Utility of serum Aspergillus-galactomannan antigen to evaluate the risk of severe acute exacerbation in chronic obstructive pulmonary disease.

Utility of serum Aspergillus-galactomannan antigen to evaluate the risk of severe acute exacerbation in chronic obstructive pulmonary disease.

<h4>Background</h4>Recent studies have shown that the microbiome, namely Aspergillus species, play a previously unrecognized role in both stable and exacerbated chronic obstructive pulmonary disease (COPD). Galactomannan is a major component of the Aspergillus cell wall that has been wid...

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Main Authors: Katsuhiro Yoshimura, Yuzo Suzuki, Yusuke Inoue, Koji Nishimoto, Kazutaka Mori, Masato Karayama, Hironao Hozumi, Kazuki Furuhashi, Noriyuki Enomoto, Tomoyuki Fujisawa, Yutaro Nakamura, Naoki Inui, Koushi Yokomura, Shiro Imokawa, Takafumi Suda
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2018-01-01
Series:PLoS ONE
Online Access:https://storage.googleapis.com/plos-corpus-prod/10.1371/journal.pone.0198479/1/pone.0198479.pdf?X-Goog-Algorithm=GOOG4-RSA-SHA256&X-Goog-Credential=wombat-sa%40plos-prod.iam.gserviceaccount.com%2F20210222%2Fauto%2Fstorage%2Fgoog4_request&X-Goog-Date=20210222T200406Z&X-Goog-Expires=3600&X-Goog-SignedHeaders=host&X-Goog-Signature=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Summary:<h4>Background</h4>Recent studies have shown that the microbiome, namely Aspergillus species, play a previously unrecognized role in both stable and exacerbated chronic obstructive pulmonary disease (COPD). Galactomannan is a major component of the Aspergillus cell wall that has been widely used as a diagnostic marker.<h4>Objectives</h4>To explore whether serum levels of Aspergillus-galactomannan antigen could be used to evaluate the risk of severe acute exacerbation of COPD (AE-COPD).<h4>Methods</h4>We measured the Aspergillus-galactomannan antigen levels of 191 patients with stable COPD, and examined its clinical relevance including AE-COPD.<h4>Results</h4>There were 77 (40.3%) patients who were positive for serum Aspergillus-galactomannan antigen (≥0.5). High Aspergillus-galactomannan antigen level (≥0.7) was associated with older age and presence of bronchiectasis and cysts on computed tomography images. Compared to patients with low Aspergillus-galactomannan antigen level (<0.7), patients with high Aspergillus-galactomannan antigen level had significantly higher incidence of severe AE-COPD (P = 0.0039, Gray's test) and respiratory-related mortality (P = 0.0176, log-rank test). Multivariate analysis showed that high Aspergillus-galactomannan antigen level was independently associated with severe AE-COPD (hazard ratio, 2.162; 95% confidence interval, 1.267-3.692; P = 0.005).<h4>Conclusion</h4>Serum Aspergillus-galactomannan antigen was detected in patients with COPD, and elevated serum Aspergillus-galactomannan antigen was associated with severe AE-COPD.
ISSN:1932-6203

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