the correlation between serological sensitization to Aspergillus fumigatus and other Aspergillus species.
- To assess the utility of current serological tests in identifying broader Aspergillus sensitization.
Main Methods:
- A cohort of 107 patients with positive skin prick tests to A. fumigatus was analyzed.
- Quantification of specific immunoglobulin E (IgE) levels against A. fumigatus, A. terreus, A. niger, A. flavus, and A. versicolor using fluorescent enzyme-linked immunoassays.
Main Results:
- Patients exhibited significantly higher IgE concentrations against A. fumigatus compared to other tested Aspergillus species.
- Regression analysis revealed weak positive correlations between A. fumigatus sensitization and sensitization to other species.
- Low R-squared values and heteroscedasticity indicated poor model fit, suggesting limited predictive value.
Conclusions:
- Serological sensitization to A. fumigatus does not correlate well with sensitization to other Aspergillus species.
- Existing serological diagnostic tools are insufficient for detecting sensitization to non-fumigatus Aspergillus species.
- Development of alternative diagnostic approaches, such as skin prick test solutions with diverse Aspergillus species, is recommended.
