Rapid blood test for chronic pulmonary aspergillosis (CPA)

Clinician discussing a blood sample with a patient during a respiratory clinic appointment. — CPA, chronic pulmonary aspergillosis, diagnosis, blood tests, Aspergillus IgG, fungal diagnostics, research

Chronic pulmonary aspergillosis (CPA) can be difficult to diagnose. Its symptoms — including cough, tiredness, weight loss, breathlessness and coughing up blood — can overlap with other lung conditions such as tuberculosis (TB), bronchiectasis, COPD and lung cancer.

Diagnosis usually brings together several pieces of information: symptoms, lung scans, microbiology results and blood tests for antibodies to Aspergillus. No single test can diagnose CPA on its own.

A simple test with an important role

In 2019, researchers at the University of Manchester and the National Aspergillosis Centre evaluated a rapid blood test called the LD Bio Aspergillus ICT. The test looks for antibodies made by the immune system in response to Aspergillus.

It uses a small blood sample and does not need complex laboratory equipment. This means it can potentially provide a result more quickly and may be particularly valuable in places where specialist laboratory testing is difficult to access.

What did the study find?

The Manchester study compared blood samples from 154 people with CPA and 150 healthy volunteers. In that group, the test correctly identified many people with CPA and correctly gave a negative result for most people without the condition.

This was encouraging because a rapid, affordable blood test could help clinicians investigate possible CPA sooner — especially in countries where TB is common and access to specialist fungal diagnostics is limited.

Why earlier diagnosis matters

CPA can gradually damage the lungs if it is not recognised and treated. It often develops in lungs already affected by a previous condition, including TB, COPD, bronchiectasis, sarcoidosis or previous lung surgery.

Earlier recognition gives clinicians the opportunity to arrange the right scans and laboratory tests, consider treatment where appropriate, and monitor lung health before further damage occurs.

A blood test is only one part of the picture

A positive antibody test does not automatically mean someone has CPA. Some people may have antibodies because they have encountered Aspergillus before, while others with CPA may not produce a clearly positive result. Results must therefore be interpreted alongside symptoms, CT or X-ray findings, sputum or other microbiology tests, and the person’s medical history.

Different tests are used in different hospitals and countries. Your clinical team will choose the investigations that are appropriate for you.

What this means for patients

The development and evaluation of practical diagnostic tests is important progress, particularly for people who may otherwise face long delays before CPA is considered. If you have ongoing respiratory symptoms, lung damage from a previous illness, or are worried about CPA, speak to your respiratory team or GP. They can decide whether further investigation or specialist advice is needed.