Innate and adaptive immune defects in chronic pulmonary aspergillosis

Felix Bongomin, Chris Harris, Philip Foden, Chris Kosmidis, David Denning

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Abstract

We evaluated the expression of biomarkers of innate and adaptive immune response in correlation with underlying conditions in 144 patients with chronic pulmonary aspergillosis (CPA). Patients with complete medical and radiological records, white cell counts and a complete panel of CD3, CD4, CD8, CD19 and CD56 lymphocyte subsets were included. Eighty-four (58%) patients had lymphopenia. Six (4%) patients had lymphopenia in all five CD variables. There were 62 (43%) patients with low CD56 and 62 (43%) patients with low CD19. Ten (7%) patients had isolated CD19 lymphopenia, 18 (13%) had isolated CD56 lymphopenia, and 15 (10%) had combined CD19 and CD56 lymphopenia only. Forty-eight (33%) patients had low CD3 and 46 (32%) had low CD8 counts. Twenty-five (17%) patients had low CD4, 15 (10%) of whom had absolute CD4 counts <200/μl. Multivariable logistic regression showed associations between: low CD19 and pulmonary sarcoidosis (OR, 5.53; 95% CI, 1.43-21.33; p=0.013), and emphysema (OR, 4.58; 95% CI; 1.36-15.38; p=0.014), low CD56 and no bronchiectasis (OR, 0.27; 95% CI, 0.10-0.77; p=0.014), low CD3 and both multicavitary CPA disease (OR, 2.95; 95% CI, 1.30-6.72; p=0.010) and pulmonary sarcoidosis (OR, 4.94; 95% CI, 1.39-17.57; p=0.014). Several subtle immune defects are found in CPA.
Original languageEnglish
JournalJournal of Fungi
Volume3
Issue number2
Early online date29 May 2017
DOIs
Publication statusPublished - 2017

Keywords

  • Chronic pulmonary aspergillosis
  • innate and adaptive immune defects
  • underlying lung disease

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