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Chest Infections: Chest Infections |

Immunity Status of IPA Patients With Structural Lung Diseases in Chinese Adults FREE TO VIEW

Shuo Liang, PhD; Jinfu Xu, PhD; Haiwen Lu, MD; Bei Mao, BA; Manhui Li, BA; Chengwei Li, BA; Shuyi Gu, MD; Jiuwu Bai, MD
Author and Funding Information

Pulmonary Hospital of Shanghai Affiliated to Tongji University, Shanghai, China


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(4_S):A79. doi:10.1016/j.chest.2016.02.084
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SESSION TITLE: Chest Infections

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Invasive pulmonary aspergillosis (IPA) is frequently observed in immune dysfunction patients. The incidence of IPA with Structural lung diseases is low, but increasead in recent years. Deferent structural lung diseases has the deferent immune status. This study and is Mechanism are unknown. Study of assessing IPA with other common respiratory diseases are scarce, especially its immune status. This study aimed to compare the immunity status of IPA patients with Structural lung diseases COPD, ILD, Non-cystic fibrosis bronchiectasis.

METHODS: This retrospective study was carried out at Shanghai Pulmonary Hospital, Tongji University from 2004 to 2013. Seventy-seven patients positive for Aspergillus in lower respiratory tract samples were examined. Blood examinations of CD3, CD4, CD8, CD4/CD8, IgG, IgA, and IgM levels.

RESULTS: CD4/CD8 double positive cells, representing cell-mediated immunity, were less abundant in IPA patients with COPD (0.81) compared with those with ILD (1.39) and NCFB (1.57) (p<0,001). In agreement, corticosteroid and broad-spectrum antibiotics were mostly used in individuals with COPD among all IPA patients (41/72, 57%). Immunoglobulin A (IgA) levels, which indicate humoral immunity, were lowest in IPA patients with NCFB (0.95), i.e. lower compared with IPA patients with COPD (1.64) and ILD (3.16) (p<0,001). Finally, secretory IgA (sIgA) levels were most abundant in bronchiectasis patients.

CONCLUSIONS: Immunity status are deferent in IPA patients with Structural lung diseases. The Mechanism maybe long term treatment with broad-spectrum antibiotics and steroids.

CLINICAL IMPLICATIONS: IPA causes high mortality; however, sensitivity of lower respiratory tract cultures and serology remain poor. Cellular and humoral immunity parameters vary with the degree of damage induced by invasive pulmonary fungal infections combined with COPD, ILD, and NCFB. Immunity status should be taken into account in the differential diagnosis of IPA in patients, especially those with COPD and NCFB under treatment with broad-spectrum antibiotics and steroids. This study is helpful for future prospects of IPA immunotherapy.

DISCLOSURE: The following authors have nothing to disclose: Shuo Liang, jinfu Xu, Haiwen Lu, Bei Mao, Manhui Li, Chengwei Li, Shuyi Gu, Jiuwu Bai

No Product/Research Disclosure Information


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