Introduction: Sensitization to Aspergillus fumigatus is a risk factor for severe asthma. However, little is known about its presence, appearance, and impact on allergic rhinitis. Herein, we investigated the usefulness of component resolved diagnostics in patients sensitized to Aspergillus fumigatus protein extract. Methods: Seventy-eight patients with suspected allergic rhinitis and elevated IgE levels toward Aspergillus fumigatus protein extract were retrospectively evaluated regarding their total and Aspergillus-specific IgE levels and their skin prick test. Furthermore, they were tested for specific IgE antibodies against Asp f 1, 2, 3, 4, and 6. Results: Skin prick test missed 6 patients (7.7%) with elevated IgE toward Aspergillus fumigatus protein extract. Fifty percent of patients (n = 39) were sensitized to at least one component. Even though monosensitization affected all components, all patients with positivity toward more than one component were sensitized to Asp f 1. There was a statistically significant increase of Aspergillus-specific IgE with increasing number of components affected by sensitization. Many patients were oligo- (34.6%) or polysensitized (51.3%). There was a high prevalence of sinusitis (61.8%). Conclusions: Component resolved diagnostic testing toward the major allergen Asp f 1 was less sensitive than skin prick test and serology to Aspergillus fumigatus protein extract. However, sensitivity of component resolved diagnostics might be underestimated. Diagnostics of the species-specific allergens Asp f 1, 2, and 4 might allow to differentiate between genuine and cross-reactive sensitization. In the clinical routine, skin prick test and serology to crude extract remain the methods of choice.
Int Arch Allergy Immunol

中文翻译：

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组分分辨诊断对上呼吸道主诉患者烟曲霉的诊断价值。

简介：对烟曲霉过敏是严重哮喘的危险因素。然而，人们对其存在、外观和对过敏性鼻炎的影响知之甚少。在此，我们研究了成分解析诊断在对烟曲霉蛋白提取物敏感的患者中的有用性。方法：对78 名疑似过敏性鼻炎患者和对烟曲霉蛋白提取物的IgE 水平升高的患者进行回顾性评估，评估他们的总IgE 水平和曲霉特异性 IgE 水平以及他们的皮肤点刺试验。此外，他们还测试了针对 Asp f 1、2、3、4 和 6 的特异性 IgE 抗体。结果：皮肤点刺试验漏掉了 6 名患者 (7.7%) 对烟曲霉蛋白提取物的IgE 升高。50% 的患者 ( n = 39) 对至少一种成分敏感。即使单一致敏作用影响所有组分，所有对一种以上组分呈阳性的患者都对 Asp f 1致敏。随着受致敏作用影响的组分数量增加，曲霉菌特异性 IgE的统计学显着增加。许多患者是寡敏 (34.6%) 或多敏 (51.3%)。鼻窦炎的患病率很高（61.8%）。结论：针对主要过敏原 Asp f 1 的成分分辨诊断测试不如皮肤点刺试验和血清学对烟曲霉蛋白提取物。然而，组件解析诊断的敏感性可能被低估了。物种特异性过敏原 Asp f 1、2 和 4 的诊断可能允许区分真正的和交叉反应的致敏。在临床常规中，皮肤点刺试验和粗提物血清学仍是首选方法。
Int Arch 过敏免疫