BackgroundAspergillus is one of the most common pathogens causing fungal allergy in the respiratory tract. Serum Aspergillus fumigatus-specific immunoglobulin G (Af-sIgG) levels have been used as a biomarker for the diagnosis and treatment response monitoring in airway allergic diseases such as allergic bronchopulmonary aspergillosis and allergic fungal rhinosinusitis. However, its role in common primary chronic rhinosinusitis (CRS) was unclear.ObjectiveThis study aims to evaluate whether serum Af-sIgG level could serve as a biomarker for the disease presentation of primary CRS.MethodsWe obtained serum Af-sIgG levels from patients diagnosed as bilateral primary CRS refractory to medical treatment and evaluated the correlations between serum Af-sIgG levels and disease severity in patients with type 2 (T2) and non-T2 CRS.ResultsPatients with T2 CRS exhibited significantly higher serum Af-sIgG levels than non-T2 CRS patients. The cut-off value of serum Af-sIgG in T2 CRS was 20.9 mg/L, with an odds ratio of 3.8 (95% CI 1.17-12.20, P = .026). Furthermore, serum Af-sIgG levels were positively correlated with symptom scores evaluated by the Sino-Nasal Outcome Test-22 (SNOT-22) scores in T2 patients ( P = .009). While stratified by SNOT-22 total scores, patients with severe disease had higher serum Af-sIgG levels only in T2 CRS ( P = .034). In individual domains of SNOT-22 analysis, serum Af-sIgG levels showed a significant correlation with “ear/facial” symptom scores in the T2 group ( P < .001).ConclusionsSerum Af-sIgG levels may serve as a supplementary objective biomarker that correlates with identification and subjective measurements of T2 CRS, and may be associated with symptoms arising from Eustachian tube dysfunction.

中文翻译：

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血清烟曲霉特异性 IgG 作为区分慢性鼻窦炎内型的补充生物标志物：其在 2 型炎症中的作用和诊断功效的研究


背景曲霉菌是引起呼吸道真菌过敏的最常见病原体之一。血清烟曲霉特异性免疫球蛋白 G (Af-sIgG) 水平已被用作气道过敏性疾病（如过敏性支气管肺曲霉病和过敏性真菌性鼻窦炎）诊断和治疗反应监测的生物标志物。然而，其在常见原发性慢性鼻窦炎（CRS）中的作用尚不清楚。目的本研究旨在评估血清Af-sIgG水平是否可以作为原发性CRS疾病表现的生物标志物。方法我们获得了诊断为原发性慢性鼻窦炎（CRS）的患者的血清Af-sIgG水平。研究人员对药物治疗难治性的双侧原发性 CRS 进行了研究，并评估了 2 型（T2）和非 T2 CRS 患者血清 Af-sIgG 水平与疾病严重程度之间的相关性。结果 T2 CRS 患者的血清 Af-sIgG 水平显着高于非 T2 患者慢性鼻窦炎患者。 T2 CRS 中血清 Af-sIgG 的临界值为 20.9 mg/L，比值比为 3.8 (95% CI 1.17-12.20，P = .026)。此外，T2 期患者的血清 Af-sIgG 水平与鼻鼻结果测试 22 (SNOT-22) 评分评估的症状评分呈正相关 (P = .009)。按 SNOT-22 总分分层时，重症患者仅在 T2 CRS 中血清 Af-sIgG 水平较高 ( P = .034)。在 SNOT-22 分析的各个领域中，血清 Af-sIgG 水平与 T2 组中的“耳/面部”症状评分显着相关 ( P < .001)。结论血清 Af-sIgG 水平可作为补充客观生物标志物与 T2 CRS 的识别和主观测量相关，并且可能与咽鼓管功能障碍引起的症状有关。