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

Abstract

BACKGROUND:Diagnosis of asthma with sensitization toAspergillusspp. 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 toAspergillusspp. 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 allergenAspergillus fumigatus(Alcor Bio, Russia) was used to stimulate basophils. RESULTS:The first group consisted of 57 patients with asthma without sensitization toAspergillusspp. The second group included 36 patients with asthma with sensitization toAspergillusspp. The third group consisted of 25 patients with allergic bronchopulmonary aspergillosis. The number of basophils activated by theAspergillusfumigatusallergen in patients with asthma with sensitization toAspergillusspp. 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 withAspergillusspp. 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 toAspergillusspp. a positive correlation was established between the level of specific IgE toAspergillusspp. and the percentage of basophils activated by the allergenAspergillusfumigatus(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 toAspergillusspp. and allergic bronchopulmonary aspergillosis.