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Background   Until now, there have been no objective criteria to determine the activity of chronic pulmonary aspergillosis (CPA). This study aims to analyze the correlation between serum level of IL-1B and the activity of CPA and to determine whether serum IL-1B could be used to assess the activity of CPA.Methods   A total of 469 newly diagnosed CPA patients were enrolled. Correlation analysis in the whole subjects showed that only IL-1B level was associated with the activity of CPA. Then, 381 cases with factors significantly affecting IL-1B expression was excluded through multiple linear regression; the remaining 88 patients were divided into high IL-1B group and low IL-1B group, according to the median value of serum IL-1B, for subgroup analysis. A retrospective comparative analysis was subsequently performed between the two groups, including the clinical manifestation, microbiology and laboratory tests results, and imaging findings. We further investigated the relationship between IL-1B levels and CT characteristic which acted as the indicator of CPA activity, as well as changes in IL-1B level before and after surgery.Results   For all patients, correlation analysis revealed that IL-1B level correlated with both cavitary diameter ( P =0.035) and aspergilloma size ( P <0.047) but not with the thickness of the cavity ( P =0.479). In subgroup comparative analysis, CT characteristics suggested that high activity of CPA, such as cavitary (27/44 vs 13/44,  P =0.003) and aspergilloma lesions (25/44 vs. 11/44,  P <0.002), were more frequently found in high IL-1B group. The cavity diameter ( P <0.001), aspergilloma size ( P =0.006), and cavity wall thickness ( P =0.023) were significantly different between the two groups. When Spearman correlation analysis was performed once again in subgroup, an even stronger relationship of serum IL-1B with the cavity diameter ( Rs =0.501,  P =0.002) and aspergilloma size ( Rs =0.615,  P =0.001) was observed. Interestingly, a significant reduction of IL-1B level was observed after successful resection of CPA lesions.Conclusion   Higher level of serum IL-1B is associated with more severe cavitary and aspergilloma lesions, which are indicative of more active CPA. In addition, IL-1B level reduced accordingly after lesion resection. Measuring IL-1B level therefore could be served as a convenient method to monitor the activity of CPA and be a potential predictive/prognostic marker for treatment response.

The Serum Level of IL-1B Correlates with the Activity of Chronic Pulmonary Aspergillosis