Aspergillus Sensitization or Carriage in Cystic Fibrosis Patients
| Autor: | Jean-François Magnaval, Christine Segonds, M. Murris, Sophie Cassaing, F. Brémont, Laurent Tétu, Bernard Pipy, Judith Fillaux |
|---|---|
| Přispěvatelé: | Pharmacochimie et Biologie pour le Développement (PHARMA-DEV), Institut de Recherche pour le Développement (IRD)-Institut de Chimie de Toulouse (ICT-FR 2599), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC), Institut de Recherche pour le Développement (IRD)-Institut de Chimie de Toulouse (ICT), Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse) |
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Male
predictive factors MESH: Aspergillus fumigatus / immunology Cystic Fibrosis [SDV]Life Sciences [q-bio] Immunoglobulin E / blood Azithromycin Aspergillosis Cystic fibrosis Gastroenterology sensitization 0302 clinical medicine MESH: Antibodies Fungal / blood Child Sensitization 2. Zero hunger MESH: Aspergillus fumigatus / isolation & purification 0303 health sciences MESH: Carrier State / epidemiology Hazard ratio MESH: Immunoglobulin E / blood 3. Good health Infectious Diseases medicine.anatomical_structure Child Preschool Carrier State Female Allergic bronchopulmonary aspergillosis medicine.symptom Aspergillosis Allergic medicine.drug Microbiology (medical) medicine.medical_specialty Adolescent Aspergillus fumigatus / immunology Cystic Fibrosis / complications 03 medical and health sciences Internal medicine medicine Humans Aspergillus fumigatus / isolation & purification Antibodies Fungal Survival analysis MESH: Aspergillosis Allergic Bronchopulmonary / epidemiology MESH: Adolescent Child Preschool 030306 microbiology business.industry fungal infection Aspergillus fumigatus Aspergillosis Allergic Bronchopulmonary Carrier State / epidemiology Infant MESH: Cystic Fibrosis / complications Immunoglobulin E medicine.disease Bronchopulmonary / epidemiology 030228 respiratory system Pediatrics Perinatology and Child Health Sputum Antibodies Fungal / blood business |
| Zdroj: | Pediatric Infectious Disease Journal Pediatric Infectious Disease Journal, Lippincott, Williams & Wilkins, 2014, 33 (7), pp.680-686. ⟨10.1097/INF.0000000000000231⟩ Pediatric Infectious Disease Journal, 2014, 33 (7), pp.680-686. ⟨10.1097/INF.0000000000000231⟩ |
| ISSN: | 0891-3668 |
| DOI: | 10.1097/INF.0000000000000231⟩ |
| Popis: | International audience; Background: Aspergillus fumigatus (Af) sensitization and persistent carriage are deleterious to lung function, but no consensus has been reached defining these medical entities. This work aimed to identify possible predictive factors for patients who become sensitized to Af, compared with a control group of non-sensitized Af carriers.Methods: Between 1995 and 2007, 117 pediatric patients were evaluated. Demographic data, CFTR gene mutations, body mass index and FEV1 were recorded. The presence of Af in sputum, the levels of Af-precipitin, total IgE (t-IgE) and specific IgE to Af (Af-IgE) were determined. Patients were divided into 2 groups: (1) "sensitization": level of Af-IgE > 0.35 IU/mL with t-IgE level < 500 IU/mL and (2) "persistent or transient carriage": Af-IgE level ≤ 0.35 IU/mL with either an Af transient or persistent positive culture. A survival analysis was performed with the appearance of Af-IgE in serum as an outcome variable.Results: Severe mutation (hazard ratio = 3.2), FEV1 baseline over 70% of theoretical value (hazard ratio = 4.9), absence of Pa colonization, catalase activity and previous azithromycin administration (hazard ratio = 9.8, 4.1 and 1.9, respectively) were predictive factors for sensitization. We propose a timeline of the biological events and a tree diagram for risk calculation.Conclusions: Two profiles of cystic fibrosis patients can be envisaged: (1) patients with nonsevere mutation but low FEV1 baselines are becoming colonized with Af or (2) patients with high FEV1 baselines who present with severe mutation are more susceptible to the Af sensitization and then to the presentation of an allergic bronchopulmonary aspergillosis event. |
| Databáze: | OpenAIRE |
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