Scholarlink

Background <p>Allergic bronchopulmonary mycosis (ABPM), including allergic bronchopulmonary aspergillosis (ABPA), is an immune-mediated lung disease characterized by high serum total IgE and eosinophilia. The serum total IgE level is a well-established diagnostic and monitoring marker for ABPM/ABPA; however, its prognostic significance has not been fully elucidated. In particular, whether serum total IgE level at diagnosis is associated with subsequent longitudinal decline in lung function is unknown. Here we evaluated whether serum total IgE level at diagnosis is predictive of lung function decline and disease exacerbation in ABPA/ABPM.</p> Methods <p>We retrospectively analyzed 39 patients diagnosed with ABPA/ABPM from April 2022 through February 2025. Clinical data, lung function, exacerbation rates (no./y), and treatment were assessed at diagnosis, 1 y afterward, and at final follow-up (mean, 4.7 y). Patients were classified according to IgE level at 1 y (dichotomized to ≥ 50% IgE reduction and &lt; 50% IgE reduction).</p> Results <p>During the study period, 100% of patients received inhaled corticosteroid, 56% received systemic corticosteroids, and 23% received antifungal therapy, but none was treated with any biologic. The exacerbation rate was correlated with serum IgE level at diagnosis (<i>p</i> = 0.026, <i>r</i> = 0.36) but not with eosinophilia. The serum IgE level at diagnosis was inversely correlated with change in percent vital capacity (<i>P</i> = 0.0015, <i>r </i>= –0.68), percent forced vital capacity (%FVC; <i>P</i> = 0.009, <i>r </i>= –0.70), and percent forced expiratory volume in 1&#xa0;s (%FEV<sub>1</sub>; <i>P</i> = 0.038, <i>r </i>= – 0.48). Exacerbation rates at 1 y after diagnosis (<i>p</i> = 0.03) and final follow-up (<i>p</i> = 0.011) were lower in the IgE-decreased group than IgE-unchanged/increased group. The three patients with chronic pulmonary fibrosis were the only patients who showed consistently high serum total IgE levels and low pulmonary function (%FVC and %FEV₁) at diagnosis, as confirmed by computed tomography. In contrast, high-attenuation mucus, bronchiectasis, and mucus plugging showed no consistent relationship between serum total IgE levels and pulmonary function.</p> Conclusion <p>High serum IgE levels at diagnosis may predict a decline in lung function and increased exacerbation risk in patients with ABPA/ABPM. Management of serum IgE levels may mitigate ABPA/ABPM exacerbation and help preserve pulmonary function.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

High total serum IgE level at diagnosis was associated with a progressive decline in lung function in asthmatic patients with allergic bronchopulmonary mycosis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年3月8日

查看全文
  • Yuka Kodama,
  • Sachiko Takaoka,
  • Takuya Nakashima,
  • Kaho Matsunaga,
  • Kosuke Terada,
  • Yuga Yamashita,
  • Hinako Masumitsu,
  • Atsushi Miyasaka,
  • Tatsuya Muraoka,
  • Nami Masumoto,
  • Takeshi Kaneko,
  • Maiko Watanabe,
  • Naomi Tsurikisawa

摘要

Background

Allergic bronchopulmonary mycosis (ABPM), including allergic bronchopulmonary aspergillosis (ABPA), is an immune-mediated lung disease characterized by high serum total IgE and eosinophilia. The serum total IgE level is a well-established diagnostic and monitoring marker for ABPM/ABPA; however, its prognostic significance has not been fully elucidated. In particular, whether serum total IgE level at diagnosis is associated with subsequent longitudinal decline in lung function is unknown. Here we evaluated whether serum total IgE level at diagnosis is predictive of lung function decline and disease exacerbation in ABPA/ABPM.

Methods

We retrospectively analyzed 39 patients diagnosed with ABPA/ABPM from April 2022 through February 2025. Clinical data, lung function, exacerbation rates (no./y), and treatment were assessed at diagnosis, 1 y afterward, and at final follow-up (mean, 4.7 y). Patients were classified according to IgE level at 1 y (dichotomized to ≥ 50% IgE reduction and < 50% IgE reduction).

Results

During the study period, 100% of patients received inhaled corticosteroid, 56% received systemic corticosteroids, and 23% received antifungal therapy, but none was treated with any biologic. The exacerbation rate was correlated with serum IgE level at diagnosis (p = 0.026, r = 0.36) but not with eosinophilia. The serum IgE level at diagnosis was inversely correlated with change in percent vital capacity (P = 0.0015, r = –0.68), percent forced vital capacity (%FVC; P = 0.009, r = –0.70), and percent forced expiratory volume in 1 s (%FEV1; P = 0.038, r = – 0.48). Exacerbation rates at 1 y after diagnosis (p = 0.03) and final follow-up (p = 0.011) were lower in the IgE-decreased group than IgE-unchanged/increased group. The three patients with chronic pulmonary fibrosis were the only patients who showed consistently high serum total IgE levels and low pulmonary function (%FVC and %FEV₁) at diagnosis, as confirmed by computed tomography. In contrast, high-attenuation mucus, bronchiectasis, and mucus plugging showed no consistent relationship between serum total IgE levels and pulmonary function.

Conclusion

High serum IgE levels at diagnosis may predict a decline in lung function and increased exacerbation risk in patients with ABPA/ABPM. Management of serum IgE levels may mitigate ABPA/ABPM exacerbation and help preserve pulmonary function.