Specific IgG Antibodies to Aspergillus Fumigatus Are Associated with Fungal Isolation from Respiratory Samples and CLAD Occurence After Lung Transplantation

• Published in: The Journal of heart and lung transplantation Vol. 41; no. 4; p. S291
• Main Authors: Beeckmans, H., Van Roy, E., Sacreas, A., Vanstapel, A., Kaes, J., Geudens, V., Vanaudenaerde, B.M., Bos, S., Van Slambrouck, J., Orlitova, M., Ceulemans, L., Van Raemdonck, D.E., Neyrinck, A.P., Dupont, L.J., Godinas, L., Verleden, G.M., Vos, R.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.04.2022
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2022.01.715

Fungal exposure and sensitization may negatively affect outcomes in various respiratory diseases, however, its effect on lung transplant (LTx) recipients is still unknown. We performed a retrospective cohort-analysis of prospectively collected data on circulating specific IgE/IgG antibodies to Aspergillus fumigatus (A fum)with regards to fungal isolation from respiratory samples and CLAD occurrence after LTx. Patients who underwent LTx at our center between 09-2014 and 12-2019 were evaluated for inclusion. Inclusion criteria were: conditional survival to 1 year post-LTx and availability of ≥ 1blood sample for specific IgE/IgG antibodies to A fum obtained at annual check-up at 1, 2 or 3 years post-LTx. Data regarding fungal isolation from respiratory samples and CLAD onset were obtained from electronic patient files. Outcome analysis was performed 06-2021 (6 months after the last measurement). Kaplan-Meier method was used for evaluation of the occurrence of fungal isolation and CLAD using GraphPad Prism. A total of 311 patients were included, of which IgE/IgG antibodies were available in 198, 188 and 186 patients at respectively 1, 2 or 3 years post-LTx. Elevated A fum IgE was detected in 51/311 (16.4%) of patients, but not associated with a significant difference in occurrence of fungal isolation or CLAD. Elevated A fum IgG was detected in 30/311 (9.6%) of patients, and associated with a higher prevalence of CLAD (p=0.0286) and demonstrated a predictive trend for fungal isolation from respiratory samples in the year post measurement (p=0.0913 and p=0.0527 at respectively 1 or 2 years post-LTx). Fungus specific IgG could be useful in long term follow up post-LTx, as it is a measure of fungal exposure and could be used as a predictor for fungal infections. Also it was associated with a higher CLAD occurrence, possibly because fungal infections are an important risk factor for CLAD, which needs further investigation.