Identification of distinct immunophenotypes in chronic pulmonary aspergillosis using cluster analysis.
Mycoses
; 66(4): 299-303, 2023 Apr.
Article
en En
| MEDLINE
| ID: mdl-36504459
ABSTRACT
BACKGROUND:
Whether chronic pulmonary aspergillosis (CPA) has different immunophenotypes remains unknown.OBJECTIVE:
To identify different CPA immunophenotypes using cluster analysis.METHODS:
We used a subject-centred multivariate clustering approach without prior assumptions to identify CPA phenotypes. We retrospectively included the data of treatment-naïve subjects with CPA and excluded subjects with asthma and allergic bronchopulmonary aspergillosis (ABPA). We performed a scalable two-step cluster analysis using the log-likelihood distance measures to identify CPA phenotypes based on the blood immunological profile (total IgE, eosinophil count and Aspergillus-specific IgE and IgG).RESULTS:
We included 351 CPA subjects and found two clusters. Cluster 2 (n = 118) had significantly higher serum total IgE, peripheral blood eosinophil count, and serum A. fumigatus-specific IgE and IgG than cluster 1 (n = 233). Cluster 2 subjects had a lower FEV1FVC ratio on spirometry and were more likely to have a fungal ball (88 [74.6%] vs. 145 (62.2%), p = .023) on the CT thorax than cluster 1. After treatment discontinuation, cluster 2 had a longer median (interquartile range) time to relapse than cluster 1 (11.5 [7.3-27.4] vs. 4 [1.1-8.9] months, p = .005).CONCLUSION:
We identified two distinct CPA phenotypes, type-2 dominant and non-type-2, with different clinical and radiological findings and treatment outcomes. Future studies should confirm our findings and investigate different treatment strategies based on CPA phenotypes.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Aspergilosis Broncopulmonar Alérgica
/
Aspergilosis Pulmonar
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
Idioma:
En
Revista:
Mycoses
Asunto de la revista:
MICROBIOLOGIA
Año:
2023
Tipo del documento:
Article
País de afiliación:
India