PLoS ONE (Jan 2018)

Utility of serum Aspergillus-galactomannan antigen to evaluate the risk of severe acute exacerbation in chronic obstructive pulmonary disease.

  • Katsuhiro Yoshimura,
  • Yuzo Suzuki,
  • Yusuke Inoue,
  • Koji Nishimoto,
  • Kazutaka Mori,
  • Masato Karayama,
  • Hironao Hozumi,
  • Kazuki Furuhashi,
  • Noriyuki Enomoto,
  • Tomoyuki Fujisawa,
  • Yutaro Nakamura,
  • Naoki Inui,
  • Koushi Yokomura,
  • Shiro Imokawa,
  • Takafumi Suda

DOI
https://doi.org/10.1371/journal.pone.0198479
Journal volume & issue
Vol. 13, no. 6
p. e0198479

Abstract

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BACKGROUND:Recent studies have shown that the microbiome, namely Aspergillus species, play a previously unrecognized role in both stable and exacerbated chronic obstructive pulmonary disease (COPD). Galactomannan is a major component of the Aspergillus cell wall that has been widely used as a diagnostic marker. OBJECTIVES:To explore whether serum levels of Aspergillus-galactomannan antigen could be used to evaluate the risk of severe acute exacerbation of COPD (AE-COPD). METHODS:We measured the Aspergillus-galactomannan antigen levels of 191 patients with stable COPD, and examined its clinical relevance including AE-COPD. RESULTS:There were 77 (40.3%) patients who were positive for serum Aspergillus-galactomannan antigen (≥0.5). High Aspergillus-galactomannan antigen level (≥0.7) was associated with older age and presence of bronchiectasis and cysts on computed tomography images. Compared to patients with low Aspergillus-galactomannan antigen level (<0.7), patients with high Aspergillus-galactomannan antigen level had significantly higher incidence of severe AE-COPD (P = 0.0039, Gray's test) and respiratory-related mortality (P = 0.0176, log-rank test). Multivariate analysis showed that high Aspergillus-galactomannan antigen level was independently associated with severe AE-COPD (hazard ratio, 2.162; 95% confidence interval, 1.267-3.692; P = 0.005). CONCLUSION:Serum Aspergillus-galactomannan antigen was detected in patients with COPD, and elevated serum Aspergillus-galactomannan antigen was associated with severe AE-COPD.