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(Chest. 2002;121:782-788.)
© 2002 American College of Chest Physicians

Serologic IgE Immune Responses Against Aspergillus fumigatus and Candida albicans in Patients With Cystic Fibrosis*

Luis Máiz, MD; Manuela Cuevas, MD; Santiago Quirce, MD; José F. Cañón, MD; Adalberto Pacheco, MD; Aurora Sousa, MD and Héctor Escobar, MD

* From the Departments of Pulmonology [Cystic Fibrosis Unit] (Drs. Máiz and Pacheco), Immunology (Dr. Cuevas), Allergology (Dr. Quirce), Microbiology (Dr. Sousa), and Pediatrics [Cystic Fibrosis Unit] (Dr. Escobar), Hospital Ramón y Cajal; and National Organization of Transplant (Dr. Cañón), Madrid, Spain.

Correspondence to: Luis Máiz, MD, Unidad de Fibrosis Quística, Servicio de Neumología, Hospital Ramón y Cajal, Ctra. Colmenar Km. 9,1. 28034 Madrid, Spain; e-mail: lmaiz{at}hrc insalud.es

Objectives: The objectives of this study were to determine the prevalence of Aspergillus fumigatus and Candida albicans in the sputa of patients with cystic fibrosis (CF), to assess serologic IgE responses of these patients to the presence of fungi in the sputum, to evaluate what effect this may have on clinical status, and to determine how the above-mentioned factors relate to allergic bronchopulmonary aspergillosis (ABPA).

Patients: Seventy-six CF patients (40 male and 36 female patients; age, 15.3 ± 8.7 years [mean ± SD]) were studied.

Measurements and results: A total of 1,239 sputum samples from 66 patients were cultured for fungi. A fumigatus was grown in 256 sputum specimens (20.7%), and C albicans was grown in 588 sputum samples (47.5%). Forty patients (60.6%) had at least one positive culture finding for A fumigatus, and 58 patients (87.9%) had at least one positive culture finding for C albicans. Forty-nine patients (64.5%) were sensitized to A fumigatus, and 20 patients (26.7%) were sensitized to C albicans. No correlation was found between the finding of A fumigatus in sputum and IgE to A fumigatus. Only patients who had at least one positive culture finding for C albicans had IgE to C albicans develop. Lung function values and chest radiograph scores were not significantly lower in patients sensitized to either A fumigatus or C albicans as compared to nonsensitized patients. Of the 20 patients sensitized to C albicans, 10 patients had confirmed ABPA and 10 patients had some immunologic characteristics of ABPA.

Conclusions: A high prevalence of colonization and sensitization to A fumigatus and C albicans in CF patients was observed. The sensitization to these fungi was not related to the clinical severity. IgE to C albicans may be an immunologic marker related to the development of ABPA in patients with CF.

Key Words: allergic bronchopulmonary aspergillosis • Aspergillus fumigatus • Candida albicans • cystic fibrosis • IgE






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