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Comparison of serum markers for allergic bronchopulmonary aspergillosis in cystic fibrosis

¹ Division of Respiratory Medicine, Children’s University Hospital of Bern, Bern, Switzerland, ² Children’s Hospital of the Ludwig Maximilian University of Munich, Munich, Germany, ³ Both authors contributed equally to this article.

CORRESPONDENCE: P. Latzin, Division of Respiratory Medicine, Dept of Paediatrics, University Children’s Hospital of Bern, Inselspital, 3010 Bern, Switzerland. Fax: 41 316324807. E-mail: philipp.latzin{at}insel.ch

Keywords: Allergic bronchopulmonary aspergillosis, cystic fibrosis, diagnostic value, immunoglobulin E, serum marker, thymus- and activation-regulated chemokine

Received: June 26, 2007
Accepted September 11, 2007

The diagnosis of allergic bronchopulmonary aspergillosis (ABPA) in cystic fibrosis (CF) is a challenge. Thymus- and activation-regulated chemokine (TARC) has recently been reported to play a role in ABPA. The aim of this study was to compare the diagnostic value of TARC with that of known serological markers for diagnosis of ABPA in CF patients.

The present study longitudinally followed 48 CF patients, of whom 12 had a diagnosis of ABPA according to Nelson's criteria, for 1–8 yrs with repeated measurements of serum total immunoglobulin (Ig)E, specific Aspergillus fumigatus IgE and IgG, specific IgE against recombinant A. fumigatus allergens (rAsp f) 1, 3, 4 and 6, and TARC.

Median (interquartile range) TARC levels were 589 (465–673) pg·mL^–1 in ABPA patients and 232 (189–289) pg·mL^–1 in non-ABPA patients. Receiver operating characteristic curves revealed that TARC was superior to the other markers for diagnosis of ABPA. Diagnostic accuracy was greater for TARC (93%) than for total IgE (74%), or rAsp f 4 (75%) or f 6 (79%).

The present study indicates that thymus- and activation-regulated chemokine may be useful in the diagnosis of allergic bronchopulmonary aspergillosis in cystic fibrosis patients. However, larger studies are needed before thymus- and activation-regulated chemokine can routinely be used in diagnostic algorithms.