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Aspergillus-specific immunoglobulin G seropositivity and lung function decline in patients with chronic lung
Geng-Ning Hu1, Sheng-Yuan Ruan2, Kuei-Pin Chung3
1Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, National Taiwan University College of Medicine, Hsinchu, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Background:
Aspergillus-specific immunoglobulin G (IgG) positivity typically indicates exposure to Aspergillus species, but its clinical significance among chronic lung diseases remains uncertain.
Methods:
This prospective study enrolled patients with bronchiectasis, chronic obstructive pulmonary disease (COPD), asthma, and interstitial lung disease (ILD) in Taiwan between July 2019 and June 2023. Forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were measured at baseline and repeated 1 year later. Lung function rapid decline was defined as FEV1 decline ≥ 60 mL/year or FVC decline ≥ 10 % predicted/year based on previous literature.
Results:
A total of 97 patients were enrolled, including 75 (77.3 %) with bronchiectasis, 42 (43.3 %) with COPD, 26 (26.8 %) with asthma, and 6 (6.2 %) with ILD. Higher Aspergillus-specific IgG levels were significantly associated with greater FEV1 decline (r = 0.34, P < 0.001) but not with greater FVC decline (r = 0.10, P = 0.327). Multivariable analysis demonstrated that higher Aspergillus-specific IgG levels were an independent risk factor for rapid FEV1 decline (odds ratio = 1.04; 95 % confidence interval [CI]: 1.01-1.08; P = 0.007). The area under the receiver operating characteristic curve of Aspergillus-specific IgG for predicting FEV1 rapid decline was 0.72 (95 % CI: 0.61-0.82). A cutoff of 30 mgA/L provided a sensitivity of 63.64 % and specificity of 71.43 % in predicting rapid FEV1 decline.
Conclusions:
Higher Aspergillus-specific IgG levels may be associated with rapid FEV1 decline in patients with chronic lung diseases, although this association requires further validation in larger, disease-specific cohorts.
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