Clinical Significance Of Eosinophils In Allergic Bronchopulmonary Aspergillosis

PurposeWe retrospectively reviewed clinical manifestations,laboratory results,and imaging characteristics of 37 patients with Allergic bronchopulmonary aspergillosis(ABPA).We try to describe the relationship between peripheral eosinophils and ABPA.MethodWe retrospectively analyzed a cohort of 37 Allergic bronchopulmonary aspergillosis patients.The correlation between eosinophils and carcinoembryonic antigen was studied after controlling the confounding variables including gender and age.Statistical analysis was performed with the independent sample t-test,analysis of variance,and Pearson/Spearman correlation analysis.Histological changes were checked by hematoxylin and eosin staining and subjected to carcinoembryonic antigen immunohistochemistry.ResultActivated carcinoembryonic antigen partially colocalized on eosinophils.Blood carcinoembryonic antigen levels were positively correlated with blood eosinophils in Allergic bronchopulmonary aspergillosis patients(p<0.05).Relationship between peripheral eosinophil count and the presence of Mucus embolism in the ABPA was found in this study.The median eosinophil count was higher in patients with an high resolution computed tomography(HRCT)chest finding of lymphadenopathy(1240 vs.830,p < 0.05)vs.those without and in patients with high-attenuation mucus(1220 vs.900,p < 0.05)compared to those without high-attenuation mucus.Serum carcinoembryonic antigen levels were significantly higher in patients whose blood eosinophils was more than 1000 cells/ul.ConclusionThe clinical manifestations of ABPA patients lack specificity.When uncontrollable cough,sputum,chest tightness,wheezing symptoms occur in patients with asthma,chronic obstructive pulmonary disease,or bronchiectasis,and combined with pulmonary infiltrates,We need be alert to the diagnosis of ABPA.The higher eosinophil count that we observed in patients with and lymphadenopathy suggests that eosinophils are primary mediators of inflammatory activity in ABPA.Most of the patients with ABPA have elevated CEA,which may be related to eosinophils.CEA can return to normal levels after treatment.Eosinophils might be the CEA-secreting-cells in ABPA patients.