IgE and IgG Antibodies against Bipolaris Australiensis (Ba) in Allergic Fungal Sinusitis

Abstract

DescriptionTwelve adult patients suffering an allergic fungal sinusitis were checked by skin-testing with a Ba extract (13 mg/mL of proteins detected by the Bradford technique) and their sera were submitted to an ELISA-IgE and IgG methods following Phadebas recommendations [1][2][3][4][5][6][7]. Seven patients aged 22 years-45 years old were atopic (serum IgE ≥ 120 KU/L) and suffered chronic allergic rhinitis and asthma; the other 5 patients aged 33 years-54 years old were not atopic (serum IgE 40 ± 18 KU/L) and no other respiratory complaints [8][9][10][11][12][13][14][15][16][17][18][19]. The former revealed positive skin tests to the Ba extract with a wheal & flare reaction ≥ 5 mm meanwhile the latter group did not show any positive result and behave as a control group [20][21][22][23][24][25]. The atopic group was weekly subcutaneous vaccinated with the Ba extract (1 mg/dose/week) and after 3 years they revealed significant decrease of their IgE-anti-Ba levels and a marked increase of their IgG-anti-Ba values correlated with a significant improvement of their respiratory condition [26][27][28][29][30][31][32]. On the other hand, the control group was not vaccinated by ethical considerations, showed no changes in their serum values and suffered the recurrence of their illness [33][34][35][36][37][38][39][40][41]. The usefulness of specific immune-therapy with Ba is reinforced for the treatment of allergic fungal sinusitis. An experimental model with guinea-pigs was developed by the daily aerosolization of the protein-peak of Ba obtained by Sephadex G-50 column fractionation [42][43][44][45][46][47][48][49]. After 12 weeks a typical hypersensitivity pneumonitis was obtained with intense interstitial infiltrates of the lungs, solitary granulomas and foamy cells. It was also checked the presence of IgE-anti-Ba antibodies by the Ovary-Bier's test and of IgG-anti-Ba by the Ouchterlony technique [50][51][52]. It was demonstrated that the fungus Ba or Cochliobolus species is a potent antigen that inducing a chronic inflammatory process requires aggressive chirurgical and pharmacological treatments reinforced by immune-therapy [53,54].