Biomarkers for the diagnosis of allergic bronchopulmonary aspergillosis in cystic fibrosis: a systematic review and meta-analysis.

Biomarkers for the diagnosis of allergic bronchopulmonary aspergillosis in cystic fibrosis: a systematic review and meta-analysis.

J Allergy Clin Immunol Pract. 2021 Jan 14;:

Authors: Li BC, Huh SM, Prieto MD, Hong G, Schwarz C, Moss RB, Quon BS

Abstract
BACKGROUND: Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus fumigatus and impacts 10% of individuals with cystic fibrosis (CF). A diagnosis of ABPA is challenging to establish in CF due to overlapping clinical and radiologic features with CF lung disease. Recent studies have identified blood tests, imaging, and other biomarkers that may be useful for diagnosis.
OBJECTIVE: To summarize biomarkers that can aid in the diagnosis of ABPA in CF patients and to quantify their diagnostic accuracy through meta-analysis.
METHODS: We searched MEDLINE, EMBASE and the Cochrane Controlled Register of Trials and included studies that used a laboratory technique or imaging modality in CF patients diagnosed with ABPA. Pooled sensitivity and specificity were calculated using a hierarchical summary receiver operating characteristic model.
RESULTS: We identified 791 articles, of which 29 met our eligibility criteria and 9 were included in the meta-analysis. Hyperattenuating mucus on CT scan (n=3 studies; pooled sensitivity 62% and specificity 92%) and serum specific IgE against recombinant Af antigens f4 (n=6; 69%, 89%) and f6 (n=6; 39%, 97%) demonstrated high specificity. Based on single studies, serum thymus and activation regulated chemokine (92%, 94%), stimulated basophil expression of CD203c (94%, 74%), the inverted mucoid impaction signal on MRI (94%, 100%), and skin prick testing with rAsp f4 and/or f6 (100%, 100%) showed high sensitivity and specificity.
CONCLUSION: Recent studies have found promising biomarkers for diagnosing ABPA. Further research is needed to improve our understanding of their utility in diagnosis and disease monitoring.

PMID: 33454395 [PubMed – as supplied by publisher]

Source: Industry