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Natural history and relationship of serum immunoglobulin a responses to aspergillus fumigatus extracts and components in pediatric cystic fibrosis patients. Natural history and relationship of serum immunoglobulin a responses to aspergillus fumigatus extracts and components in pediatric cystic fibrosis patients: Meeting Abstract 001653
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International audience. Background: Cystic fibrosis (CF) is an inherited condition predisposing to Aspergillus fumigatus (AF)-induced pulmonary disease, including life-threatening allergic bronchopulmonary aspergillosis. Humoral responses to AF are currently monitored with serum IgE and IgG quantification, but specific IgA are usually not assessed. However, a protective role for AF-IgA has been suggested. Here, we describe the natural history of AF-specific IgA responses in a pediatric CF cohort.Method: IgA and IgE determination to AF extract and components Asp f 1, Asp f 2, Asp f 3, Asp f 4, and Asp f 6 (ThermoFisher Scientific, Phadia, Sweden) were assessed in a cohort of 84 consecutive CF patients undergoing routine monitoring for total IgE and AF-specific IgE between July 2015 and September 2018 in the competence center for pediatric CF from the University Hospital of Marseille (France). AF-specific IgA were measured retrospectively on excess serum samples. Clinical data were retrospectively collected.Results: The cohort comprised 36 males (43%) and 48 females (57%), with a median age of 13 years (range 9 months to 18 years), of whom 35 had detectable AF-specific IgE. In non-sensitized subjects, the prevalence of AF-specific IgA increased with age: 6% (0–4 years), 47% (5–9), 70% (10–14), 100% (15–18), p = 0.0002. AF component-specific IgA followed the same pattern, with Asp f 1 the apparent immunodominant allergen, followed by Asp f 2 and Asp f 6 with a maximum of 50% respectively, while Asp f 3 and Asp f 4 reached prevalence levels of 20%–25%. AF sensitization was associated with increased prevalence and levels of AF-specific IgA (extract and components). Levels of AF-specific IgE and IgA showed a small but significant correlation (Spearman r 0.3, p 0.02). Two children had active ABPA at the sampling time and displayed moderate levels of AF-specific IgA (6 mgA/L).Conclusion: We describe here the natural evolution of serum AF-specific IgA to extract and components in a pediatric CF cohort aged 9 months to 18 years, reporting that the prevalence and levels of serum AF-specific IgA increase with age and are associated with AF-specific IgE responses, however their molecular IgA profile is different from IgE, especially in terms of prevalence of Asp f 2, Asp f 4 and Asp f 6.
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