Frontiers in Allergy (Jun 2022)

Basophil Activation Test With Aspergillus Molecules: The Case for ABPA

  • Moïse Michel,
  • Moïse Michel,
  • Youssouf Sereme,
  • Farid Mankouri,
  • Marion Gouitaa,
  • Clarisse Gautier,
  • Jean-Louis Mège,
  • Jean-Louis Mège,
  • Carole Cassagne,
  • Carole Cassagne,
  • Stéphane Ranque,
  • Stéphane Ranque,
  • Martine Reynaud-Gaubert,
  • Martine Reynaud-Gaubert,
  • Joana Vitte,
  • Joana Vitte

DOI
https://doi.org/10.3389/falgy.2022.898731
Journal volume & issue
Vol. 3

Abstract

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BackgroundAllergic bronchopulmonary aspergillosis (ABPA) is an underestimated allergic disease due to Aspergillus fumigatus (AF). The main diagnostic criteria for ABPA rely on the evaluation of immunoglobulin (Ig) E and IgG responses to AF extracts, although these cannot discriminate AF-sensitization from ABPA.ObjectivesTo evaluate the performance of cellular functional assays with extract and molecular AF allergens in ABPA.MethodsA prospective cohort of 67 patients (6 ABPA) was investigated with basophil activation test (BAT) with AF extract. Twelve patients were further investigated for BAT responses to molecular AF components: Asp f 1, Asp f 2, Asp f 3, Asp f 4, and Asp f 6.ResultsBAT with AF extract with an optimized cutoff displayed 100% sensitivity and 77.6% specificity for ABPA diagnosis. Among patients with positive BAT to AF, BAT with Asp f 4 was significantly higher in ABPA patients at 10 ng/mL (mean basophil stimulation index 10.56 in ABPA vs. 1.24 in non-ABPA patients, p = 0.0002).ConclusionBAT with AF is a promising diagnostic biomarker in the context of suspected ABPA, which can be further improved with AF molecular allergens, especially Asp f 4.

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