AUTHOR=Michel Moïse , Sereme Youssouf , Mankouri Farid , Gouitaa Marion , Gautier Clarisse , Mège Jean-Louis , Cassagne Carole , Ranque Stéphane , Reynaud-Gaubert Martine , Vitte Joana 

TITLE=Basophil Activation Test With Aspergillus Molecules: The Case for ABPA

JOURNAL=Frontiers in Allergy

VOLUME=3

YEAR=2022

URL=https://www.frontiersin.org/journals/allergy/articles/10.3389/falgy.2022.898731

DOI=10.3389/falgy.2022.898731

ISSN=2673-6101

ABSTRACT=<sec><title>Background</title><p>Allergic bronchopulmonary aspergillosis (ABPA) is an underestimated allergic disease due to <italic>Aspergillus fumigatus</italic> (AF). The main diagnostic criteria for ABPA rely on the evaluation of immunoglobulin (Ig) E and IgG responses to AF extracts, although these cannot discriminate AF-sensitization from ABPA.</p></sec><sec><title>Objectives</title><p>To evaluate the performance of cellular functional assays with extract and molecular AF allergens in ABPA.</p></sec><sec><title>Methods</title><p>A prospective cohort of 67 patients (6 ABPA) was investigated with basophil activation test (BAT) with AF extract. Twelve patients were further investigated for BAT responses to molecular AF components: Asp f 1, Asp f 2, Asp f 3, Asp f 4, and Asp f 6.</p></sec><sec><title>Results</title><p>BAT with AF extract with an optimized cutoff displayed 100% sensitivity and 77.6% specificity for ABPA diagnosis. Among patients with positive BAT to AF, BAT with Asp f 4 was significantly higher in ABPA patients at 10 ng/mL (mean basophil stimulation index 10.56 in ABPA vs. 1.24 in non-ABPA patients, <italic>p</italic> = 0.0002).</p></sec><sec><title>Conclusion</title><p>BAT with AF is a promising diagnostic biomarker in the context of suspected ABPA, which can be further improved with AF molecular allergens, especially Asp f 4.</p></sec>