[The role of allergological tests in allergic bronchopulmonary aspergillosis (ABPA)].

Allergic Bronchopulmonary Aspergillosis (ABPA) is an uncommon respiratory condition in which Asp. spp spores and mycelia inhalation trigger an immuno allergic inflammatory response in the bronchial airways. ABPA mostly develops in asthmatic and cystic fibrosis patients. The true prevalence of ABPA in not known. It is important to exclude ABPA in all asthmatics with positive skin reactivity to Aspergillus. Currently, a number of allergens from A. fumigatus have been cloned and the mRNA was purified - these are the recombinant antigens which can be used to distinguish between ABPA and fungal sensitization. IgE specific for Asp f 4 and Asp f 6 are restricted to ABPA patients and have a sensitivity and specificity of 90% and 100%, respectively. Aspergillus hipersensitivity can be demonstrated using in vivo (skin prick test) and in vitro methods (specific IgE and IgG, serum precipitins). In ABPA skin prick test is almost always positive. Normal levels of total IgE exclude ABPA. Serum total and specific IgE vary according to disease activity and are usefull for monitoring the treatment.