PT  - JOURNAL ARTICLE
AU  - Kerry Woolnough
AU  - Catherine Pashley
AU  - Andrew Wardlaw
TI  - LATE-BREAKING ABSTRACT: <em>Aspergillus fumigatus</em> specific IgE, but not total IgE or <em>A. fumigatus</em> specific IgG is associated with evidence of lung damage in asthma
AID  - 10.1183/13993003.congress-2015.PA4357
DP  - 2015 Sep 01
TA  - European Respiratory Journal
PG  - PA4357
VI  - 46
IP  - suppl 59
4099  - http://erj.ersjournals.com/content/46/suppl_59/PA4357.short
4100  - http://erj.ersjournals.com/content/46/suppl_59/PA4357.full
SO  - Eur Respir J2015 Sep 01; 46
AB  - Introduction: Total IgE and A.fumigatus IgG distinguish ABPA and severe asthma with fungal sensitisation (SAFS) from asthmatics with IgE sensitisation (sIgE) to A.fumigatus. However, the relationship between these biomarkers and evidence of lung damage in asthma is not known.Aim: To investigate which immunological biomarkers of fungal sensitisation are associated with fixed airflow obstruction and radiological evidence of lung damage in asthma.Methods: Clinical characteristics and lung function were recorded from stable asthmatics (n=364). Serum biomarkers and CT scans were performed and then analysed.Results: 73.4% (n=267) were sensitised to ≥1 fungi. Bronchiectasis was more prevalent in asthmatics sensitised to fungi (present in 51.1% vrs 28.6%, p‹0.05), as was tree and bud (17.5% vrs 3.9%; p‹0.05), collapse/consolidation (36.2% vrs 22.1%, p‹0.05) and fleeting shadows (5.3% vrs 0%, p‹0.05).SIgE to A. fumigatus was associated with bronchiectasis (AUC 0.72, p‹0.001), tree in bud (AUC 0.654 p‹0.006) and fleeting shadows (AUC 0.75, p‹0.05). Total IgE predicted the presence of fleeting shadows only (AUC 0.75, p‹0.05). A. fumigatus IgG was not related to any radiological abnormality.FEV1 was inversely correlated with A. fumigatus sIgE (p‹0.0001) and was not related to total IgE or A. fumigatus IgG.Conclusions: SIgE to A. fumigatus is associated with lung damage in asthma. Two of the major biomarkers used to define ABPA and SAFS (total IgE and aspergillus specific IgG), did not relate to bronchiectasis or fixed airflow obstruction, suggesting that a more inclusive term such as allergic fungal airway disease would better capture those at risk of lung damage.