The association of lung shadowing with hypersensitivity responses in patients with allergic broncho‐pulmonary aspergillosis

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Abstract
Summary: The levels of total serum IgE and IgE antibodies to Aspergillus fumigatus allergens were highest during an episode of symptoms associated with fresh pulmonary shadowing and a rise in the direct cosinophil count in patients with allergic bronchopulmonary aspergillosis. Agglutinin titres were greater than those found in the sera of control subjects hut did not always correlate in magnitude with total serum IgE and IgE antibody levels. The highest agglutinin titre was found in the serum of a patient with an aspergilloma in association with allergic aspergillosis. The maximum in vitro histamine release from leucocytes exposed to A. fumigatus extracts or anti‐human IgE was independent of the concentration of total IgE or IgL antibodies. The leucocytes appeared to he relatively insensitive to both allergic and reverse allergic histamine release. This was considered to result from either continuous in vivo desensitization of the leucocytes by antigens shed from the fungal hyphae or, to the effect of drugs used in the treatment of (he disease, It was concluded that serial serum IgE measurements may be of value in monitoring the onset of the active phase of this disease.