https://doi.org/10.4081/monaldi.2024.3041
Exploring the role of Aspergillus galactomannan antigen in assessing the risk factor of acute exacerbations in chronic obstructive pulmonary disease patients: a cross-sectional study
Submitted: April 28, 2024
Accepted: July 29, 2024
Published: September 12, 2024
Accepted: July 29, 2024
Abstract Views: 142
PDF_EARLY VIEW: 75
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Chronic obstructive pulmonary disease (COPD) is characterized by permanent airflow obstruction due to abnormalities of the airways and alveoli. This study investigated the potential role of Aspergillus species in acute exacerbations of COPD (AECOPD) and evaluated the diagnostic utility of serum Aspergillus galactomannan antigen. This cross-sectional study, carried out at the Jawaharlal Institute of Postgraduate Medical Education and Research from January 2021 to June 2022, involved COPD patients aged ≥40 years. Serum galactomannan and serum Aspergillus-specific antibodies were analyzed, along with the collection of demographic details, symptoms, and comorbidities. Statistical analyses, including univariate analysis and receiver operating characteristic (ROC) curve analysis, were performed. Among the 61 recruited COPD patients, 24.5% showed serum galactomannan positivity. Significant associations were found between galactomannan positivity, hemoptysis, and previous tuberculosis. ROC analysis revealed modest diagnostic accuracy (area under the ROC=0.6027) with a sensitivity of 44.4% and a specificity of 83.7% at a cut-off of 0.5. Univariate analysis did not show any potential links between diabetes, hypertension, previous exacerbations, and severe gold stages with a risk of exacerbation. Serum galactomannan antigen showed limited sensitivity, and its routine testing may not be justified for predicting exacerbation risk. Further studies are warranted to validate these findings and explore other diagnostic methods using bronchoalveolar lavage galactomannan antigen in AECOPD.
Halpin DMG, Celli BR, Criner GJ, et al. The GOLD Summit on chronic obstructive pulmonary disease in low- and middle-income countries. Int J Tuberc Lung 2019;23:1131-41.
DOI: https://doi.org/10.5588/ijtld.19.0397
Meghji J, Mortimer K, Agusti A, et al. Improving lung health in low-income and middle-income countries: from challenges to solutions. Lancet 2021;397:928-40.
DOI: https://doi.org/10.1016/S0140-6736(21)00458-X
Vestbo J, Edwards LD, Scanlon PD, et al. Changes in forced expiratory volume in 1 second over time in COPD. N Engl J Med 2011;365:1184-92.
DOI: https://doi.org/10.1056/NEJMoa1105482
Jain NK. Chronic obstructive pulmonary disease and tuberculosis. Lung India 2017;34:468-9.
DOI: https://doi.org/10.4103/lungindia.lungindia_183_17
Vijayasaratha K, Stockley RA. Reported and unreported exacerbations of COPD: analysis by diary cards. Chest 2008;133:34-41.
DOI: https://doi.org/10.1378/chest.07-1692
Wilkinson TMA, Donaldson GC, Hurst JR, et al. Early therapy improves outcomes of exacerbations of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2004;169:1298-303.
DOI: https://doi.org/10.1164/rccm.200310-1443OC
White AJ, Gompertz S, Stockley RA. Chronic obstructive pulmonary disease. 6: the aetiology of exacerbations of chronic obstructive pulmonary disease. Thorax 2003;58:73-80.
DOI: https://doi.org/10.1136/thorax.58.1.73
Bafadhel M, Mckenna S, Agbetile J, et al. Aspergillus fumigatus during stable state and exacerbations of COPD. Eur Respir J 2014;43:64-71.
DOI: https://doi.org/10.1183/09031936.00162912
Huerta A, Soler N, Esperatti M, et al. Importance of Aspergillus spp. isolation in acute exacerbations of severe COPD: prevalence, factors and follow-up: the FUNGI-COPD study. Respir Res 2014;15:17.
DOI: https://doi.org/10.1186/1465-9921-15-17
Hammond EE, McDonald CS, Vestbo J, Denning DW. The global impact of Aspergillus infection on COPD. BMC Pulm Med 2020;20:241.
DOI: https://doi.org/10.1186/s12890-020-01259-8
Mennink-Kersten MA, Donnelly JP, Verweij PE. Detection of circulating galactomannan for the diagnosis and management of invasive aspergillosis. Lancet Infect Dis 2004;4:349-57.
DOI: https://doi.org/10.1016/S1473-3099(04)01045-X
Celli BR, Fabbri LM, Aaron SD, et al. An updated definition and severity classification of chronic obstructive pulmonary disease exacerbations: the Rome proposal. Am J Respir Crit Care Med 2021;204:1251-8.
DOI: https://doi.org/10.1164/rccm.202108-1819PP
Palanivel J, Mohapatra MM, Rajaram M, et al. Prevalence and risk factors for chronic pulmonary aspergillosis in chronic obstructive pulmonary disease patients with acute exacerbations. Monaldi Arch Chest Dis 2024. doi: 10.4081/monaldi.2024.2927.
DOI: https://doi.org/10.4081/monaldi.2024.2927
Yoshimura K, Suzuki Y, Inoue Y, et al. Utility of serum Aspergillus-galactomannan antigen to evaluate the risk of severe acute exacerbation in chronic obstructive pulmonary disease. PLoS One 2018;13:e0198479.
DOI: https://doi.org/10.1371/journal.pone.0198479
Hamaki T, Kami M, Kanda Y, et al. False-positive results of Aspergillus enzyme-linked immunosorbent assay in a patient with chronic graft-versus-host disease after allogeneic bone marrow transplantation. Bone Marrow Transplant 2001;28:633-4.
DOI: https://doi.org/10.1038/sj.bmt.1703209
Nguyen LDN, Viscogliosi E, Delhaes L. The lung mycobiome: an emerging field of the human respiratory microbiome. Front Microbiol 2015;6:89.
DOI: https://doi.org/10.3389/fmicb.2015.00089
Denning DW, Cadranel J, Beigelman-Aubry C, et al. Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management. Eur Respir J 2016;47:45-68.
DOI: https://doi.org/10.1183/13993003.00583-2015
Bongomin F, Gago S, Oladele RO, Denning DW. Global and multi-national prevalence of fungal diseases-estimate precision. J Fungi 2017;3:57.
DOI: https://doi.org/10.3390/jof3040057
Tiew PY, Ko FWS, Pang SL, et al. Environmental fungal sensitisation associates with poorer clinical outcomes in COPD. Eur Respir J 2020;56:2000418.
DOI: https://doi.org/10.1183/13993003.00418-2020
Barberan J, Sanz F, Hernandez JL, et al. Clinical features of invasive pulmonary aspergillosis vs. colonization in COPD patients distributed by gold stage. J Infect 2012;65:447-52.
DOI: https://doi.org/10.1016/j.jinf.2012.07.006
Pourbaix A, Lafont Rapnouil B, Guéry R, et al. Smoking as a risk factor of invasive fungal disease: systematic review and meta-analysis. Clin Infect Dis 2020;71:1106-19.
DOI: https://doi.org/10.1093/cid/ciaa001
Mei ZX, Han JF, Yu HW, et al. Detection of serum Aspergillus-specific IgM and IgG antibody levels for the diagnosis of chronic pulmonary aspergillosis developed in patients with tuberculosis. Eur J Clin Microbiol Infect Dis 2023;42:1081-9.
DOI: https://doi.org/10.1007/s10096-023-04637-2
Kono Y, Tsushima K, Yamaguchi K, et al. The utility of galactomannan antigen in the bronchial washing and serum for diagnosing pulmonary aspergillosis. Respir Med 2013;107:1094-100.
DOI: https://doi.org/10.1016/j.rmed.2013.04.007
Izumikawa K, Yamamoto Y, Mihara T, et al. Bronchoalveolar lavage galactomannan for the diagnosis of chronic pulmonary aspergillosis. Med Mycol 2012;50:811-7.
DOI: https://doi.org/10.3109/13693786.2012.682228
Yu Q, He J, Xing B, et al. Potential value of serum Aspergillus IgG antibody detection in the diagnosis of invasive and chronic pulmonary aspergillosis in non-agranulocytic patients. BMC Pulm Med 2020;20:89.
DOI: https://doi.org/10.1186/s12890-020-1125-y
Baxter CG, Denning DW, Jones AM, et al. Performance of two Aspergillus IgG EIA assays compared with the precipitin test in chronic and allergic aspergillosis. Clin Microbiol Infect 2013;19:E197-204.
DOI: https://doi.org/10.1111/1469-0691.12133
Park SY, Lee SO, Choi SH, et al. Serum and bronchoalveolar lavage fluid galactomannan assays in patients with pulmonary aspergilloma. Clin Infect Dis 2011;52:e149-52.
DOI: https://doi.org/10.1093/cid/cir027
Ethics Approval
The study protocol received approval from the Institutional Ethical Committee for observational studies DHR REG.NO.EC/NEW/INST/2020/331issued by Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER) (Protocol no. JIP/IEC/2021/077 dated 25/06/2021).How to Cite
Palanivel, Jayabharathi, Madhusmita Mohanty Mohapatra, Manju Rajaram, Debasis Gochhait, Sunitha Vellathussery Chakkalakkoombil, and Rakesh Singh. 2024. “Exploring the Role of Aspergillus Galactomannan Antigen in Assessing the Risk Factor of Acute Exacerbations in Chronic Obstructive Pulmonary Disease Patients: A Cross-Sectional Study”. Monaldi Archives for Chest Disease, September. https://doi.org/10.4081/monaldi.2024.3041.
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