Serological evidence of Aspergillus type I hypersensitivity in a subgroup of pulmonary aspergilloma patients.

Aspergillus causes a spectrum of diseases, among which aspergilloma (saprophytic colonization) and allergic bronchopulmonary aspergillosis (ABPA). We investigated the possible presence of type I hypersensitivity in patients with aspergilloma (as is classically found in ABPA). The sera of 38 patients with aspergilloma were investigated for the presence of Aspergillus-specific IgE by the CAP System (CAP) and by the RAST System (RAST). Twelve of these patients (32%) showed positive Aspergillus-specific IgE (group ASP-IgE+), with the CAP being more sensitive than the RAST. Median total IgE was higher in the ASP-IgE+ group as compared with the ASP-IgE- f1p4p (p < 0.05), but no differences were seen between the ASP-IgE+ group and patients with ABPA. Furthermore, when Alternaria-specific IgE were compared between ASP-IgE+ and ABPA groups, they were found more frequently in the latter group (p < 0.05). Thus, an aspergilloma group with type I hypersensitivity was isolated whose serologic profile to Aspergillus antigens was similar to the ABPA group. However, the patients in this group did not show sensitization to another mould (i.e., Alternaria), in contrast to the ABPA group. The presence of type I hypersensitivity in a subgroup of aspergillomas suggests an immunoallergic component to this disease which could contribute to a chronic inflammatory response to Aspergillus in some aspergillomas.