{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T01:16:09Z","timestamp":1790471769991,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,7,29]],"date-time":"2019-07-29T00:00:00Z","timestamp":1564358400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity lung disease due to <jats:italic>Aspergillus fumigatus (Af)<\/jats:italic> which occurs in 10% of patients with cystic fibrosis (CF). ABPA is associated with increased morbidity and accelerated lung function decline; however, existing diagnostic criteria are nonspecific and diagnosis remains challenging. As ABPA is driven by Th2 inflammation, the aim of this study was to evaluate exhaled nitric oxide (FE\n<jats:sub>NO<\/jats:sub>), eosinophilic cationic protein (ECP), peripheral eosinophil count, and bronchodilator response (BDR) in patients with CF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective observational cohort study of pediatric CF patients in a tertiary center. Patients had a clinical and serologic ABPA assessment, FE<jats:sub>NO<\/jats:sub>, serum ECP, peripheral eosinophil count, and assessment of BDR. Patients were stratified into three\u00a0groups; ABPA, <jats:italic>Af<\/jats:italic> sensitized (AFS), and non\u2010ABPA non\u2010<jats:italic>Af<\/jats:italic>\u2010sensitized (non\u2010AFS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 62 patients were included in the study: 13% ABPA, 19% AFS, and 68% non\u2010AFS. Mean FE<jats:sub>NO<\/jats:sub> was higher in the ABPA group at 37.8 ppb compared to AFS 15.1\u2009ppb (<jats:italic>P<\/jats:italic>\u2009=\u2009.05) and non\u2010AFS 13.7\u2009ppb (<jats:italic>P<\/jats:italic>\u2009=\u2009.04). Mean peripheral eosinophil count in ABPA group was also higher at 1000\u2009cells\/uL, compared to AFS 221\u2009cells\/uL (<jats:italic>P<\/jats:italic>\u2009=\u2009.03) and non\u2010AFS 220\u2009cells\/uL (<jats:italic>P<\/jats:italic>\u2009=\u2009.03). Mean BDR in ABPA group was 13% compared to 5.5% in non\u2010AFS (<jats:italic>P<\/jats:italic>\u2009=\u2009.01). Serum ECP was higher in patients with ABPA positive compared to the other groups, although this was not statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In children with cystic fibrosis, FE<jats:sub>NO<\/jats:sub> and peripheral eosinophil counts are elevated in ABPA compared to those that are just sensitized to Aspergillus and may serve as useful diagnostic tests.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.24465","type":"journal-article","created":{"date-parts":[[2019,7,30]],"date-time":"2019-07-30T04:15:21Z","timestamp":1564460121000},"page":"1787-1793","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["An investigation into biomarkers for the diagnosis of ABPA and aspergillus disease in cystic fibrosis"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6095-9585","authenticated-orcid":false,"given":"Karen","family":"Keown","sequence":"first","affiliation":[{"name":"Division of Respiratory Medicine BC Children's Hospital  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salome","family":"Abbott","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine BC Children's Hospital  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris","family":"Kuzeljevic","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine BC Children's Hospital  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan H.","family":"Rayment","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine BC Children's Hospital  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Chilvers","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine BC Children's Hospital  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2060-3290","authenticated-orcid":false,"given":"Connie L.","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine BC Children's Hospital  Vancouver British Columbia 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