3.1 Totality
In AIR-NCRCRD, 7.30% of general population (295/4033) were sensitive to A.fumigatus in Guanzghou, sIgE level was 1.10 (0.54-3.79) kUA/L. The positive rate of A.fumigatus sIgE was significantly higher in adults than in children (10.50% vs. 2.20%, P < 0.001), but there were no differences between men and women. (Table 1). In 18 ABPA patients, there were 11 females, and the average age were 44.2 (range: 19 - 68) year old. In 54 patients with Af-sensitized asthma, there were 12 female, and the average age were 49.1 (range: 21 - 79) year old. There was no significant difference in age and gender between them.
3.2 Fungal sensitization between ABPA patients and Af-sensitized asthma patients
There was no significant difference of A.fumigatus sIgE levels between ABPA and Af-sensitized asthma patients (P > 0.05). In this study, 94.44% of ABPA patients and 87.04% of Af-sensitized asthma patients were sIgE-positive to at least one fungal allergen among the P.chrysogenum, C.herbarum, M.racemosus, C.albicans, A.alternata, and H.halodes. High positive rates to P.chrysogenum were found in 94.44% of ABPA patients and in 77.78% Af-sensitized asthma patients. The positivity rates of C.herbarum (88.89% vs 62.96%, P < 0.05) and A.alternata (72.22% vs 44.44%, P < 0.05) were higher in patients with ABPA than in Af-sensitized asthma patients (Figure 1). Although sIgE levels of P.chrysogenum, C.herbarum, M.racemosus, C.albicans, A.alternata, and H.halodes sIgE were higher in ABPA patients than in Af-sensitized asthma patients, there were no significant differences between two groups (Figure 2a).
3.3 A.fumigatus component sensitization between ABPA patients and Af-sensitized asthma patients
The positive rates of Asp f 1 (88.89% vs 59.26%, P < 0.05), Asp f 2 (66.67% vs 33.33%, P < 0.05), Asp f 4 (61.11% vs 33.33%, P < 0.05) and Asp f 6 (66.67% vs 14.81%, P < 0.001) in ABPA patients were significantly higher than those in Af-sensitized asthma patients.
As shown in Figure 2b, sIgE levels of Asp f 1 [7.93 (1.40, 30.18) kUA/L vs. 0.18 (1.18, 10.65) kUA/L, P < 0.05], Asp f 4 [3.17 (0.10, 17.65) kUA/Lvs. 0.03 (0.18, 5.07) kUA/L, P < 0.05] and Asp f 6 [1.22 (0.07, 5.70) kUA/L vs. 0.01 (0.05, 0.61) kUA/L, P < 0.001] in ABPA patients were higher than those in Af-sensitized asthma patients. The co-sensitization of five allergen components was shown in Figure 3, and there were 7 ABPA patients and 10 Af-sensitized asthma patients co-sensitization to Asp f 1, Asp f 2, Asp f 3, Asp f 4 and Asp f 6 at the same time. Interestingly, among them, there were 100% ABPA patients co-sensitization to P.chrysogenum and C.albicans (Table.2).
3.4 Correlation analysis between A.fumigatus components and various mycotic allergens in ABPA patients and Af-sensitized asthma patients
Spearman correlation analysis show that tIgE (rs = 0.586, P < 0.05), P.chrysogenum (rs = 0.686, P < 0.05), C.herbarum (rs = 0.688, P < 0.05), M.racemosus (rs = 0.358, P < 0.05), C.albicans (rs = 0.492, P < 0.05), A.alternata (rs = 0.692, P < 0.05), and H.halodes (rs = 0.585, P < 0.05) had correlation with A.fumigatus. A.fumigatus component Asp f 1 (rs = 0.473, P < 0.05), Asp f 2 (rs = 0.553, P < 0.05), Asp f 3 (rs = 0.558, P < 0.05), Asp f 4 (rs = 0.646, P < 0.05) and Asp f 6 (rs = 0.730, P < 0.05) was correlated with tIgE. In addition, Asp f 2 (rs = 0.653, P < 0.05), Asp f 3 (rs = 0.478, P < 0.05), Asp f 4 (rs = 0.540, P < 0.05) and Asp f 6 (rs = 0.483, P < 0.05) was correlated with P.chrysogenum, Asp f 2 (rs = 0.524, P < 0.05) and Asp f 6 (rs = 0.537, P < 0.05) was correlated with M.racemosus, Asp f 2 (rs = 0.568, P < 0.05) and Asp f 3 (rs = 0.514, P < 0.05) was correlated with A.alternata, other mycotic allergens hadn`t significant correlation with A.fumigatus components. Interestingly, the correlation between A.fumigatus and it`s component Asp f 2 was the strongest (ABPA: rs = 0.786; Af-sensitized asthma: rs = 0.663). Optimal scale analysis was show that ABPA was more relevant to Af-components (Cronbach`s alpha = 90.7%) (Figure 4).