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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to analyze the clinical significance of <span class="elsevierStyleItalic">Aspergillus fumigatus</span> and <span class="elsevierStyleItalic">Candida albicans</span> in respiratory secretions from patients with cystic fibrosis and to assess the immune response to these fungi in serum&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">The study included 66 patients with cystic fibrosis &#40;34 men&#59; mean age&#44; 16&#46;2 years&#41;&#46; Sera from 15 healthy individuals were used as controls&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The serum concentrations of immunoglobulin &#40;Ig&#41; G&#44; IgA&#44; and IgM against <span class="elsevierStyleItalic">A fumigatus</span> and <span class="elsevierStyleItalic">C albicans</span> were higher in patients than in the control group&#46; There was no correlation between the presence of <span class="elsevierStyleItalic">A fumigatus</span> in respiratory secretions and the immune response to the fungus measured in serum&#46; In contrast&#44; the presence of <span class="elsevierStyleItalic">C albicans</span> in respiratory secretions was correlated with the immune response to that fungus&#46; The likelihood of obtaining <span class="elsevierStyleItalic">A fumigatus</span> cultures from respiratory secretions increased with age&#46; The presence of these fungi in respiratory samples was not a risk factor for greater respiratory impairment&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">In response to increased colonization of the lower respiratory tract by <span class="elsevierStyleItalic">A fumigatus</span> and <span class="elsevierStyleItalic">C albicans</span>&#44; patients with cystic fibrosis have elevated serum levels of IgG&#44; IgA&#44; and IgM against those fungi&#46; In patients with cystic fibrosis&#44; culture of sputum and oropharyngeal secretions is adequate for the assessment of lower respiratory tract colonization by <span class="elsevierStyleItalic">C albicans</span> but not <span class="elsevierStyleItalic">A fumigatus</span>&#46; Fungal colonization of the lower respiratory tract is not a risk factor for greater respiratory impairment in patients with cystic fibrosis&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Estudiar el significado cl&#237;nico de <span class="elsevierStyleItalic">Aspergillus fumigatus</span> y <span class="elsevierStyleItalic">Candida albicans</span> en las secreciones respirato-rias de los pacientes con fibrosis qu&#237;stica &#40;FQ&#41; y las inmuno-rrespuestas s&#233;ricas frente a estos hongos&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se estudi&#243; a 66 pacientes con FQ &#40;34 varones&#59; edad media&#58; 16&#44;2 a&#241;os&#41;&#46; Como grupo control se utilizaron los sueros de 15 individuos sanos&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Las concentraciones de inmunoglobulina &#40;Ig&#41; G&#44; IgA e IgM frente a <span class="elsevierStyleItalic">A&#46; fumigatus</span> y <span class="elsevierStyleItalic">C&#46; albicans</span> estuvieron m&#225;s elevadas en los pacientes con FQ que en el grupo control&#46; No hubo correlaci&#243;n entre el hallazgo de <span class="elsevierStyleItalic">A&#46; fumigatus</span> en las secreciones respiratorias y las inmunorrespuestas s&#233;ricas frente al hongo&#46; S&#237; hubo correlaci&#243;n entre la presencia de <span class="elsevierStyleItalic">C&#46; albicans</span> en las secreciones respiratorias y las inmunorrespuestas frente a <span class="elsevierStyleItalic">C&#46; albicans</span>&#46; A medida que aumentaba la edad de los pacientes&#44; aumentaba la probabilidad de cultivar <span class="elsevierStyleItalic">A&#46; fumigatus</span> en las secreciones respiratorias&#46; La presencia de estos hongos en muestras respiratorias no fue un factor de riesgo para un mayor deterioro respiratorio&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Como respuesta a la elevada colonizaci&#243;n del aparato respiratorio inferior por <span class="elsevierStyleItalic">A&#46; fumigatus</span> y <span class="elsevierStyleItalic">C&#46; albicans</span>&#44; los pacientes con FQ presentan respuestas s&#233;ricas elevadas de IgG&#44; IgA e IgM frente a estos hongos&#46; En los pacientes con FQ el cultivo de esputos y aspirados orofar&#237;ngeos no sirve para evaluar la colonizaci&#243;n del aparato respiratorio inferior por <span class="elsevierStyleItalic">A&#46; fumigatus</span>&#44; pero s&#237; por <span class="elsevierStyleItalic">C&#46; albicans</span>&#46; En estos pacientes&#44; la colonizaci&#243;n f&#250;ngica del aparato respiratorio inferior no es un factor de riesgo para el deterioro respiratorio&#46;</p>"
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Vol. 44. Issue 3.
Pages 146-151 (January 2008)
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Vol. 44. Issue 3.
Pages 146-151 (January 2008)
Original Articles
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Aspergillus fumigatus and Candida albicans in Cystic Fibrosis: Clinical Significance and Specific Immune Response Involving Serum Immunoglobulins G, A, and M
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Luis Máiza,
Corresponding author
lmaiz.hrc@salud.madrid.org

Correspondence: Dr L. Máiz Unidad de Fibrosis Quística, Hospital Ramón y Cajal Ctra Colmenar, km 9.128034 Madrid, Spain
, Manuela Cuevasb, Adelaida Lamasa, Aurora Sousac, Santiago Quirced, Lucrecia Suáreza
a Unidad de Fibrosis Quística, Hospital Ramón y Cajal, Madrid, Spain
b Servicio de Inmunología, Hospital Ramón y Cajal, Madrid, Spain
c Servicio de Microbiología, Hospital Ramón y Cajal, Madrid, Spain
d Servicio de Alergia, Hospital Universitario La Paz, Madrid, Spain
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Objective

The aim of this study was to analyze the clinical significance of Aspergillus fumigatus and Candida albicans in respiratory secretions from patients with cystic fibrosis and to assess the immune response to these fungi in serum.

Patients and methods

The study included 66 patients with cystic fibrosis (34 men; mean age, 16.2 years). Sera from 15 healthy individuals were used as controls.

Results

The serum concentrations of immunoglobulin (Ig) G, IgA, and IgM against A fumigatus and C albicans were higher in patients than in the control group. There was no correlation between the presence of A fumigatus in respiratory secretions and the immune response to the fungus measured in serum. In contrast, the presence of C albicans in respiratory secretions was correlated with the immune response to that fungus. The likelihood of obtaining A fumigatus cultures from respiratory secretions increased with age. The presence of these fungi in respiratory samples was not a risk factor for greater respiratory impairment.

Conclusions

In response to increased colonization of the lower respiratory tract by A fumigatus and C albicans, patients with cystic fibrosis have elevated serum levels of IgG, IgA, and IgM against those fungi. In patients with cystic fibrosis, culture of sputum and oropharyngeal secretions is adequate for the assessment of lower respiratory tract colonization by C albicans but not A fumigatus. Fungal colonization of the lower respiratory tract is not a risk factor for greater respiratory impairment in patients with cystic fibrosis.

Key words:
Aspergillus fumigatus
Candida albicans
Cystic fibrosis
Fungal colonization
Objetivo

Estudiar el significado clínico de Aspergillus fumigatus y Candida albicans en las secreciones respirato-rias de los pacientes con fibrosis quística (FQ) y las inmuno-rrespuestas séricas frente a estos hongos.

Pacientes y métodos

Se estudió a 66 pacientes con FQ (34 varones; edad media: 16,2 años). Como grupo control se utilizaron los sueros de 15 individuos sanos.

Resultados

Las concentraciones de inmunoglobulina (Ig) G, IgA e IgM frente a A. fumigatus y C. albicans estuvieron más elevadas en los pacientes con FQ que en el grupo control. No hubo correlación entre el hallazgo de A. fumigatus en las secreciones respiratorias y las inmunorrespuestas séricas frente al hongo. Sí hubo correlación entre la presencia de C. albicans en las secreciones respiratorias y las inmunorrespuestas frente a C. albicans. A medida que aumentaba la edad de los pacientes, aumentaba la probabilidad de cultivar A. fumigatus en las secreciones respiratorias. La presencia de estos hongos en muestras respiratorias no fue un factor de riesgo para un mayor deterioro respiratorio.

Conclusiones

Como respuesta a la elevada colonización del aparato respiratorio inferior por A. fumigatus y C. albicans, los pacientes con FQ presentan respuestas séricas elevadas de IgG, IgA e IgM frente a estos hongos. En los pacientes con FQ el cultivo de esputos y aspirados orofaríngeos no sirve para evaluar la colonización del aparato respiratorio inferior por A. fumigatus, pero sí por C. albicans. En estos pacientes, la colonización fúngica del aparato respiratorio inferior no es un factor de riesgo para el deterioro respiratorio.

Palabras clave:
Aspergillus fumigatus
Candida albicans
Fibrosis quística
Colonización fúngica
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