Prospective study on clinical and immunological Aspergillus categorization in cystic fibrosis.

Objective: Aspergillus fumigatus (asp) is the most common detected filamentous fungus in CF airways yet data about the exact aspergillosis entities in CF are incomplete. Therefore, a study to evaluate patients with CF regarding their different aspergillus entities was established in 2016. Methods: Patients with CF producing sputum and with the ability to perform pulmonary function testing were included into a prospective, longitudinal study (DRKS00012862). Total serum IgE, asp-specific IgE, asp IgG, sputum galactomannan, sputum qPCR, sputum culture, asp-specific T cells response (ARTE), and clinical data were measured on the basis of an established protocol used in all patients to define asp categories. Results: 145/206 patients could be analysed from 12/2016-12/2017. 44% were male with a median age of 28 years (range 5-69) and a median BMI of 19,3±3,6 kg/m2. 45% were homozygous and 35,9% heterozygous for F508del. The median FEV1pp was 45±24,5. Total IgE was 48±742, asp-specific IgE was elevated in 37%, asp IgG was elevated in 52%, sputum GM was elevated in 48%, qPCR was positive in 39%, asp-specific T cells response was positive in 28% (TH1+TH2). During the ERS congress more data will be available. Conclusion: Aspergillus categorizations using recommended definitions could not be confirmed in all patients. Using asp-specific T cell responses expand the aspergillus categories and enables to distinguish between allergic and infectious disease.