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. 2024 May 23:17:2043-2052.
doi: 10.2147/IDR.S460513. eCollection 2024.

Value Evaluation of Quantitative Aspergillus fumigatus-Specific IgG Antibody Test in the Diagnosis of Non-neutropenic Invasive Pulmonary Aspergillosis

Lingyan Sheng #  1 , Wenhong Jiang #  1   2 , Yake Yao  1 , Jianying Zhou  1 , Hua Zhou  1
Affiliations

Value Evaluation of Quantitative Aspergillus fumigatus-Specific IgG Antibody Test in the Diagnosis of Non-neutropenic Invasive Pulmonary Aspergillosis

Lingyan Sheng et al. Infect Drug Resist. .

Abstract

Background: The role of Aspergillus-specific IgG antibody test in the diagnosis of non-neutropenic invasive pulmonary aspergillosis (IPA) is still uncertain, and related studies are also limited.

Purpose: This study aims to evaluate the quantitative test value of Aspergillus fumigatus-specific IgG antibody in non-neutropenic IPA, which could provide additional evidence for related clinical diagnosis.

Methods: This prospective study collected clinical data of suspected IPA patients from January, 2020 to December, 2022, and patients were divided into two groups, IPA and non-IPA. The study analyzed clinical characteristics and diagnostic value of Aspergillus-specific IgG antibody test, using the receiver operating characteristic (ROC) curve to evaluate diagnostic efficacy.

Results: The study enrolled 59 IPA cases and 68 non-IPA cases, the average admission age of IPA group was 63.2±9.6 (33-79), and the gender ratio (male:female) of IPA group was 42:17. The proportion of patients with history of smoking and COPD were higher in IPA group (59.3% vs 39.7%, P=0.027; 33.9% vs 14.7%, P =0.011, respectively). The level of Aspergillus fumigatus-specific IgG antibody in IPA group was significantly higher than non-IPA group (202.1±167.0 vs 62.6±58.0, P<0.001). The area under the ROC curve was 0.799 (95%CI: 0.718, 0.865 P<0.001), and the cut-off with best diagnostic efficacy was 91 AU/mL.

Conclusion: Immunological test plays an important role in the diagnosis of pulmonary aspergillosis, and Aspergillus-specific IgG antibody test has the good diagnostic value in non-neutropenic IPA.

Keywords: Aspergillus; IgG; diagnosis; invasive pulmonary aspergillosis; non-neutropenic.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The flow chart of the study. The criteria of possible IPA: (1) Patients’ age ≥18; (2) immune insufficiency (such as congenital immunodeficiency, long-term glucocorticoid treatment (glucocorticoid treatment time ≥3 weeks in the past 60 days), long-term immunosuppressive therapy after solid organ transplantation, radiotherapy and chemotherapy for malignant tumors, etc) or others with emerging risk factors of IPA, such as end-stage COPD, liver cirrhosis, etc; (3) The time for appearance of suspected clinical symptoms or abnormal imaging manifestations of IPA was ≤1 month; (4) abnormal infiltrative manifestations in pulmonary CT images. On the basis of the possible IPA, proven IPA criteria should also meet: histopathological evidence or positive culture result from sterile environment (excluding BALF), probable IPA criteria should meet: mycologic evidence such as GM test, positive culture result (qualified specimen from sputum, BALF, bronchial brush), Aspergillus PCR, etc.
Figure 2
Figure 2
(A) The level of Aspergillus fumigatus-specific IgG antibody in IPA and non-IPA patients. (B) The level of A. fumigatus-specific IgG antibody in possible, probable and proven IPA patients. ***p < 0.001.
Figure 3
Figure 3
The ROC curve of Aspergillus fumigatus-specific IgG antibody test in the diagnosis of IPA.
See this image and copyright information in PMC

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