Asthma and lower airway diseaseThe basophil surface marker CD203c identifies Aspergillus species sensitization in patients with cystic fibrosis
Section snippets
Patient recruitment
We prospectively recruited 48 patients with CF to the study between October 2012 and October 2014. As control subjects, 11 healthy volunteers without CF were also recruited. Ethical approval was obtained from our institutional review board. CF was confirmed by sweat chloride levels (>60 mmol/L) and genotyping. Pulmonary function testing (see the Methods section in this article's Online Repository at www.jacionline.org) and serum sampling were performed on the day of the BAT. Total circulating
The BAT discriminates between nonsensitized and A fumigatus–sensitized patients with CF
Flow cytometry was used to measure basophil activation in response to A fumigatus. Basophils were gated as the Live/Dead−CD3−HLA-DR−CD41a−CD66b−CD123+ population and evaluated for CD203c expression after A fumigatus extract stimulation (see Fig E1 in this article's Online Repository at www.jacionline.org). PBS and peanut extract were used as nonoffending and immunogenic controls, respectively. An arbitrary cutoff of 1.36 was determined by using the stimulation index of the control subjects
Discussion
The role of bacteria in the lungs of patients with CF has been extensively studied, and potential roles for fungi are beginning to emerge. Recently, much focus has been given to the wide spectrum of A fumigatus–associated morbidities in patients with CF, including A fumigatus sensitization and ABPA. Both of these clinical states are associated with poorer clinical outcomes.16, 31 For this reason, identifying patients with A fumigatus sensitization with or without ABPA is important to ensure
References (45)
- et al.
Fungi in the cystic fibrosis lung: Bystanders or pathogens?
Int J Biochem Cell Biol
(2014) - et al.
A neutrophil intrinsic impairment affecting Rab27a and degranulation in cystic fibrosis is corrected by CFTR potentiator therapy
Blood
(2014) - et al.
Molecular epidemiology of Aspergillus collected from cystic fibrosis patients
J Cyst Fibros
(2015) - et al.
The effect of chronic infection with Aspergillus fumigatus on lung function and hospitalization in patients with cystic fibrosis
Chest
(2010) - et al.
Airway and parenchymal manifestations of pulmonary aspergillosis
Respir Med
(2013) - et al.
Allergic bronchopulmonary aspergillosis in cystic fibrosis: role of atopy and response to itraconazole
Chest
(1999) - et al.
Novel immunologic classification of aspergillosis in adult cystic fibrosis
J Allergy Clin Immunol
(2013) - et al.
Serum IgE discriminates allergy from sensitisation better than skin testing
Allergol Immunopathol (Madr)
(2014) - et al.
IgE-mediated immune responses and airway detection of Aspergillus and Candida in adult cystic fibrosis
Chest
(2013) - et al.
Blood basophils from cystic fibrosis patients with allergic bronchopulmonary aspergillosis are primed and hyper-responsive to stimulation by aspergillus allergens
J Cyst Fibros
(2012)
Emerging functions of basophils in protective and allergic immune responses
Mucosal Immunol
Basophil activation test discriminates between allergy and tolerance in peanut-sensitized children
J Allergy Clin Immunol
Intravenous monthly pulse methylprednisolone treatment for ABPA in patients with cystic fibrosis
J Cyst Fibros
Skin test results but not serology reflect immediate type respiratory sensitivity: a study performed with recombinant allergen molecules
J Invest Dermatol
Assays for measuring in vitro basophil activation induced by recombinant allergens
Methods
The airway microbiota in cystic fibrosis: a complex fungal and bacterial community—implications for therapeutic management
PLoS One
Aspergillus species and other molds in respiratory samples from patients with cystic fibrosis: a laboratory-based study with focus on Aspergillus fumigatus azole resistance
J Clin Microbiol
Immunoevasive Aspergillus virulence factors
Mycopathologia
Aspergillus-associated airway disease, inflammation and the innate immune response
Biomed Res Int
Allergic bronchopulmonary aspergillosis in cystic fibrosis—state of the art: Cystic Fibrosis Foundation Consensus Conference
Clin Infect Dis
Fungi and allergic lower respiratory tract diseases
J Allergy Clin Immunol
Assessment of Aspergillus sensitization or persistent carriage as a factor in lung function impairment in cystic fibrosis patients
Scand J Infect Dis
Cited by (0)
Supported by Science Foundation Ireland via a United States–Ireland partnership (grant no. SFI/08/US/B1676) and by the US Cystic Fibrosis Foundation.
Disclosure of potential conflict of interest: P. Murphy has received research support from the National Clinical Research Centre and Crumlin Hospital Dublin, has been supported by a National Children's Hospital joint grant on Metagenomics in Cystic Fibrosis, and is a board member for and has received travel support from Novartis. N. G. McElvaney has received research support from the Health Research Board and Science Foundation Ireland and has received consultancy fees from Chiesi and CSL Behring. The rest of the authors declare that they have no relevant conflicts of interest.
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These authors contributed equally to this work.