Ex vivo cellular activation against several fungi also suggests that ABPM is the result of molecular epitope spreading due to similar T cell activation against three distinct fungi. Watai et al. showed that de novo sensitization to fungal antigens is constant during life, contrary to most inhalant allergens (39). Our data showed a major correlation in LST results with all the three allergens, thus an LST cross-reactivity due to a permanent sensitization addition on the T cell repertoire in CF patients.