Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 May 29;3(2):26.
doi: 10.3390/jof3020026.

Innate and Adaptive Immune Defects in Chronic Pulmonary Aspergillosis

Felix Bongomin  1   2 , Chris Harris  3 , Philip Foden  4 , Chris Kosmidis  5   6 , David W Denning  7   8   9
Affiliations

Innate and Adaptive Immune Defects in Chronic Pulmonary Aspergillosis

Felix Bongomin et al. J Fungi (Basel). .

Abstract

We evaluated the expression of biomarkers of innate and adaptive immune response in correlation with underlying conditions in 144 patients with chronic pulmonary aspergillosis (CPA). Patients with complete medical and radiological records, white cell counts, and a complete panel of CD3, CD4, CD8, CD19, and CD56 lymphocyte subsets were included. Eighty-four (58%) patients had lymphopenia. Six (4%) patients had lymphopenia in all five CD variables. There were 62 (43%) patients with low CD56 and 62 (43%) patients with low CD19. Ten (7%) patients had isolated CD19 lymphopenia, 18 (13%) had isolated CD56 lymphopenia, and 15 (10%) had combined CD19 and CD56 lymphopenia only. Forty-eight (33%) patients had low CD3 and 46 (32%) had low CD8 counts. Twenty-five (17%) patients had low CD4, 15 (10%) of whom had absolute CD4 counts <200/μL. Multivariable logistic regression showed associations between: low CD19 and pulmonary sarcoidosis (Odds Ratio (OR), 5.53; 95% Confidence Interval (CI), 1.43-21.33; p = 0.013), and emphysema (OR, 4.58; 95% CI; 1.36-15.38; p = 0.014), low CD56 and no bronchiectasis (OR, 0.27; 95% CI, 0.10-0.77; p = 0.014), low CD3 and both multicavitary CPA disease (OR, 2.95; 95% CI, 1.30-6.72; p = 0.010) and pulmonary sarcoidosis (OR, 4.94; 95% CI, 1.39-17.57; p = 0.014). Several subtle immune defects are found in CPA.

Keywords: chronic pulmonary aspergillosis; innate and adaptive immune defects; underlying lung disease.

PubMed Disclaimer

Conflict of interest statement

Denning and family hold Founder shares in F2G Ltd., a University of Manchester spin-out antifungal discovery company, in Novocyt which markets the Myconostica real-time molecular assays. He acts or has recently acted as a consultant to Astellas, Sigma Tau, Basilea, Scynexis, Cidara, Biosergen, Quintilles, and Pulmocide. In the last 3 years, he has been paid for talks on behalf of Astellas, Dynamiker, Gilead, Merck, and Pfizer. He is a longstanding member of the Infectious Disease Society of America Aspergillosis Guidelines group, the European Society for Clinical Microbiology and Infectious Diseases Aspergillosis Guidelines group, and the British Society for Medical Mycology Standards of Care committee. Felix Bongomin: None; Chris Kosmidis: None; Chris Harris: None; Philip Foden: None.

Figures

Figure 1
Figure 1
A flow chart showing the selection criteria for the 144 patients. ICE: Integrated Clinical Environment, PACS: Picture archiving and communication system, CD: Cluster of differentiation.
Figure 2
Figure 2
A Venn-diagram showing the distribution of all of the five CDs among the 144 patients. Six (4%) patients had lymphopenia in all the five CDs. Eighteen (13%), 10 (7%), and 15 (10%) patients had isolated CD56, CD19, and both CD56 and CD19 lymphopenia, respectively. Four (3%) patients had isolated CD8 lymphopenia. No patient had an isolated low CD4 or low CD3 count.
See this image and copyright information in PMC

References

    1. Kwon-Chung K.J., Sugui J.A. Aspergillus fumigatus-What Makes the Species a Ubiquitous Human Fungal Pathogen? PLoS Pathog. 2013;9:e1003743. doi: 10.1371/journal.ppat.1003743. - DOI - PMC - PubMed
    1. Denning D.W. Invasive Aspergillosis. Clin. Infect. Dis. 1998;26:781–803. doi: 10.1086/513943. - DOI - PubMed
    1. Hope W.W., Walsh T.J., Denning D.W. The invasive and saprophytic syndromes due to Aspergillus spp. Med. Mycol. 2005;43:S207–S238. doi: 10.1080/13693780400025179. - DOI - PubMed
    1. Segal B.H. Aspergillosis. N. Engl. J. Med. 2009;360:1870–1884. doi: 10.1056/NEJMra0808853. - DOI - PubMed
    1. Agarwal R., Chakrabarti A., Shah A., Gupta D., Meis J.F., Guleria R., Moss R., Denning D.W., ABPA complicating asthma ISHAM working group Allergic bronchopulmonary aspergillosis: Review of literature and proposal of new diagnostic and classification criteria. Clin. Exp. Allergy. 2013;43:850–873. doi: 10.1111/cea.12141. - DOI - PubMed

LinkOut - more resources