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Comparison of six Aspergillus-specific IgG assays for the diagnosis of chronic pulmonary aspergillosis (CPA)
Open accessAbstract
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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Metadata
- 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
- Open access
- Licence
- 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 › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
- Health Sciences › Medicine › Infectious Diseases › 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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