The general and specific humoral immune response to pulmonary aspergillosis

The genus Aspergillus may cause one of several clinical entities in affected patients. Serum specimens from 79 patients, including 41 with aspergilloma, 28 with allergic bronchopulmonary aspergillosis, 3 with both aspergilloma and the allergic variant, and 7 with invasive or disseminated aspergillosis, were studied for antibodies to aspergillus. The ammonium sulfate test was used with a mycelial component labeled with iodine-125 derived from Aspergillus fumigatus. Complement fixation and immunodiffusion tests using a culture filtrate antigen (aspergillin) from the same species were also performed. Immunoglobulins G, A, and M and complement component C-3 were determined by radial immunodiffusion. Total serum IgE was measured by radioimmunoassay. Serum specimens from patients with aspergilloma manifested increased binding to the radio-labeled mycelial component, multiple precipitin bands, and/or increased complement fixation titers to aspergillin. Serum concentrations of IgG and IgA were increased. Patients with allergic bronchopulmonary aspergillosis were characterized by moderately increased binding to the radio-labeled mycelial component, a paucity of precipitating and complement-fixing antibody to aspergillin, and increased total serum IgE. Serum from patients with locally invasive or disseminated aspergillosis had increased concentrations of C-3 and variable binding to the radiolabeled mycelial component, depending on the duration of the disease process. Use of a battery of tests with both mycelial and culture filtrate antigens enhanced detection of circulating aspergillus antibody.