چکیده (انگلیسی):

Prompt diagnosis of allergic bronchopulmonary mycosis (ABPM) is an important clinical issue in preventing
irreversible lung damage. Therefore, a good serological marker for the diagnosis of ABPM is
desired in clinical practice.
The measurement of IgE antibody to crude Aspergillus fumigatus allergen is considered the first step in
screening asthmatic patients for allergic bronchopulmonary aspergillosis (ABPA). However, presence of
IgE to A. fumigatus does not always indicate genuine sensitization to A. fumigatus because of crossreactivity
between crude extracts from different fungal sources. The application of molecular-based allergy
diagnosis can solve this problem. The specificity of testing can be greatly improved by measuring
the IgE antibody to Asp f 1 and f 2, specific allergen components for genuine A. fumigatus allergy.
The problem of cross-reactivity between crude fungal extracts is also true for the identification of
genuine causal fungi in each ABPM patient. Some patients with ABPM induced by fungi other than
Aspergillus may be consistent with ABPA diagnostic criteria because current criteria depend on IgE/IgG
reactivity to crude extracts. Accurate identification of genuine causal fungi for ABPM is of clinical
importance, considering that clinical presentation, anti-fungal treatment strategies and disease prognosis
can be influenced by different causal fungi. The diagnosis of causal fungi can be robustly validated
by the confirmation of genuine sensitization to fungi after measuring IgE to specific allergen components,
as well as repeated microbiological isolation of the fungi from their airway.