New opportunities in the diagnosis of asthma with sensitization to Aspergillus spp.

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Abstract

BACKGROUND: Diagnosis of asthma with sensitization to Aspergillus spp. is becoming increasingly important due to the severe, uncontrolled course of the disease and the possibility of the formation of allergic bronchopulmonary aspergillosis.

AIM: To evaluate the possibility of using the basophil activation test using flow cytometry for the diagnosis of asthma with sensitization to Aspergillus spp.

MATERIALS AND METHODS: 118 patients with asthma were examined. The levels of total IgE and specific IgE to aeroallergens were determined in the blood serum by the enzyme immunoassay. Basophil activation was studied by flow cytometry using the Allergenicity kit (Cellular Analysis of Allergy, Beckman-Coulter, USA). The allergen Aspergillus fumigatus (Alcor Bio, Russia) was used to stimulate basophils.

RESULTS: The first group consisted of 57 patients with asthma without sensitization to Aspergillus spp. The second group included 36 patients with asthma with sensitization to Aspergillus spp. The third group consisted of 25 patients with allergic bronchopulmonary aspergillosis. The number of basophils activated by the Aspergillus fumigatus allergen in patients with asthma with sensitization to Aspergillus spp. and allergic bronchopulmonary aspergillosis was significantly higher than in the asthma group and amounted to 8.1 [5.2; 20.9]% and 84.6 [75.7; 94.0]%, respectively (p < 0.001). The stimulation index in the study groups ranged from 0.7 to 72.6. The optimal diagnostic point (cut off) for identifying patients with asthma with Aspergillus spp. sensitization there was an stimulation index value of more than 2.4, and for patients with allergic bronchopulmonary aspergillosis — 15.95. Among all patients with sensitization to Aspergillus spp. a positive correlation was established between the level of specific IgE to Aspergillus spp. and the percentage of basophils activated by the allergen Aspergillus fumigatus (r = 0.792, p < 0.001) and stimulation index (r = 0.796, p < 0.05).

CONCLUSIONS: The basophil activation test can be used as an additional diagnostic method for asthma with sensitization to Aspergillus spp. and allergic bronchopulmonary aspergillosis.

About the authors

Yana I. Kozlova

North-Western State Medical University named after I.I. Mechnikov

Email: kozlova510@mail.ru
ORCID iD: 0000-0002-4602-2438
SPIN-code: 5842-6039

MD, Cand. Sci. (Med.), Assistant Professor

Russian Federation, 1/28 Santiago de Cuba str., Saint Petersburg, 194291

Alexandra E. Uchevatkina

North-Western State Medical University named after I.I. Mechnikov

Email: a.uchevatkina@szgmu.ru
SPIN-code: 3001-4022

MD, Cand. Sci. (Med.)

Russian Federation, 1/28 Santiago de Cuba str., Saint Petersburg, 194291

Larisa V. Filippova

North-Western State Medical University named after I.I. Mechnikov

Email: larisa.filippova@szgmu.ru
SPIN-code: 6810-0871

MD, Cand. Sci. (Med.)

Russian Federation, 1/28 Santiago de Cuba str., Saint Petersburg, 194291

Oleg V. Aak

North-Western State Medical University named after I.I. Mechnikov

Email: oleg.aak@szgmu.ru
SPIN-code: 1198-7810

Cand. Sci. (Chem.)

Russian Federation, 1/28 Santiago de Cuba str., Saint Petersburg, 194291

Valeriy D. Kuznetsov

North-Western State Medical University named after I.I. Mechnikov

Email: valeriy_smith@inbox.ru

PhD student

Russian Federation, 1/28 Santiago de Cuba str., Saint Petersburg, 194291

Ekaterina V. Frolova

North-Western State Medical University named after I.I. Mechnikov

Email: ekaterina.frolova@szgmu.ru
SPIN-code: 9904-8776

MD, Cand. Sci. (Med.)

Russian Federation, 1/28 Santiago de Cuba str., Saint Petersburg, 194291

Natalya V. Vasilyeva

North-Western State Medical University named after I.I. Mechnikov

Email: mycobiota@szgmu.ru

Dr. Sci. (Biol.), Professor, Honoured Science Worker

Russian Federation, 1/28 Santiago de Cuba str., Saint Petersburg, 194291

Nikolay N. Klimko

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: n_klimko@mail.ru
SPIN-code: 9215-4069

MD, Dr. Sci. (Med.), Professor

Russian Federation, 1/28 Santiago de Cuba str., Saint Petersburg, 194291

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2. Fig. 1. Basophil activation test in patients with asthma. Patients С. (а, b) and patients D. (c, d) at the final basophil gaiting (CD3–CRTH2+CD203++) after the spontaneous (a, c) and specific Aspergillus fumigatus (b, d) activation. High percentage of the activated basophils (b) confirms the sensibility

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3. Fig. 2. ROC curves illustrating the optimal cut off points of the index stimulation to detect sensitization to Aspergillus spp. patients with asthma (a) and ABPA (b)

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Copyright (c) 2021 Kozlova Y.I., Uchevatkina A.E., Filippova L.V., Aak O.V., Kuznetsov V.D., Frolova E.V., Vasilyeva N.V., Klimko N.N.

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