ArtVortrag
TitelEvaluation of Sensitisation against Colonising Fungal Species by Individualised Skin Prick Tests (SPTs) in Patients with Cystic Fibrosis (CF)
TopicPneumologie und Allergologie
Einleitung

Lung function deterioration in CF patients may be caused by allergic bronchopulmonary aspergillosis (ABPA) or mycosis (ABPM). The lack of SPT extracts or specific IgE tests against most fungi possibly leads to underestimation of ABPM.
We aimed to investigate if CF patients are sensitised against fungal species colonising their airways, if a sensitisation is detectable via SPTs using individually produced extracts, and if a sensitisation is associated with lung function deterioration.

Patient/en und Methoden

This prospective study included CF patients whose sputum cultures grew fungi. Fungal extracts individually produced from colonising fungi, and Aspergillus fumigatus and Candida albicans commercial extracts were used to perform SPTs. The patients’ clinical state, lung function, eosinophil count, and total and specific IgE against A. fumigatus and C. albicans were analysed.

Ergebnisse

Out of 111 CF patients, 44 (39.6%) were colonised with fungi in relevant amounts and were tested with a total of 67 individually produced fungal extracts of colonising Aspergillus species (10 patients), Candida species (39), Exophiala dermatitidis (8), Scedosporium species (6), and Cryptococcus cyanovorans, Geotrichium capitatum, Penicillium variotii and Rasamsonia argillacea (1 each).
The SPTs of 16/44 (36.4%) patients resulted positive: 4 were positive to individually produced extracts, 3 of them to individually produced and commercial extracts of A. fumigatus. The fourth patient was positive to individually produced and commercial extracts of C. albicans, and an individually produced extract of A. fumigatus “non-sporulating” subtype, but negative to A. fumigatus “sporulating” subtype and commercial extract.
Twelve patients were positive to commercial extracts (10 to A. fumigatus, 2 to C. albicans) but were not colonised and therefore not tested with individually produced extracts.
Only in 1/28 cases (3.6%) a discordant result was observed between commercial and individually produced extracts. No patient had ABPM.

Schlussfolgerung/Diskussion

We performed SPTs using individually produced fungal extracts to identify sensitisations against colonising fungi. We found no sensitisation to other fungi than A. fumigatus or C. albicans. This finding might be due to other fungi not inducing sensitisation or to the low number of colonised patients. The method appears to be reliable but other studies are needed for confirmation.

review
Erstautor*in ist unter 35 Jahre alt
Autor*in 1Sara Zanella Department of Women's and Children's Health, University of Padova; Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University Graz
Autor*in 2Volker Strenger Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University Graz
Autor*in 3Walter Buzina Institute of Hygiene, Microbiology and Environmental Medicine, Medical University Graz
Autor*in 4Sophie Kienreich Institute of Hygiene, Microbiology and Environmental Medicine, Medical University Graz
Autor*in 5Markus Egger Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University Graz
Autor*in 6Andreas Pfleger Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University Graz
Autor*in 7Ernst Eber Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University Graz