CYTOPHILIC ANTIBODIES IN BRONCHOPULMONARY ASPERGILLOMA AND CRYPTOGENIC PULMONARY EOSINOPHILIA

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  • 1 January 1976
    • journal article
    • research article
    • Vol. 26  (1) , 67-77
Abstract
The immunoglobulin [Ig] class and subclass of cytophilic antibodies were studied using peripheral leukocytes from 22 patients with allergic bronchopulmonary aspergillosis, aspergilloma and cryptogenic pulmonary eosinophilia. In patients with allergic bronchopulmonary aspergillosis, significantly increased histamine liberation occurred following challenge of their leukocytes with antisera to IgE [immunoglobulin E], IgG2, IgG3 and IgG4 as well as with Aspergillus fumigatus antigen. The results were considerably modified if the patient was receiving corticosteroids at the time of the test. The presence of IgG2-specific antibody to A. fumigatus in the serum of 1 patient, capable of sensitizing donor leukocytes, was demonstrated in passive sensitization experiments. In 2 patients with uncomplicated aspergillomas, no evidence of cytophilic antibody to any class was found, although large amounts of precipitating IgG antibody was present in the serum. Two patients with aspergilloma and systemic symptoms of weight loss and fatigue (which were previously interpreted as hypersensitivity responses) had increased amounts of cytophilic antibody similar to those with allergic bronchopulmonary aspergillosis. Six patients with cryptogenic pulmonary eosinophilia were also studied. No evidence of specific antibody to A. fumigatus was found but, as a group, significantly increased histamine liberation using antisera to IgG2 was demonstrated. Individual patients also showed evidence of other classes of cytophilic antibody, 1 having IgE, 3 IgG3 and 2 IgG4. The relationship between heat-stable short-term sensitizing antibody (IgG STS) inducing immediate skin responses and the pattern of cytophilic antibodies found in these patients with bronchopulmonary aspergillosis having dual (immediate and late reactions) is discussed. Clinically, these tests are of diagnostic value and they may be helpful in assessing symptomatic patients with aspergillomas for corticosteroid treatment.