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
. 2024 Nov 5;16(1):28.
doi: 10.1186/s41479-024-00154-8.

Seroprevalence and prognostic value of Aspergillus-specific IgG among non-neutropenic invasive pulmonary aspergillosis patients: a prospective multicenter study

Meng-Rui Lee #  1   2 , Hsu-Liang Chang #  3   4   5 , Yung-Hsuan Chen  1 , Chia-Jung Liu  2 , Li-Ta Keng  2 , Hung-Ling Huang #  6   7   8   9   10   11 , Jann-Yuan Wang #  12 , Chau-Chyun Sheu  3   4   13 , Inn-Wen Chong  3   4   13   14   15   16
Affiliations

Seroprevalence and prognostic value of Aspergillus-specific IgG among non-neutropenic invasive pulmonary aspergillosis patients: a prospective multicenter study

Meng-Rui Lee et al. Pneumonia (Nathan). .

Abstract

Background: This study aimed to assess the diagnostic and prognostic value of Aspergillus-specific IgG (Asp-IgG) for invasive pulmonary aspergillosis (IPA) in non-neutropenic non-hematologic patients.

Methods: Between November 2019 and February 2022, we recruited 40 non-neutropenic, non-hematologic IPA patients from Taiwan and measured serum Asp-IgG levels using Phadia, Thermofisher. A positive Asp-IgG test was defined as a level > 40 mgA/L. We evaluated the association between Asp-IgG levels and overall survival, as well 90-day mortality rate of IPA patients.

Results: Of the 40 participants, 11 (27.5%) tested positive for Asp-IgG, while 16 (40%) had positive galactomannan antigen (optical density > 1). Higher Asp-IgG levels were associated with improved overall survival (HR: 0.22, 95% CI: 0.05-0.99, p = 0.035) in multivariable Cox regression. The overall 90-day mortality rate was 65% (26/40). We found that patients with low Asp-IgG levels (≤ 40 mgA/L) had a borderline higher 90-day mortality rate compared to patients with high Asp-IgG levels (OR: 3.15, 95% CI: 0.75-13.28, p = 0.118). Stratifying by serum galactomannan and Aspergillus IgG levels, patients with elevated serum GM and low Asp-IgG had the highest 90-day mortality (80%, 8/10), followed by patients with low serum GM and low Asp-IgG (68.4%, 13/19).

Conclusions: Asp-IgG was positive in approximately one-fourth of non-neutropenic IPA patients. Asp-IgG may hold potential as a clinical prognostic factor for IPA. Further studies are required to validate this finding.

Keywords: Aspergillus IgG; Aspergillus fumigatus; Diagnosis; Invasive pulmonary aspergillosis; Outcome.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow-chart of patient recruitment
Fig. 2
Fig. 2
Kaplan–Meier curve of high and low Asp-IgG level
Fig. 3
Fig. 3
Aspergillus-specific IgG level in patients with different level of serum GM (A), BAL GM (B), Aspergillus culture-positivity (C) and disease entity (D)
See this image and copyright information in PMC

References

    1. Lin SJ, Schranz J, Teutsch SM. Aspergillosis case-fatality rate: systematic review of the literature. Clin Infect Dis. 2001;32(3):358–66. - PubMed
    1. Barchiesi F, Santinelli A, Biscotti T, Greganti G, Giannini D, Manso E. Delay of antifungal therapy influences the outcome of invasive aspergillosis in experimental models of infection. J Antimicrob Chemother. 2016;71(8):2230–3. - PubMed
    1. Lackner N, Thome C, Ofner D, Joannidis M, Mayerhofer T, Arora R, Samardzic E, Posch W, Breitkopf R, Lass-Florl C: COVID-19 Associated Pulmonary Aspergillosis: Diagnostic Performance, Fungal Epidemiology and Antifungal Susceptibility. J Fungi (Basel) 2022;8(2):93. - PMC - PubMed
    1. Verweij PE, Rijnders BJA, Bruggemann RJM, Azoulay E, Bassetti M, Blot S, Calandra T, Clancy CJ, Cornely OA, Chiller T, et al. Review of influenza-associated pulmonary aspergillosis in ICU patients and proposal for a case definition: an expert opinion. Intensive Care Med. 2020;46(8):1524–35. - PMC - PubMed
    1. Lass-Florl C, Samardzic E, Knoll M. Serology anno 2021-fungal infections: from invasive to chronic. Clin Microbiol Infect. 2021;27(9):1230–41. - PubMed

LinkOut - more resources