ArticleAllergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology2026
High total serum IgE level at diagnosis was associated with a progressive decline in lung function in asthmatic patients with allergic bronchopulmonary mycosis.
Article in Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAllergic bronchopulmonary mycosis (ABPM), including allergic bronchopulmonary aspergillosis (ABPA), is an immune-mediated lung disease characterized by high serum total IgE and eosinophilia. The serum total IgE level is a well-established diagnostic and monitoring marker for ABPM/ABPA; however, its prognostic significance has not been fully elucidated. In particular, whether serum total IgE level at diagnosis is associated with subsequent longitudinal decline in lung function is unknown. Here we evaluated whether serum total IgE level at diagnosis is predictive of lung function decline and disease exacerbation in ABPA/ABPM.
methodsWe retrospectively analyzed 39 patients diagnosed with ABPA/ABPM from April 2022 through February 2025. Clinical data, lung function, exacerbation rates (no./y), and treatment were assessed at diagnosis, 1 y afterward, and at final follow-up (mean, 4.7 y). Patients were classified according to IgE level at 1 y (dichotomized to ≥ 50% IgE reduction and < 50% IgE reduction).
resultsDuring the study period, 100% of patients received inhaled corticosteroid, 56% received systemic corticosteroids, and 23% received antifungal therapy, but none was treated with any biologic. The exacerbation rate was correlated with serum IgE level at diagnosis (p = 0.026, r = 0.36) but not with eosinophilia. The serum IgE level at diagnosis was inversely correlated with change in percent vital capacity (P = 0.0015, r = -0.68), percent forced vital capacity (%FVC; P = 0.009, r = -0.70), and percent forced expiratory volume in 1 s (%FEV
conclusionHigh serum IgE levels at diagnosis may predict a decline in lung function and increased exacerbation risk in patients with ABPA/ABPM. Management of serum IgE levels may mitigate ABPA/ABPM exacerbation and help preserve pulmonary function.
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