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Published on: March 22, 2012
Serum Aspergillus Immunoglobulin G as an Independent Biomarker for Extrasinonasal Involvement in Chronic Invasive
Jun-Tian Huang1, Ling-Hong Zhou1, Wen-Jia Qiu1
1Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
Background:
To investigate the seroprevalence of Aspergillus IgG antibodies among patients with chronic invasive Aspergillus rhinosinusitis (CIARS) and to assess their prognostic value for extrasinonasal involvement and therapeutic outcomes.
Methods:
A total of 132 patients with histopathologically confirmed CIARS were included. Serum Aspergillus IgG antibody levels were measured by enzyme-linked immunosorbent assay. Univariate and multivariable analyses were conducted to identify independent predictors of extrasinonasal involvement. To evaluate the prognostic value of antibody monitoring, serial Aspergillus IgG levels were assessed, and their association with radiological remission was analyzed.
Results:
Among the 132 patients, 50 (37.9%) tested positive for Aspergillus IgG antibodies. Seropositivity was significantly higher among patients with extrasinonasal involvement than among those without such involvement (59.2% vs 8.9%; P < .001). Multivariable analysis identified positive serum Aspergillus IgG antibodies (odds ratio [OR] = 11.28, 95% confidence interval [CI]: 3.67-34.64, P < .001), sphenoid sinus involvement (OR = 4.72, 95% CI: 1.89-11.79, P < .001), and ethmoid sinus involvement (OR = 5.22, 95% CI: 1.53-17.86, P = .008) as independent predictors of extrasinonasal involvement. Serial antibody monitoring was conducted to evaluate treatment outcomes, revealed a significant decrease in Aspergillus IgG levels in the radiological and clinical remission groups after antifungal therapy (median = 16.12 NovaTec units [NTU]; interquartile range [IQR] = 12.87-21.96 vs median = 9.21 NTU; IQR = 6.52-13.23; P < .001). In contrast, no significant change was observed in the stable disease group.
Conclusions:
Aspergillus IgG antibody is a promising noninvasive biomarker associated with extrasinonasal invasion and disease progression in CIARS.
