دورية أكاديمية
Sensitisation to recombinant Aspergillus fumigatus allergens and clinical outcomes in COPD.
| العنوان: | Sensitisation to recombinant Aspergillus fumigatus allergens and clinical outcomes in COPD. |
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| المؤلفون: | Tiew PY; Dept of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore., Narayana JK; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore., Quek MSL; Dept of Biological Sciences, National University of Singapore, Singapore., Ang YY; Dept of Biological Sciences, National University of Singapore, Singapore., Ko FWS; Dept of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong., Poh ME; Dept of Medicine, University of Malaya, Kuala Lumpur, Malaysia., Jaggi TK; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore., Xu H; Dept of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore., Thng KX; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore., Koh MS; Dept of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore., Tee A; Dept of Respiratory and Critical Care Medicine, Changi General Hospital, Singapore., Hui DSC; Dept of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong., Abisheganaden JA; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.; Dept of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore., Tsaneva-Atanasova K; Living Systems Institute and Department of Mathematics, College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, UK.; EPSRC Hub for Quantitative Modelling in Healthcare, University of Exeter, Exeter, UK., Chew FT; Dept of Biological Sciences, National University of Singapore, Singapore., Chotirmall SH; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore schotirmall@ntu.edu.sg.; Dept of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore. |
| المصدر: | The European respiratory journal [Eur Respir J] 2023 Jan 06; Vol. 61 (1). Date of Electronic Publication: 2023 Jan 06 (Print Publication: 2023). |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: European Respiratory Society Country of Publication: England NLM ID: 8803460 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 1399-3003 (Electronic) Linking ISSN: 09031936 NLM ISO Abbreviation: Eur Respir J Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Sheffield, United Kingdom : European Respiratory Society Original Publication: Copenhagen : Published jointly by the Society and Munksgaard, 1988- |
| مواضيع طبية MeSH: | Aspergillus fumigatus*/genetics , Pulmonary Disease, Chronic Obstructive*/complications, Humans ; Allergens ; Prospective Studies ; Immunoglobulin E ; Aspergillus |
| مستخلص: | Background: Variable clinical outcomes are reported with fungal sensitisation in chronic obstructive pulmonary disease (COPD), and it remains unclear which fungi and what allergens associate with the poorest outcomes. The use of recombinant as opposed to crude allergens for such assessment is unknown. Methods: A prospective multicentre assessment of stable COPD (n=614) was undertaken in five hospitals across three countries: Singapore, Malaysia and Hong Kong. Clinical and serological assessment was performed against a panel of 35 fungal allergens including crude and recombinant Aspergillus and non- Aspergillus allergens. Unsupervised clustering and topological data analysis (TDA) approaches were employed using the measured sensitisation responses to elucidate if sensitisation subgroups exist and their related clinical outcomes. Results: Aspergillus fumigatus sensitisation was associated with increased exacerbations in COPD. Unsupervised cluster analyses revealed two "fungal sensitisation" groups. The first was characterised by Aspergillus sensitisation and increased exacerbations, poorer lung function and worse prognosis. Polysensitisation in this group conferred even poorer outcome. The second group, characterised by Cladosporium sensitisation, was more symptomatic. Significant numbers of individuals demonstrated sensitisation responses to only recombinant (as opposed to crude) A. fumigatus allergens f 1, 3, 5 and 6, and exhibited increased exacerbations, poorer lung function and an overall worse prognosis. TDA validated these findings and additionally identified a subgroup within Aspergillus -sensitised COPD of patients with frequent exacerbations. Conclusion: Aspergillus sensitisation is a treatable trait in COPD. Measuring sensitisation responses to recombinant Aspergillus allergens identifies an important patient subgroup with poor COPD outcomes that remains overlooked by assessment of only crude Aspergillus allergens. Competing Interests: Conflict of interest: P.Y. Tiew received honoraria for lectures and advisory board meetings paid to her hospital (Singapore General Hospital) from AstraZeneca, GlaxoSmithKline and Boehringer Ingelheim, outside the submitted work. M.S. Koh received research grant support from AstraZeneca, and honoraria for lectures and advisory board meetings paid to her hospital (Singapore General Hospital) from GlaxoSmithKline, AstraZeneca, Novartis, Sanofi and Boehringer Ingelheim, outside the submitted work. K. Tsaneva-Atanasova reports EPSRC grant EP/T017856/1. F.T. Chew reports personal fees for consultancy from Sime Darby Technology Centre, First Resources Ltd, Genting Plantation and Olam International, outside the submitted work. S.H. Chotirmall is on advisory boards for CSL Behring, Pneumagen Ltd and Boehringer Ingelheim, serves on a data and safety monitoring board for Inovio Pharmaceuticals Inc. and Imam Abdulrahman Bin Faisal University, and has received personal fees from AstraZeneca, all outside of the submitted work. All other authors have no conflicts of interest to declare. (Copyright ©The authors 2023.) |
| التعليقات: | Comment in: Eur Respir J. 2023 Jan 6;61(1):. (PMID: 36609522) |
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| المشرفين على المادة: | 0 (Allergens) 37341-29-0 (Immunoglobulin E) |
| تواريخ الأحداث: | Date Created: 20220804 Date Completed: 20230110 Latest Revision: 20230323 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC9816419 |
| DOI: | 10.1183/13993003.00507-2022 |
| PMID: | 35926878 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1399-3003 |
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| DOI: | 10.1183/13993003.00507-2022 |