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Rouzet A, Scherer E, Barrera C, Gondouin A, Reboux G, Humbert K, Millon L, Bellanger AP. Bird fancier's lung serodiagnosis by automated r-IgLL1 ELISA. J Immunol Methods 2022; 505:113267. [PMID: 35421363 DOI: 10.1016/j.jim.2022.113267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/28/2022] [Accepted: 04/04/2022] [Indexed: 11/27/2022]
Abstract
CONTEXT Bird fancier's lung (BFL) is the most prevalent form of hypersensitivity pneumonitis (HP) worldwide. The current techniques used for the serological diagnosis of BFL all use crude extracts from feathers, droppings, and blooms as test antigens, which is associated with a lack of standardization and variability of the results. An antigenic protein, immunoglobulin lambda-like polypeptide-1 (IgLL1), isolated from pigeon droppings, was recently identified to be associated with BFL. We used genetic engineering to produce IgLL1 as a recombinant antigen. AIM We aimed to prospectively validate the use of an automated ELISA based on recombinant IgLL1 protein (r-IgLL1) as the test antigen for the serological diagnosis of BFL. METHODS Immunoprecipitation (IP) techniques (immunodiffusion (ID), immunoelectrophoresis (IEP)) and ELISA using r-IgLL1 were performed concomitantly over 10 months on 634 sera from patients with a BFL serodiagnosis request. Questionnaires were sent to obtain details on the avian exposure, clinical data, and final diagnosis. Concordance, sensitivity (Se), and specificity (Sp) of the two techniques were compared. RESULTS In total, 72 completed questionnaires were returned with 18 cases of BFL diagnosed and 54 of non-BFL. The concordance between the ELISA and ID+IEP precipitation techniques was 71%. The combination of immunoprecipitation techniques showed a Se of 78% and a Sp of 67%. The ELISA using r-IgLL1 showed a Se of 89% and a Sp of 91%. The automated r-IgLL1 ELISA test is sufficiently efficient to be used alone for the diagnosis of patients exposed solely to Columbidae. In cases of other avian exposure, the Se and Sp of the r-IgLL1 ELISA used for screening combined with the immunodiffusion test for confirmation were 89% and 93%, respectively. CONCLUSIONS The automated ELISA using r-IgLL1 is a promising tool for BFL serodiagnosis. Replacing immunodiffusion by the automated ELISA using r-IgLL1 as a screening technique will be the basis of our future strategy for BFL serodiagnosis.
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Affiliation(s)
- Adeline Rouzet
- Department of Parasitology-Mycology, University Hospital of Besancon, Besancon, France; Chrono-Environment Research Team UMR/CNRS-6249, University of Bourgogne Franche-Comté, Besancon, France; Referent Biology Medical Laboratory for the serological diagnosis of hypersensitivity pneumonitis, LBMR-PHS, University Hospital of Besancon, France.
| | - Emeline Scherer
- Department of Parasitology-Mycology, University Hospital of Besancon, Besancon, France; Chrono-Environment Research Team UMR/CNRS-6249, University of Bourgogne Franche-Comté, Besancon, France; Referent Biology Medical Laboratory for the serological diagnosis of hypersensitivity pneumonitis, LBMR-PHS, University Hospital of Besancon, France
| | - Coralie Barrera
- Department of Parasitology-Mycology, University Hospital of Besancon, Besancon, France; Chrono-Environment Research Team UMR/CNRS-6249, University of Bourgogne Franche-Comté, Besancon, France; Referent Biology Medical Laboratory for the serological diagnosis of hypersensitivity pneumonitis, LBMR-PHS, University Hospital of Besancon, France
| | - Anne Gondouin
- Department of Pneumology, University Hospital of Besancon, Besancon, France
| | - Gabriel Reboux
- Department of Parasitology-Mycology, University Hospital of Besancon, Besancon, France; Chrono-Environment Research Team UMR/CNRS-6249, University of Bourgogne Franche-Comté, Besancon, France; Referent Biology Medical Laboratory for the serological diagnosis of hypersensitivity pneumonitis, LBMR-PHS, University Hospital of Besancon, France
| | - Karine Humbert
- Department of Parasitology-Mycology, University Hospital of Besancon, Besancon, France; Referent Biology Medical Laboratory for the serological diagnosis of hypersensitivity pneumonitis, LBMR-PHS, University Hospital of Besancon, France
| | - Laurence Millon
- Department of Parasitology-Mycology, University Hospital of Besancon, Besancon, France; Chrono-Environment Research Team UMR/CNRS-6249, University of Bourgogne Franche-Comté, Besancon, France; Referent Biology Medical Laboratory for the serological diagnosis of hypersensitivity pneumonitis, LBMR-PHS, University Hospital of Besancon, France
| | - Anne-Pauline Bellanger
- Department of Parasitology-Mycology, University Hospital of Besancon, Besancon, France; Chrono-Environment Research Team UMR/CNRS-6249, University of Bourgogne Franche-Comté, Besancon, France; Referent Biology Medical Laboratory for the serological diagnosis of hypersensitivity pneumonitis, LBMR-PHS, University Hospital of Besancon, France
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Bellanger AP, Lallemand S, Tumasyan Horikian A, Navellou JC, Barrera C, Rouzet A, Scherer E, Reboux G, Piton G, Millon L. OUP accepted manuscript. Med Mycol 2022; 60:6590791. [PMID: 35604675 PMCID: PMC9213863 DOI: 10.1093/mmy/myac031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/08/2022] [Accepted: 04/25/2022] [Indexed: 12/12/2022] Open
Abstract
Although a high prevalence of COVID-19-associated pulmonary aspergillosis has been reported, it is still difficult to distinguish between colonization with Aspergillus fumigatus and infection. Concomitantly, similarities between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and hypersensitivity pneumonitis were suggested. The objective of this study was to investigate retrospectively if precipitin assays targeting A. fumigatus could have been useful in the management of SARS-CoV-2 patients hospitalized in an Intensive Care Unit (ICU) in 2020. SARS-CoV-2 ICU patients were screened for Aspergillus co-infection using biomarkers (galactomannan antigen, qPCR) and culture of respiratory samples (tracheal aspirates and bronchoalveolar lavage). For all these patients, clinical data, ICU characteristics and microbial results were collected. Electrosyneresis assays were performed using commercial A. fumigatus somatic and metabolic antigens. ELISA were performed using in-house A. fumigatus purified antigen and recombinant antigens. Our study population consisted of 65 predominantly male patients, with a median ICU stay of 22 days, and a global survival rate of 62%. Thirty-five patients had at least one positive marker for Aspergillus species detection. The number of arcs obtained by electrosyneresis using the somatic A. fumigatus antigen was significantly higher for these 35 SARS-CoV-2 ICU patients (P 0.01, Welch's t-test). Our study showed that SARS-CoV-2 ICU patients with a positive marker for Aspergillus species detection more often presented precipitins towards A. fumigatus. Serology assays could be an additional tool to assess the clinical relevance of the Aspergillus species in respiratory samples of SARS-CoV-2 ICU patients.
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Affiliation(s)
- A P Bellanger
- To whom correspondence should be addressed. Anne-Pauline Bellanger, Pharm-D PhD, Department of Parasitology-Mycology, Jean Minjoz University Hospital, 25030 Besançon, France. Tel: +33 (0)3 70 63 23 51; Fax: +33 (0)3 70 63 23 24; E-mail:
| | - S Lallemand
- Department of Parasitology-Mycology, University Hospital of Besançon, Besancon, France
| | - A Tumasyan Horikian
- Department of Parasitology-Mycology, University Hospital of Besançon, Besancon, France
| | - J C Navellou
- Intensive Medical Care Unit, Regional Hospital of Besancon, Besancon, France
| | - C Barrera
- Department of Parasitology-Mycology, University Hospital of Besançon, Besancon, France
- Referent Laboratory of Medical Biology for the serological diagnosis of hypersensitivity pneumonitis (LBMR PHS), University Hospital of Besançon, Besancon, France
- CNRS-University of Franche-Comte/ UMR 6249 Chrono-environment, Besançon, Besancon, France
| | - A Rouzet
- Department of Parasitology-Mycology, University Hospital of Besançon, Besancon, France
- Referent Laboratory of Medical Biology for the serological diagnosis of hypersensitivity pneumonitis (LBMR PHS), University Hospital of Besançon, Besancon, France
- CNRS-University of Franche-Comte/ UMR 6249 Chrono-environment, Besançon, Besancon, France
| | - E Scherer
- Department of Parasitology-Mycology, University Hospital of Besançon, Besancon, France
- Referent Laboratory of Medical Biology for the serological diagnosis of hypersensitivity pneumonitis (LBMR PHS), University Hospital of Besançon, Besancon, France
- CNRS-University of Franche-Comte/ UMR 6249 Chrono-environment, Besançon, Besancon, France
| | - G Reboux
- Department of Parasitology-Mycology, University Hospital of Besançon, Besancon, France
- Referent Laboratory of Medical Biology for the serological diagnosis of hypersensitivity pneumonitis (LBMR PHS), University Hospital of Besançon, Besancon, France
| | - G Piton
- Intensive Medical Care Unit, Regional Hospital of Besancon, Besancon, France
| | - L Millon
- Department of Parasitology-Mycology, University Hospital of Besançon, Besancon, France
- Referent Laboratory of Medical Biology for the serological diagnosis of hypersensitivity pneumonitis (LBMR PHS), University Hospital of Besançon, Besancon, France
- CNRS-University of Franche-Comte/ UMR 6249 Chrono-environment, Besançon, Besancon, France
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Rouzet A, Morell F, Reboux G, Villar A, Millon L, Cruz MJ. Pilot Study Using Recombinant Antigens r-PROE and r-IGLL1 for the Serodiagnosis of Feather Duvet Lung. Arch Bronconeumol 2021; 58:S0300-2896(21)00073-9. [PMID: 33771385 DOI: 10.1016/j.arbres.2021.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 02/07/2021] [Accepted: 02/09/2021] [Indexed: 11/02/2022]
Abstract
BACKGROUND Feather duvet lung (FDL) is an underestimated form of acute and chronic hypersensitivity pneumonitis. Serological tests for FDL need to be validated. We investigated the ability of recombinant pigeon Proproteinase E (r-PROE) and Immunoglobulin-lambda-like-polypeptide-1 (r-IGLL1) proteins to support the serological diagnosis of FDL, and propose them as a serological tool for clinicians to differentiate cases from FDL and Bird fancier's lung (BFL). METHODS Specific IgG antibodies against r-PROE and r-IGLL1, analyzed with ELISA, were measured in patients diagnosed with FDL (n=31), BFL (n=15) controls exposed (n=15) and unexposed to feathers (n=15). RESULTS The sensitivity and specificity of the r-PROE ELISA for the serological diagnosis of FDL cases versus exposed and unexposed controls were 74.2% and 86.7% respectively, with an index threshold of 0.5 (AUC: 0.89). In addition, this serological test was effective to support the serological diagnosis of FDL and BFL cases with significantly different thresholds. The r-IGLL1 ELISA was only effective for the serological diagnosis of BFL. Also, these two serological tests were useful for the diagnosis of both chronic and acute forms. CONCLUSIONS The new diagnostic test for FDL using r-PROE protein should help to detect overt and hidden cases of FDL. The combination of both test will help the clinician in distinguish between the etiology of birds or feathers duvet.
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Affiliation(s)
- Adeline Rouzet
- Chrono-Environment Research Team UMR/CNRS-6249, University of Bourgogne Franche-Comté, Besançon, France; Parasitology-Mycology Department, University Hospital, Besançon, France.
| | - Ferran Morell
- Pulmonology Department, Hospital Universitari Vall d'Hebron, and VHIR, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Spain; CIBER enfermedades respiratorias (CIBERES), Catalonia, Spain
| | - Gabriel Reboux
- Chrono-Environment Research Team UMR/CNRS-6249, University of Bourgogne Franche-Comté, Besançon, France; Parasitology-Mycology Department, University Hospital, Besançon, France
| | - Ana Villar
- Pulmonology Department, Hospital Universitari Vall d'Hebron, and VHIR, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Spain; CIBER enfermedades respiratorias (CIBERES), Catalonia, Spain
| | - Laurence Millon
- Chrono-Environment Research Team UMR/CNRS-6249, University of Bourgogne Franche-Comté, Besançon, France; Parasitology-Mycology Department, University Hospital, Besançon, France
| | - Maria Jesús Cruz
- Pulmonology Department, Hospital Universitari Vall d'Hebron, and VHIR, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Spain; CIBER enfermedades respiratorias (CIBERES), Catalonia, Spain
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Bellanger AP, Reboux G, Rouzet A, Barrera C, Rocchi S, Scherer E, Millon L. Hypersensitivity pneumonitis: A new strategy for serodiagnosis and environmental surveys. Respir Med 2019; 150:101-106. [PMID: 30961934 DOI: 10.1016/j.rmed.2019.02.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 02/25/2019] [Accepted: 02/26/2019] [Indexed: 01/08/2023]
Abstract
We propose a strategy for serodiagnosis of hypersensitivity pneumonitis (HP): 1) question patients about their private or occupational activity, or visit him on site; 2) select panels of six somatic specific antigens appropriate for each type of exposure; 3) and use ELISA to test concomitantly two recombinant antigens highly specific to Farmer's lung, Metalworking-fluid HP, and for Bird fancier's lung. The serodiagnosis provides an immunological argument that may complete radiological, functional lung exploration and clinical features; 4) If the serodiagnosis is negative but the suspicion of HP is strong, a microbial analysis of the patient's specific exposure is conducted; 5) "A la carte" antigens are produced from the microorganisms isolated in the patient's environment sample and tested; 6) Finally, the patient may be asked to undergo a specific inhalation challenge with the offending antigens in a safety cabin, or to avoid his usual environment for a few days.
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Affiliation(s)
- Anne-Pauline Bellanger
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne- Franche-Comté, France
| | - Gabriel Reboux
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne- Franche-Comté, France.
| | - Adeline Rouzet
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne- Franche-Comté, France
| | - Coralie Barrera
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne- Franche-Comté, France
| | - Steffi Rocchi
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne- Franche-Comté, France
| | - Emeline Scherer
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne- Franche-Comté, France
| | - Laurence Millon
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne- Franche-Comté, France
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Rouzet A, Valot B, Reboux G, Millon L, Roussel S. Common Proteins Located in Pigeon, Budgerigar, and Hen Droppings Related to Bird Fancier’s Lung. J Investig Allergol Clin Immunol 2018; 28:182-184. [DOI: 10.18176/jiaci.0223] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Rouzet A, Reboux G, Dalphin JC, Gondouin A, De Vuyst P, Balliau T, Millon L, Valot B, Roussel S. An immunoproteomic approach revealed antigenic proteins enhancing serodiagnosis performance of bird fancier's lung. J Immunol Methods 2017; 450:58-65. [DOI: 10.1016/j.jim.2017.07.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 07/25/2017] [Accepted: 07/25/2017] [Indexed: 10/19/2022]
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Rouzet A, Reboux G, Dalphin JC, De Vuyst P, Laboissière A, Valot B, Millon L, Roussel S. Usefulness of à la carte antigens for bird fancier’s lung serodiagnosis: total dropping extract and/or dropping’s microflora antigens. J Med Microbiol 2017; 66:1467-1470. [DOI: 10.1099/jmm.0.000586] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Adeline Rouzet
- UMR 6249 Chrono-Environment, University of Bourgogne-Franche-Comté, Besançon, France
| | - Gabriel Reboux
- UMR 6249 Chrono-Environment, University of Bourgogne-Franche-Comté, Besançon, France
- Parasitology-Mycology Department, University Hospital of Besançon, Besançon, France
| | - Jean-Charles Dalphin
- UMR 6249 Chrono-Environment, University of Bourgogne-Franche-Comté, Besançon, France
- Pneumology Department, University Hospital of Besançon, Besançon, France
| | - Paul De Vuyst
- Pneumology Department, ULB Erasme Hospital, Brussels, Belgium
| | - Audrey Laboissière
- UMR 6249 Chrono-Environment, University of Bourgogne-Franche-Comté, Besançon, France
- Parasitology-Mycology Department, University Hospital of Besançon, Besançon, France
| | - Benoit Valot
- UMR 6249 Chrono-Environment, University of Bourgogne-Franche-Comté, Besançon, France
| | - Laurence Millon
- UMR 6249 Chrono-Environment, University of Bourgogne-Franche-Comté, Besançon, France
- Parasitology-Mycology Department, University Hospital of Besançon, Besançon, France
| | - Sandrine Roussel
- UMR 6249 Chrono-Environment, University of Bourgogne-Franche-Comté, Besançon, France
- Biomedical Department, University Hospital of Besançon, Besançon, France
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Rouzet A, Reboux G, Barrera C, Rognon B, Dalphin J, De Vuyst P, Millon L, Roussel S. Identification et spécificité d’espèce des protéines d’intérêt pour le diagnostic sérologique de la maladie du poumon d’éleveur d’oiseaux. Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Rouzet A, Reboux G, Rognon B, Barrera C, De Vuyst P, Dalphin JC, Millon L, Roussel S. Immunogenic proteins specific to different bird species in bird fancier's lung. J Toxicol Environ Health A 2014; 77:724-30. [PMID: 24786679 DOI: 10.1080/15287394.2014.889616] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Bird fancier's lung (BFL) is a disease produced by exposure to avian proteins present in droppings, blooms, and serum of a variety of birds. Although serological test results are currently used to confirm clinical diagnosis of the disease, bird species specificity is poorly understood. This study aimed to contribute to a better understanding of the specificity of immunogenic proteins revealed from the droppings of three bird species. Sera from four patients with BFL and two controls without exposure were analyzed by Western blotting with antigens from droppings of two pigeon and budgerigar strains and two hen species. When the antigens from the droppings of the three bird species were compared, the profile of immunogenic proteins was different and there were similarities between strains of the same species. Only one 68-kD protein was common to pigeon and budgerigar droppings, while proteins of 200, 175, 140, 100, and 35 kD were detected as specific in one bird species. These results provide insight to further characterize these proteins, and to design new serological tests specific to different bird species. These tests may help to refine strategies of antigenic exclusion and also to allow a patient compensation in case of BFL of occupational origin.
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Affiliation(s)
- Adeline Rouzet
- a Parasitology-Mycology Department , University Hospital of Besançon , Besançon , France
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