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Peer-reviewedCC BY 4.0Current Medical Mycology

Establishment of Aspergillus fumigatus-specific IgG cut-off level for diagnosis of chronic pulmonary aspergillosis in the Iranian population

  • Sabrieh Asadi Shahi Sarae1,2
  • Masoud Aliyali3
  • Vida Mortezaee4
  • Hamidreza Jamaati4
  • Hossein Asgarian Omran5
  • Siavash Abedi3
  • Hossein Mehravaran3
  • Jamshid Yazdani Charati6
  • Maryam Sadat Mirenayat7
  • Mihan Pourabdollah4
  • Somayeh Lookzadeh4
  • Maryam Moazeni2,8
5 more authors
  • Sabah Mayahi2
  • Mona Ghazanfari8
  • Iman Haghani8
  • Mahdi Abastabar2,8
  • Mohammad T Hedayati2,8
8 affiliations
  1. 1Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
  2. 2Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
  3. 3Pulmonary and Critical Care Division, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
  4. 4Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
  6. 6Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
  7. 7Pulmonary Rehabilitation Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  8. 8Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
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Abstract

Background and Purpose:: The optimal cut-off level for serum Aspergillus-specific IgG (SAfIgG) in the diagnosis of chronic pulmonary aspergillosis (CPA) remains to be established for different countries. This study aimed to establish a cut-off level for SAfIgG in CPA diagnosis and validate its diagnostic accuracy in the Iranian population.

Materials and Methods:: Diagnostic performance of SAfIgG was evaluated in patients with chronic obstructive pulmonary disease (COPD) suspected of having CPA who had referred to the two reference centers for pulmonary diseases in Iran, during 2021-2023. Levels of SAfIgG were measured using an enzyme-linked immunosorbent assay. Optimal cut-off point for SAfIgG was determined using the receiver operating characteristics (ROC) curve and Youden's index and was subsequently validated.

Results:: In total, 30 (15.3%) out of 196 COPD patients were diagnosed with CPA. The ROC curve analysis yielded an area under the curve of 0.632 (95% CI: 0.421-0.843; p=0.114), with an optimal cut-off value of 23.5 U (sensitivity: 71.4%; specificity: 61.4%). The SAfIgG levels were significantly higher in CPA patients (median [IQR], 39 [31-55] U) compared with non-CPA patients (20 [15-24] U; p<0.001).

Conclusion:: The findings indicated that SAfIgG, with a cut-off value of 23.5 U, provided moderate sensitivity and specificity for screening and may be used in combination with the culture method to confirm the diagnosis of CPA in COPD patients. However, the variability in cut-off values across different populations highlights the need for standardized guidelines to improve diagnostic consistency and reliability.

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Cite

BibTeXRIS
BibTeX
@article{sarae2026establishment,
  title = {{Establishment of Aspergillus fumigatus-specific IgG cut-off level for diagnosis of chronic pulmonary aspergillosis in the Iranian population}},
  author = {Sabrieh Asadi Shahi Sarae and Masoud Aliyali and Vida Mortezaee and Hamidreza Jamaati and Hossein Asgarian Omran and Siavash Abedi and Hossein Mehravaran and Jamshid Yazdani Charati and Maryam Sadat Mirenayat and Mihan Pourabdollah and Somayeh Lookzadeh and Maryam Moazeni and Sabah Mayahi and Mona Ghazanfari and Iman Haghani and Mahdi Abastabar and Mohammad T Hedayati},
  journal = {Current Medical Mycology},
  year = {2026},
  month = jun,
  doi = {10.22034/cmm.2026.345514.1741},
  url = {https://doi.org/10.22034/cmm.2026.345514.1741},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Establishment of Aspergillus fumigatus-specific IgG cut-off level for diagnosis of chronic pulmonary aspergillosis in the Iranian population
AU  - Sabrieh Asadi Shahi Sarae
AU  - Masoud Aliyali
AU  - Vida Mortezaee
AU  - Hamidreza Jamaati
AU  - Hossein Asgarian Omran
AU  - Siavash Abedi
AU  - Hossein Mehravaran
AU  - Jamshid Yazdani Charati
AU  - Maryam Sadat Mirenayat
AU  - Mihan Pourabdollah
AU  - Somayeh Lookzadeh
AU  - Maryam Moazeni
AU  - Sabah Mayahi
AU  - Mona Ghazanfari
AU  - Iman Haghani
AU  - Mahdi Abastabar
AU  - Mohammad T Hedayati
PY  - 2026
DA  - 2026/06/03
JO  - Current Medical Mycology
DO  - 10.22034/cmm.2026.345514.1741
UR  - https://doi.org/10.22034/cmm.2026.345514.1741
AB  - Background and Purpose:: The optimal cut-off level for serum Aspergillus-specific IgG (SAfIgG) in the diagnosis of chronic pulmonary aspergillosis (CPA) remains to be established for different countries. This study aimed to establish a cut-off level for SAfIgG in CPA diagnosis and validate its diagnostic accuracy in the Iranian population.  Materials and Methods:: Diagnostic performance of SAfIgG was evaluated in patients with chronic obstructive pulmonary disease (COPD) suspected of having CPA who had referred to the two reference centers for pulmonary diseases in Iran, during 2021-2023. Levels of SAfIgG were measured using an enzyme-linked immunosorbent assay. Optimal cut-off point for SAfIgG was determined using the receiver operating characteristics (ROC) curve and Youden's index and was subsequently validated.  Results:: In total, 30 (15.3%) out of 196 COPD patients were diagnosed with CPA. The ROC curve analysis yielded an area under the curve of 0.632 (95% CI: 0.421-0.843; p=0.114), with an optimal cut-off value of 23.5 U (sensitivity: 71.4%; specificity: 61.4%). The SAfIgG levels were significantly higher in CPA patients (median [IQR], 39 [31-55] U) compared with non-CPA patients (20 [15-24] U; p<0.001).  Conclusion:: The findings indicated that SAfIgG, with a cut-off value of 23.5 U, provided moderate sensitivity and specificity for screening and may be used in combination with the culture method to confirm the diagnosis of CPA in COPD patients. However, the variability in cut-off values across different populations highlights the need for standardized guidelines to improve diagnostic consistency and reliability.
SN  - 2423-3439
SN  - 2423-3420
ER  -