Evaluation of the clinical performance of four fungus-specific immunoglobulin E detection systems in patients with Aspergillus allergy

Zhifeng Huang,¹ Wanjia Li,^1,2 Hao Chen,¹ Huiqing Zhu,¹ Baoqing Sun¹

¹ Department of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory health, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
² Yichun University, Yuanzhou District, Yichun, China

Abstract

Background: Allergic bronchopulmonary aspergillosis (ABPA) is an airway disease caused by Aspergillus (mainly Aspergillus fumigatus).
Objective: To evaluate the diagnostic performance of four fungal-related allergen-specific immunoglobulin E (sIgE) detection systems.
Methods: A total of 99 patients with ABPA and 30 control patients admitted to the First Affiliated Hospital of Guangzhou Medical University from 2017 to 2019 were included in the study. Four allergen detection systems were used to detect Aspergillus-related sIgE.
Results: The 99 patients were divided into two groups based on the total IgE. Fluorescence immunoassay for fungal mixtures detected positive rates of 100% and 81% in the Confirmed and Probable groups, respectively. For Aspergillus fumigatus, the positive rates were 90.2% and 87.9%, respectively. In the detection of sIgE of fungal mixtures in all ABPA patients, the sensitivity of System 1 was 90.9%, which was higher than for the other three systems (System 2, 38.4%; System 3, 44.4%; System 4, 52.5%), All four systems have excellent specificity (> 90.0%) and had higher consistency in the Confirmed group than in the Probable group (P < 0.05). Consistency for the Aspergillus mixture and Aspergillus fumigatus detected by fluorescence immunoassay was 90.2% and 86.2% in the Confirmed and Probable groups, respectively.
Conclusion: Despite the many methods used to detect fungal-related sIgE, the ImmunoCAP system has the best clinical diagnostic performance. It is recommended that this method be used to detect fungal (mixtures or Aspergillus fumigatus) sIgE in order to reduce the missed diagnosis rate of ABPA.
Key words: ABPA, methodology, Aspergillus fumigatus, IgE, fluorescence immunoassay