Cited by 161Antifungal resistance and susceptibilityAsthma and respiratory diseasesFungal Infections and Studies

Comparison of six Aspergillus-specific IgG assays for the diagnosis of chronic pulmonary aspergillosis (CPA)

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Page, Iain D., Richardson, Malcolm D., Denning, David W.·2016·Journal of Infection

Abstract

Objectives Chronic pulmonary aspergillosis (CPA) is estimated to affect 3 million persons worldwide. Aspergillus-specific IgG is a key component in CPA diagnosis. We aimed to establish the optimal diagnostic cut offs for CPA and the comparative performance of six assays in this context. Methods Sera from 241 patients with CPA and 100 healthy blood donors were tested using five Aspergillus-specific IgG assays plus precipitin testing using Microgen Aspergillus antigens. Results Receiver operating characteristic (ROC) curve area under the curve (AUC) results were as follows: ThermoFisher Scientific ImmunoCAP 0.996 (95% confidence interval 0.992-1), Siemens Immulite 0.991 (0.982-1), Serion 0.973 (0.960-0.987), Dynamiker 0.918 (0.89-0.946) and Genesis 0.902 (0.871-0.933). Optimal CPA diagnostic cut-offs were; ImmunoCAP 20 mg/L (96% sensitivity, 98% specificity), Immulite 10 mg/L (96% sensitivity, 98% specificity), Serion 35 U/ml (90% sensitivity, 98% specificity), Dynamiker 65 AU/ml (77% sensitivity, 97% specificity) and Genesis 20 U/ml (75% sensitivity, 99% specificity). The precipitin test was 59% sensitive and 100% specific. Conclusions ImmunoCAP and Immulite were statistically significantly superior to the other assays. Precipitins testing performed poorly. The currently accepted ImmunoCAP cut-off of 40 mg/L appears sub-optimal for CPA diagnosis and may require revision in this context.

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Crossref · 10.1016/j.jinf.2015.11.003

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Authors
Page, I. D., Richardson, M. D., & Denning, D. W.
Affiliations
Manchester Academic Health Science Centre (GB)
Corresponding author
  • Page, Iain D.
  • Richardson, Malcolm D.
  • Denning, David W.
Venue
Journal of Infection
Publisher
Elsevier BV
Published
2016-02
Volume
72
Issue
2
Pages
240-249
ISSN
0163-4453 (ISSN-L)
OpenAlex
W2239408616
Cited by
161
References
32
Citations by year
2026: 14 · 2025: 15 · 2024: 12 · 2023: 18 · 2022: 12 · 2021: 13 · 2020: 16 · 2019: 15 · 2018: 18 · 2017: 15 · 2016: 12
FWCI
11.68
Type
journal article
Language
en
Locations
  • Journal of Infection (publishedVersion)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (publishedVersion, other-oa)
Funders
National Institute for Health Research Respiratory and Allergy Clinical Research Facility
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Keywords
chronic pulmonary aspergillosis, Aspergillus-specific IgG, serological diagnosis, diagnostic thresholds, ImmunoCAP, Immulite, Genesis, precipitin test, sensitivity and specificity, Aspergillus antigen
MeSH terms
Adult, Aged, Aged, 80 and over, Antibodies, Fungal, Aspergillus, Chronic Disease, Female, Humans, Immunoglobulin G, Male, Middle Aged, Sensitivity and Specificity, Serologic Tests, Pulmonary Aspergillosis, Young Adult

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