Exploring the role of Aspergillus galactomannan antigen in assessing the risk factor of acute exacerbations in chronic obstructive pulmonary disease patients: a cross-sectional study

Chronic obstructive pulmonary disease (COPD) is characterized by permanent airflow obstruction due to abnormalities of the airways and alveoli. This study investigated the potential role of Aspergillus species in acute exacerbations of COPD (AECOPD) and evaluated the diagnostic utility of serum Aspergillus galactomannan antigen. This cross-sectional study, carried out at the Jawaharlal Institute of Postgraduate Medical Education and Research from January 2021 to June 2022, involved COPD patients aged ≥40 years. Serum galactomannan and serum Aspergillus-specific antibodies were analyzed, along with the collection of demographic details, symptoms, and comorbidities. Statistical analyses, including univariate analysis and receiver operating characteristic (ROC) curve analysis, were performed. Among the 61 recruited COPD patients, 24.5% showed serum galactomannan positivity. Significant associations were found between galactomannan positivity, hemoptysis, and previous tuberculosis. ROC analysis revealed modest diagnostic accuracy (area under the ROC=0.6027) with a sensitivity of 44.4% and a specificity of 83.7% at a cut-off of 0.5. Univariate analysis did not show any potential links between diabetes, hypertension, previous exacerbations, and severe gold stages with a risk of exacerbation. Serum galactomannan antigen showed limited sensitivity, and its routine testing may not be justified for predicting exacerbation risk. Further studies are warranted to validate these findings and explore other diagnostic methods using bronchoalveolar lavage galactomannan antigen in AECOPD.