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Steels S, Proesmans M, Bossuyt X, Dupont L, Frans G. Laboratory biomarkers in the diagnosis and follow-up of treatment of allergic bronchopulmonary aspergillosis in cystic fibrosis. Crit Rev Clin Lab Sci 2023; 60:1-24. [PMID: 35968577 DOI: 10.1080/10408363.2022.2101612] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Allergic bronchopulmonary aspergillosis (ABPA), a severe inflammatory respiratory disease, is caused by a hypersensitivity reaction to the colonization of the airways with Aspergillus fumigatus. It is most often described in patients with asthma or cystic fibrosis. The diagnosis of ABPA is based on a combination of clinical, radiological, and immunological findings that have been included in different diagnostic criteria over the years. In this paper, we review the biomarkers included in these diagnostic criteria and novel research biomarkers that may be used in the diagnosis and treatment follow-up of ABPA in cystic fibrosis.
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Affiliation(s)
- Sophie Steels
- Department of Laboratory Medicine, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Marijke Proesmans
- Department of Pediatrics, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Xavier Bossuyt
- Department of Laboratory Medicine, University Hospitals Leuven, KU Leuven, Leuven, Belgium.,Clinical and Diagnostic Immunology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Lieven Dupont
- Department of Respiratory Medicine, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Glynis Frans
- Department of Laboratory Medicine, University Hospitals Leuven, KU Leuven, Leuven, Belgium
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2
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Desoubeaux G, Cray C, Chesnay A. Challenges to establish the diagnosis of aspergillosis in non-laboratory animals: looking for alternatives in veterinary medicine and demonstration of feasibility through two concrete examples in penguins and dolphins. Front Cell Infect Microbiol 2022; 12:757200. [PMID: 35928207 PMCID: PMC9345302 DOI: 10.3389/fcimb.2022.757200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Aspergillosis remains difficult to diagnose in animals. Laboratory-based assays are far less developed than those for human medicine, and only few studies have been completed to validate their utility in routine veterinary diagnostics. To overcome the current limitations, veterinarians and researchers have to propose alternative methods including extrapolating from human diagnostic tools and using innovative technology. In the present overview, two specific examples were complementarily addressed in penguins and dolphins to illustrate how is challenging the diagnosis of aspergillosis in animals. Specific focus will be made on the novel application of simple testing in blood based on serological assays or protein electrophoresis and on the new information garnered from metabolomics/proteomics to discover potential new biomarkers. In conclusion, while the diagnostic approach of aspergillosis in veterinary medicine cannot be directly taken from options developed for human medicine, it can certainly serve as inspiration.
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Affiliation(s)
- Guillaume Desoubeaux
- Parasitologie – Mycologie – Médecine tropicale, Hôpital Bretonneau, CHRU Tours, Tours, France
- Centre d’étude des pathologies respiratoires – Inserm U1100, faculté de Médecine, Université de Tours, Tours, France
- *Correspondence: Guillaume Desoubeaux,
| | - Carolyn Cray
- University of Miami, Comparative Pathology, Miller School of Medicine, Miami, FL, United States
| | - Adélaïde Chesnay
- Parasitologie – Mycologie – Médecine tropicale, Hôpital Bretonneau, CHRU Tours, Tours, France
- Centre d’étude des pathologies respiratoires – Inserm U1100, faculté de Médecine, Université de Tours, Tours, France
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3
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Abstract
Western blotting (WB), also known as immunoblotting, is a well-known molecular biology method that biologists often use to investigate many features of the protein, ranging from basic protein analysis to disease detection. WB is simple, unique, rapid, widely used routine tool with easy interpretation and definite results. It is being used in various fields of science, research and development, diagnostic labs and hospitals. The principle of WB is to accomplish the separation of proteins based on molecular weight and charge. This review addresses in detail the individual steps involved in the WB technique, its troubleshooting, internal loading controls, total protein staining and its diverse applications in scientific research and clinical settings, along with its future perspectives.
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4
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Sehgal IS, Dhooria S, Prasad KT, Muthu V, Aggarwal AN, Agarwal R. Comparative diagnostic accuracy of immunoprecipitation versus immunoassay methods for detecting A.fumigatus-specific IgG in allergic bronchopulmonary aspergillosis: a systematic review and meta-analysis. Mycoses 2022; 65:866-876. [PMID: 35757847 DOI: 10.1111/myc.13488] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The diagnostic accuracy of immunoassays versus immunoprecipitation methods for detecting A.fumigatus-specific IgG in patients with allergic bronchopulmonary aspergillosis (ABPA) complicating asthma remains unclear. METHODS We performed a systematic review to identify studies describing both the methods in the same ABPA subjects. We assessed study quality using the QUADAS-2 tool. We derived the relative sensitivity and specificity using the HSROC meta-regression model. We calculated the number-needed-to-test using an immunoassay to detect one additional positive test in ABPA. RESULTS Our search yielded 20 studies (796 ABPA, 929 controls). The studies had a high risk of bias. The summary estimates for sensitivity and specificity of immunoprecipitation methods were 68.6% (95% CI, 48.4-83.5) and 93.8% (95% CI, 83.6-97.8), while for immunoassays they were 85.2% (95% CI, 73.3-92.3) and 84.6% (95% CI, 76.0-90.5), respectively. The relative sensitivity and specificity of immunoassays compared to immunoprecipitation tests were 1.29 (95% CI, 1.1-1.6) and 0.91 (95% CI, 0.85-0.97), respectively. The automated immunoassays (1.77; 95% CI, 1.1-2.8) had better relative sensitivity than the manual (1.1; 95% CI, 1.02-1.18) assays compared to immunoprecipitation. The relative specificity of manual immunoassays (0.95; 95% CI, 0.91-0.99) was significantly lower, while that of automated (0.88; 95% CI, 0.77-1.0) assays was lower but not statistically different. One additional positive result was detected for every 6 (95% CI, 5-7) tests performed with immunoassay (versus immunoprecipitation). CONCLUSION Manual immunoassays have higher sensitivity and lower specificity, while automated immunoassays have higher sensitivity and similar specificity than immunoprecipitation methods for detecting A.fumigatus-IgG in patients with ABPA.
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Affiliation(s)
- Inderpaul Singh Sehgal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sahajal Dhooria
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Kuruswamy Thurai Prasad
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Valliappan Muthu
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ashutosh Nath Aggarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ritesh Agarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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LDBio Aspergillus immunochromatographic test lateral flow assay for IgG/IgM antibody detection in chronic pulmonary aspergillosis: Single-centre evaluation and meta-analysis. Indian J Med Microbiol 2022; 40:204-210. [DOI: 10.1016/j.ijmmb.2022.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/12/2022] [Accepted: 03/07/2022] [Indexed: 12/23/2022]
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6
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Singh KK, Gupta A, Bharti C, Sharma H. Emerging techniques of western blotting for purification and analysis of protein. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2021. [DOI: 10.1186/s43094-021-00386-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Abstract
Background
Western blotting is frequently employed in molecular techniques like Proteomics and Biology. Because it is a sequential framework, differences and inaccuracies could even take place at any stage, decreasing this particular method's reproducibility and reliability.
Main text
New approaches, like automated microfluid western blotting, DigiWest, single cell resolution, microchip electrophoresis, and capillary electrophoresis, were all implemented to reduce the future conflicts linked with the western blot analysis approach. Discovery of new in devices and higher susceptibility for western blots gives innovative opportunities to expand Western blot’s clinical relevance. The advancements in various region of west blotting included in this analysis of transfer of protein and validation of antibody are described.
Conclusion
This paper describes another very developed strategy available as well as demonstrated the correlation among Western blotting techniques of the next generation and their clinical implications. In this review, the different techniques of western blotting and their improvement in different stages have been discussed.
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Meftahi GH, Bahari Z, Zarei Mahmoudabadi A, Iman M, Jangravi Z. Applications of western blot technique: From bench to bedside. BIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION : A BIMONTHLY PUBLICATION OF THE INTERNATIONAL UNION OF BIOCHEMISTRY AND MOLECULAR BIOLOGY 2021; 49:509-517. [PMID: 33847452 DOI: 10.1002/bmb.21516] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 03/30/2021] [Indexed: 06/12/2023]
Abstract
Western blot (WB) or immunoblot is a workhorse method. It is commonly used by biologists for study of different aspects of protein biomolecules. In addition, it has been widely used in disease diagnosis. Despite some limitations such as long time, different applications of WB have not been limited. In the present review, we have summarized scientific and clinical applications of WB. In addition, we described some new generation of WB techniques.
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Affiliation(s)
| | - Zahra Bahari
- Department of Physiology and Medical Physics, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ali Zarei Mahmoudabadi
- Department of Biochemistry, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Maryam Iman
- Department of Pharmaceutics, Faculty of Pharmacy, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Zohreh Jangravi
- Department of Biochemistry, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Nanobiotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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8
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Bui S, Dournes G, Fayon M, Bouchet S, Burgel PR, Macey J, Murris M, Delhaes L. [Allergic Broncho-Pulmonary Aspergillosis (ABPA) in cystic fibrosis: Mechanisms, diagnosis and therapeutic options]. Rev Mal Respir 2021; 38:466-476. [PMID: 33926779 DOI: 10.1016/j.rmr.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 01/28/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Fungal aspergillosis colonization and allergic bronchopulmonary aspergillosis (ABPA) can have a strong impact on the prognosis in cystic fibrosis (CF). We conducted round table discussions involving French experts from pediatric and adult centers caring for patients with CF, microbiologists, radiologists and pharmacists. The aim was to explore the current state of knowledge on: the pathophysiological mechanisms of Aspergillus and other micromycetes infections in CF (such as Scedosporium sp.), and on the clinico-biological diagnosis of ABPA. In perspective, the experts explored the role of imaging in the diagnosis of APBA, specifically CT and MRI; as well as the role of bronchoscopy in the management. We also reviewed the therapeutic management, including different corticosteroid regimens, antifungals and anti-IgE antibodies. CONCLUSION The diagnosis of ABPA in CF should be based on more standardized biological assays and imaging to optimize treatment and follow-up.
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Affiliation(s)
- S Bui
- CRCM pédiatrique, Centre d'investigation clinique (CIC 1401), hôpital Pellegrin-Enfants, CHU de Bordeaux, Bordeaux, France.
| | - G Dournes
- Service de radiologie, hôpital Haut L'Evêque, CHU de Bordeaux, Bordeaux, France
| | - M Fayon
- CRCM pédiatrique, Centre d'investigation clinique (CIC 1401), hôpital Pellegrin-Enfants, CHU de Bordeaux, Bordeaux, France
| | - S Bouchet
- Service de pharmacologie, hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France
| | - P R Burgel
- CRCM Adultes, AP-HP, hôpital Cochin, Paris, France
| | - J Macey
- CRCM adultes, hôpital Haut L'Evêque, CHU de Bordeaux, Bordeaux, France
| | - M Murris
- CRCM adultes, hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - L Delhaes
- Service de parasitologie, CHU de Bordeaux, hôpital Pellegrin, Bordeaux, France
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Rozaliyani A, Setianingrum F, Azahra S, Abdullah A, Fatril AE, Rosianawati H, Burhan E, Handayani D, Arifin AR, Zaini J, Tugiran M, Adawiyah R, Syam R, Wibowo H, Wahyuningsih R, Kosmidis C, Denning DW. Performance of LDBio Aspergillus WB and ICT Antibody Detection in Chronic Pulmonary Aspergillosis. J Fungi (Basel) 2021; 7:311. [PMID: 33919511 PMCID: PMC8073219 DOI: 10.3390/jof7040311] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 12/30/2022] Open
Abstract
The detection of Aspergillus antibody has a key role in the diagnosis of chronic pulmonary aspergillosis. Western blot (WB) and immunochromatography (ICT) lateral flow detection of Aspergillus antibody can be used as confirmatory and screening assays but their comparative performance in TB patients is not known. This study investigated the performance of these assays among 88 post-tuberculosis patients with suspected CPA. Sensitivity, specificity, receiver operating curve (ROC), area under-curve (AUC) and the agreement between two assays were evaluated. Both WB and ICT showed good sensitivity (80% and 85%, respectively) for detection of Aspergillus antibodies. Substantial agreement (0.716) between these assays was also obtained. The highest AUC result (0.804) was achieved with the combination of WB and ICT. The global intensity of WB correlated with the severity of symptoms in CPA group (p = 0.001). The combination of WB and ICT may increase specificity in CPA diagnosis.
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Affiliation(s)
- Anna Rozaliyani
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (F.S.); (A.A.); (A.E.F.); (M.T.); (R.A.); (R.S.); (H.W.); (R.W.)
- Pulmonary Mycosis Centre, Jakarta 10430, Indonesia; (E.B.); (D.H.); (A.R.A.); (J.Z.)
| | - Findra Setianingrum
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (F.S.); (A.A.); (A.E.F.); (M.T.); (R.A.); (R.S.); (H.W.); (R.W.)
- Pulmonary Mycosis Centre, Jakarta 10430, Indonesia; (E.B.); (D.H.); (A.R.A.); (J.Z.)
| | - Sresta Azahra
- Magister Program of Biomedical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia;
| | - Asriyani Abdullah
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (F.S.); (A.A.); (A.E.F.); (M.T.); (R.A.); (R.S.); (H.W.); (R.W.)
| | - Ayu Eka Fatril
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (F.S.); (A.A.); (A.E.F.); (M.T.); (R.A.); (R.S.); (H.W.); (R.W.)
| | - Harmi Rosianawati
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Persahabatan National Respiratory Referral Hospital, Jakarta 13230, Indonesia;
| | - Erlina Burhan
- Pulmonary Mycosis Centre, Jakarta 10430, Indonesia; (E.B.); (D.H.); (A.R.A.); (J.Z.)
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Persahabatan National Respiratory Referral Hospital, Jakarta 13230, Indonesia;
| | - Diah Handayani
- Pulmonary Mycosis Centre, Jakarta 10430, Indonesia; (E.B.); (D.H.); (A.R.A.); (J.Z.)
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Persahabatan National Respiratory Referral Hospital, Jakarta 13230, Indonesia;
| | - Arief Riadi Arifin
- Pulmonary Mycosis Centre, Jakarta 10430, Indonesia; (E.B.); (D.H.); (A.R.A.); (J.Z.)
- MH Thamrin Hospital, Jakarta 10440, Indonesia
| | - Jamal Zaini
- Pulmonary Mycosis Centre, Jakarta 10430, Indonesia; (E.B.); (D.H.); (A.R.A.); (J.Z.)
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Persahabatan National Respiratory Referral Hospital, Jakarta 13230, Indonesia;
| | - Mulyati Tugiran
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (F.S.); (A.A.); (A.E.F.); (M.T.); (R.A.); (R.S.); (H.W.); (R.W.)
- Pulmonary Mycosis Centre, Jakarta 10430, Indonesia; (E.B.); (D.H.); (A.R.A.); (J.Z.)
| | - Robiatul Adawiyah
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (F.S.); (A.A.); (A.E.F.); (M.T.); (R.A.); (R.S.); (H.W.); (R.W.)
- Pulmonary Mycosis Centre, Jakarta 10430, Indonesia; (E.B.); (D.H.); (A.R.A.); (J.Z.)
| | - Ridhawati Syam
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (F.S.); (A.A.); (A.E.F.); (M.T.); (R.A.); (R.S.); (H.W.); (R.W.)
- Pulmonary Mycosis Centre, Jakarta 10430, Indonesia; (E.B.); (D.H.); (A.R.A.); (J.Z.)
| | - Heri Wibowo
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (F.S.); (A.A.); (A.E.F.); (M.T.); (R.A.); (R.S.); (H.W.); (R.W.)
- Pulmonary Mycosis Centre, Jakarta 10430, Indonesia; (E.B.); (D.H.); (A.R.A.); (J.Z.)
| | - Retno Wahyuningsih
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (F.S.); (A.A.); (A.E.F.); (M.T.); (R.A.); (R.S.); (H.W.); (R.W.)
- Pulmonary Mycosis Centre, Jakarta 10430, Indonesia; (E.B.); (D.H.); (A.R.A.); (J.Z.)
- Department of Parasitology, Faculty of Medicine, Universitas Kristen, Jakarta 13530, Indonesia
| | - Chris Kosmidis
- Manchester Academic Health Science Centre, Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, School of Biological Sciences, Medicine and Health, University of Manchester, Manchester M23 9LT, UK; (C.K.); (D.W.D.)
| | - David W Denning
- Manchester Academic Health Science Centre, Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, School of Biological Sciences, Medicine and Health, University of Manchester, Manchester M23 9LT, UK; (C.K.); (D.W.D.)
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Anan K, Kataoka Y, Okabayashi S, Yamamoto R, Namkoong H, Yamamoto Y. Diagnostic accuracy of Aspergillus-specific antibodies for chronic pulmonary aspergillosis: A systematic review and meta-analysis. Mycoses 2021; 64:701-715. [PMID: 33594774 DOI: 10.1111/myc.13253] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/28/2021] [Accepted: 02/03/2021] [Indexed: 12/14/2022]
Abstract
We performed this study to provide the latest evidence of the diagnostic accuracy of all Aspergillus antibodies for chronic pulmonary aspergillosis (CPA). In this meta-analysis, we searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, and other databases, until 19 March 2020, for studies that examined the diagnostic accuracy of each Aspergillus-specific antibody for CPA and assessed the risk of bias using the revised Quality Assessment of Diagnostic Accuracy Studies-2 tool. We integrated the results using a hierarchical summary receiver operating characteristic (HSROC) model and calculated the point estimates of specificity with sensitivity fixed at 0.90 using the HSROC curve. We identified 32 published and one unpublished studies, including 75 studies on five antibody test types: 18 of precipitin test (2810 participants), 46 of IgG (8197), three of IgA (283), six of IgM (733) and two of combined IgG and IgM (IgG + IgM) (920). The results of specificity with sensitivity fixed at 0.90 were as follows: precipitin test, 0.93 (95% credible intervals: 0.86, 1.00); IgG, 0.90 (0.86, 0.95); IgA, 0.74 (0.00, 1.00); IgM, 0.50 (0.37, 0.53); IgG + IgM, 0.47 (0.00, 1.00). However, the precipitin test showed imprecision and instability in the sensitivity analysis. Most studies had a high risk of bias due to the case-control design. Although there is lack of applicability for malignancy or immunosuppressive patients, our study suggests a preference for IgG over other antibody tests in CPA screening. Particularly, IgG should be used as an adjunct when ruling out CPA.
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Affiliation(s)
- Keisuke Anan
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Systematic Review Workshop Peer Support Group (SRWS-PSG), Osaka, Japan
| | - Yuki Kataoka
- Systematic Review Workshop Peer Support Group (SRWS-PSG), Osaka, Japan.,Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan.,Hospital Care Research Unit, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Shinji Okabayashi
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryohei Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ho Namkoong
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, USA.,Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
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11
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Schein F, Munoz-Pons H, Mahinc C, Grange R, Cathébras P, Flori P. Fatal aspergillosis complicating severe SARS-CoV-2 infection: A case report. J Mycol Med 2020; 30:101039. [PMID: 32861584 PMCID: PMC7440034 DOI: 10.1016/j.mycmed.2020.101039] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/03/2020] [Accepted: 08/17/2020] [Indexed: 01/16/2023]
Abstract
As aspergillosis is a well-known complication of severe influenza, we suggest that SARS-CoV-2 might be a risk factor for invasive aspergillosis (IA). We report the case of an 87 year-old woman, with no history of immune deficit, admitted in our emergency room for severe respiratory distress. Coronavirus disease 2019 (COVID-19) diagnosis was confirmed by a SARS-CoV-2 reverse transcriptase polymerase chain reaction (PCR) on nasal swab. On day 14, pulmonary examination deteriorated with haemoptysis and a major increase of inflammatory response. A computed tomography (CT) scan revealed nodules highly suggestive of IA. Aspergillus antigen was found highly positive in sputum and blood, as was Aspergillusspp PCR on serum. Sputum cultures remained negative for Aspergillus. This patient died rapidly from severe respiratory failure, despite the addition of voriconazole. Considering SARS-CoV-2 acute respiratory distress syndrome (ARDS) as an acquired immunodeficiency, we report here a new case of "probable" IA based on clinical and biological arguments, in accordance with the last consensus definition of invasive fungal disease. On a routine basis, we have detected 30% of aspergillosis carriage (positive culture and antigen in tracheal secretions) in critically ill patients with COVID-19 in our centre. Further studies will have to determine whether sputum or tracheal secretions should be systematically screened for fungal investigations in intensive care unit (ICU) COVID-19 patients to early diagnose and treat aspergillosis.
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Affiliation(s)
- F Schein
- Department of internal medicine, University Hospital of Saint-Étienne, Saint-Étienne, France
| | - H Munoz-Pons
- Department of internal medicine, University Hospital of Saint-Étienne, Saint-Étienne, France
| | - C Mahinc
- Laboratory of infectious agents, Parasitology-Mycology Section, University Hospital of Saint-Étienne, Saint-Étienne, France
| | - R Grange
- Department of Radiology, University Hospital of Saint-Étienne, Saint-Étienne, France
| | - P Cathébras
- Department of internal medicine, University Hospital of Saint-Étienne, Saint-Étienne, France
| | - P Flori
- Laboratory of infectious agents, Parasitology-Mycology Section, University Hospital of Saint-Étienne, Saint-Étienne, France.
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12
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Evaluation of LDBio Aspergillus ICT Lateral Flow Assay for IgG and IgM Antibody Detection in Chronic Pulmonary Aspergillosis. J Clin Microbiol 2019; 57:JCM.00538-19. [PMID: 31217272 PMCID: PMC6711894 DOI: 10.1128/jcm.00538-19] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 06/13/2019] [Indexed: 02/06/2023] Open
Abstract
Detecting Aspergillus-specific IgG is critical to diagnosing chronic pulmonary aspergillosis (CPA). Existing assays are often cost- and resource-intensive and not compatible with resource-constrained laboratory settings. LDBio Diagnostics has recently commercialized a lateral flow assay based on immunochromatographic technology (ICT) that detects Aspergillus antibodies (IgG and IgM) in less than 30 min, requiring minimal laboratory equipment. A total of 154 CPA patient sera collected at the National Aspergillosis Centre (Manchester, United Kingdom) and control patient sera from the Peninsula Research Bank (Exeter, United Kingdom) were evaluated. Samples were applied to the LDBio Aspergillus ICT lateral flow assay, and results were read both visually and digitally. Results were compared with Aspergillus IgG titers in CPA patients, measured by ImmunoCAP-specific IgG assays. For proven CPA patients versus controls, sensitivity and specificity for the LDBio Aspergillus ICT were 91.6% and 98.0%, respectively. In contrast, the routinely used ImmunoCAP assay exhibited 80.5% sensitivity for the same cohort (cutoff value, 40 mg of antigen-specific antibodies [mgA]/liter). The assay is easy to perform but challenging to read when only a very faint band is present (5/154 samples tested). The ImmunoCAP Aspergillus IgG titer was also compared with the Aspergillus ICT test line intensity or rate of development, with weak to moderate correlations. The Aspergillus ICT lateral flow assay exhibits excellent sensitivity for serological diagnosis of CPA. Quantifying IgG from test line intensity measurements is not reliable. Given the short run time, simplicity, and limited resources needed, the LDBio Aspergillus ICT is a suitable diagnostic tool for CPA in resource-constrained settings.
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Ma X, Wang K, Zhao X, Liu Y, Li Y, Yu X, Li C, Denning DW, Xie L. Prospective study of the serum Aspergillus-specific IgG, IgA and IgM assays for chronic pulmonary aspergillosis diagnosis. BMC Infect Dis 2019; 19:694. [PMID: 31387539 PMCID: PMC6683501 DOI: 10.1186/s12879-019-4303-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 07/18/2019] [Indexed: 12/14/2022] Open
Abstract
Background Chronic pulmonary aspergillosis (CPA) is an underdiagnosed and misdiagnosed disease and now increasingly recognised. However, the diagnosis of CPA remains challenging. In this study, we aimed to investigate the diagnostic values of serum Aspergillus-specific IgG, IgA and IgM antibodies in patients with CPA. Methods The prospective study was performed at Chinese People’s Liberation Army General Hospital in Beijing, from January 2017 to December 2017. Adult patients with lung lesions presented as cavity, nodule, mass, bronchiectasis or severe fibrotic destruction with at least two lobes in CT imaging were enrolled. One hundred healthy persons were also enrolled as additional controls. The serum levels of Aspergillus-specific IgG, IgA and IgM antibodies and galactomannan (GM) levels were measured simultaneously by plate ELISA kit. Results A total of 202 patients were enrolled in this study, including 42 CPA patients, 60 non-CPA patients and 100 healthy persons. The most common underlying lung diseases in CPA patients were bronchiectasis (28.6%) and COPD (19.0%). The most common symptoms in the CPA patients were cough (76.2%), sputum (71.4%), and fever (45.2%); chest pain (4.8%) was infrequent. Receiver operating characteristic (ROC) curve analysis revealed that the optimal CPA diagnostic cut-off of Aspergillus-specific IgG, IgA and IgM assays and GM test were 89.3 AU/mL, 8.2 U/mL, 73.3 AU/mL and 0.5μg/L, respectively. The serum levels of Aspergillus-specific IgG and IgA in CPA patients were higher than these in non-CPA patients or healthy persons. The sensitivities and specificities of Aspergillus-specific IgG, IgA, IgM tests and GM test were 78.6 and 94.4%, 64.3 and 89.4%, 50.0 and 53.7% and 71.4 and 58.1%, respectively. Conclusions The sensitivity and specificity of serum Aspergillus-specific IgG assay are satisfactory for diagnosing CPA, while the performance of Aspergillus-specific IgA assay is moderate. Aspergillus-specific IgM assay and serum GM test have limited value for CPA diagnosis. Trial registration NCT03027089. Registered 20 January 2017.
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Affiliation(s)
- Xiuqing Ma
- Department of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing, China
| | - Kaifei Wang
- Department of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing, China
| | - Xin Zhao
- Department of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing, China
| | - Yang Liu
- Department of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing, China
| | - Yanqin Li
- Department of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing, China
| | - Xiaotian Yu
- Academy for Life Science, Nankai University, Tianjin, China
| | - Chunsun Li
- Department of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing, China
| | - David W Denning
- The National Aspergillosis Centre, Wythenshawe Hospital, The University of Manchester and Manchester Academic Health Science Centre, Manchester, UK.
| | - Lixin Xie
- Department of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing, China.
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Denning DW, Page ID, Chakaya J, Jabeen K, Jude CM, Cornet M, Alastruey-Izquierdo A, Bongomin F, Bowyer P, Chakrabarti A, Gago S, Guto J, Hochhegger B, Hoenigl M, Irfan M, Irurhe N, Izumikawa K, Kirenga B, Manduku V, Moazam S, Oladele RO, Richardson MD, Tudela JLR, Rozaliyani A, Salzer HJF, Sawyer R, Simukulwa NF, Skrahina A, Sriruttan C, Setianingrum F, Wilopo BAP, Cole DC, Getahun H. Case Definition of Chronic Pulmonary Aspergillosis in Resource-Constrained Settings. Emerg Infect Dis 2019; 24. [PMID: 30016256 PMCID: PMC6056117 DOI: 10.3201/eid2408.171312] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Chronic pulmonary aspergillosis (CPA) is a recognized complication of pulmonary tuberculosis (TB). In 2015, the World Health Organization reported 2.2 million new cases of nonbacteriologically confirmed pulmonary TB; some of these patients probably had undiagnosed CPA. In October 2016, the Global Action Fund for Fungal Infections convened an international expert panel to develop a case definition of CPA for resource-constrained settings. This panel defined CPA as illness for >3 months and all of the following: 1) weight loss, persistent cough, and/or hemoptysis; 2) chest images showing progressive cavitary infiltrates and/or a fungal ball and/or pericavitary fibrosis or infiltrates or pleural thickening; and 3) a positive Aspergillus IgG assay result or other evidence of Aspergillus infection. The proposed definition will facilitate advancements in research, practice, and policy in lower- and middle-income countries as well as in resource-constrained settings.
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15
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Guo Y, Bai Y, Yang C, Gu L. Evaluation of Aspergillus IgG, IgM antibody for diagnosing in chronic pulmonary aspergillosis: A prospective study from a single center in China. Medicine (Baltimore) 2019; 98:e15021. [PMID: 31008929 PMCID: PMC6494343 DOI: 10.1097/md.0000000000015021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Chronic pulmonary aspergillosis (CPA) is a slowly progressing pulmonary fungal infectious disease caused by Aspergillus. Aspergillus IgG, IgM are now considered to be valuable biomarkers in CPA diagnosing.Our research attempts to evaluate the effectiveness of Aspergillus IgG, IgM in diagnosing CPA.In our study, CPA patients were younger than the patients who suffered other pulmonary disease. The most common underlying disease in CPA patients was pulmonary tuberculosis. And the most common clinical symptom was hemoptysis. The comparison among the groups indicated statistical significance with regard to Aspergillus IgG and IgM between the CPA and other pulmonary disease groups (P < .01). The Aspergillus-specific IgG and IgM in infectious group exhibited higher levels than those in colonization group (P < .01). The area under the receiver operating characteristic curve of Aspergillus IgG was 0.762 (95% confidence interval: 0.664-0.860) (P < .01).Aspergillus-specific IgG offers great diagnostic value with regard to CPA.
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16
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Piarroux RP, Romain T, Martin A, Vainqueur D, Vitte J, Lachaud L, Gangneux JP, Gabriel F, Fillaux J, Ranque S. Multicenter Evaluation of a Novel Immunochromatographic Test for Anti-aspergillus IgG Detection. Front Cell Infect Microbiol 2019; 9:12. [PMID: 30766842 PMCID: PMC6365447 DOI: 10.3389/fcimb.2019.00012] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/16/2019] [Indexed: 12/26/2022] Open
Abstract
Aspergillus sp. fungi cause various diseases in both immunocompetent and immunocompromised patients. The most frequent Aspergillus disorders include chronic pulmonary aspergillosis (CPA), a life-threatening disease that affects at least 3 million people worldwide, and allergic bronchopulmonary aspergillosis (ABPA), which affects approximately 4.8 million severe asthmatic patients globally. Diagnosis of such diseases involves IgG serological testing; however, the currently available anti-Aspergillus IgG detection assays are inappropriate for resource-poor laboratory settings, as they are expensive, rely on automated procedures, and require stable electrical power. Therefore, accurate CPA or ABPA diagnosis facilities are lacking in most low- and middle-income countries. We evaluated a novel anti-Aspergillus antibody immunochromatographic test (ICT) that requires minimal laboratory equipment. Two evaluations were performed: a single-center 4-month prospective study in a French reference laboratory (44 cases/257 patients) and a retrospective study in five French reference laboratories (262 cases and 188 controls). We estimated the ICT indices for the diagnosis of chronic aspergillosis, and the test results were compared to those of anti-Aspergillus IgG immunoblot (IB) assay. Of the 713 patients included in the study, 306 had chronic aspergillosis. Test sensitivity and specificity were 88.9% (95%CI[85–92]) and 96.3% (95%CI[94–98]) for the ICT and 93.1% (95%CI[90–96]) and 94.3% (95%CI[92–96]) for the IB, respectively. Agreement between the two assays was almost perfect (kappa = 0.86). As this ICT displays good diagnostic performance and complies with the ASSURED (Affordable, Sensitive, Specific, User-friendly, Equipment-free, and Delivered) criteria, we concluded that this anti-Aspergillus antibody ICT can be used to diagnose Aspergillus diseases in resource-poor settings.
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Affiliation(s)
- Raphaël P Piarroux
- LDBIO Diagnostics, Lyon, France.,Aix-Marseille Université, APHM, IRD, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
| | - Thomas Romain
- APHM, Parasitologie-Mycologie, IHU Méditerranée Infection, Aix-Marseille Université, Marseille, France
| | - Aurélie Martin
- APHM, Parasitologie-Mycologie, IHU Méditerranée Infection, Aix-Marseille Université, Marseille, France
| | - Damien Vainqueur
- Service de Parasitologie-Mycologie, CHU de Toulouse, Toulouse, France
| | - Joana Vitte
- APHM, MEPHI, IHU Méditerranée Infection, Aix-Marseille Université, Marseille, France
| | - Laurence Lachaud
- CHU de Montpellier, Montpellier, France.,Université de Montpellier, Montpellier, France
| | - Jean-Pierre Gangneux
- Institut de Recherche en Santé, Environnement et travail, Inserm, CHU de Rennes, EHESP, Université de Rennes, UMR_S 1085, Rennes, France
| | - Frédéric Gabriel
- Laboratoire de Parasitologie-Mycologie, CHU Bordeaux, Bordeaux, France
| | - Judith Fillaux
- APHM, MEPHI, IHU Méditerranée Infection, Aix-Marseille Université, Marseille, France.,PHARMA-DEV, IRD UMR 152, Université Paul Sabatier, Toulouse, France
| | - Stéphane Ranque
- Aix-Marseille Université, APHM, IRD, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France.,APHM, Parasitologie-Mycologie, IHU Méditerranée Infection, Aix-Marseille Université, Marseille, France
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17
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Desoubeaux G, Le-Bert C, Fravel V, Clauss T, Delaune AJ, Soto J, Jensen ED, Flower JE, Wells R, Bossart GD, Cray C. Evaluation of a genus-specific ELISA and a commercial Aspergillus Western blot IgG® immunoblot kit for the diagnosis of aspergillosis in common bottlenose dolphins (Tursiops truncatus). Med Mycol 2018; 56:847-856. [PMID: 29228323 DOI: 10.1093/mmy/myx114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 10/10/2017] [Indexed: 01/20/2023] Open
Abstract
Aspergillosis is a fungal infection with high mortality and morbidity rates. As in humans, its definitive diagnosis is difficult in animals, and thus new laboratory tools are required to overcome the diagnostic limitations due to low specificity and lack of standardization. In this study of common bottlenose dolphins (Tursiops truncatus), we evaluated the diagnostic performance of a new commercial immunoblot kit that had been initially developed for the serologic diagnosis of chronic aspergillosis in humans. Using this in a quantitative approach, we first established its positive cutoff within an observation cohort of 32 serum samples from dolphins with "proven" or "probable" diagnosis of aspergillosis and 55 negative controls. A novel enzyme-linked immunosorbent assay (ELISA) test was also developed for detecting anti-Aspergillus antibodies, and results were compared between the two assays. Overall, the diagnostic performance of immunoblot and ELISA were strongly correlated (P < .0001). The former showed lower sensitivity (65.6% versus 90.6%), but higher specificity (92.7% vs. 69.1%), with no cross-reaction with other fungal infections caused by miscellaneous non-Aspergillus genera. When assessing their use in a validation cohort, the immunoblot kit and the ELISA enabled positive diagnosis before mycological cultures in 42.9% and 33.3% subjects addressed for suspicion of aspergillosis, respectively. There was also significant impact of antifungal treatment on the results of the two tests (P < .05). In all, these new serological methods show promise in aiding in the diagnosis of aspergillosis in dolphins, and illustrate the opportunity to adapt commercial reagents directed for human diagnostics to detect similar changes in other animals.
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Affiliation(s)
- Guillaume Desoubeaux
- University of Miami, Division of Comparative Pathology, Department of Pathology and Laboratory Medicine, Miller School of Medicine, Miami, FL - USA.,CHU de Tours, Service de Parasitologie - Mycologie - Médecine tropicale, Tours - France.,Université François-Rabelais, CEPR - INSERM U1100 / Équipe 3, Faculté de Médecine, Tours - France
| | | | | | | | | | - Jeny Soto
- University of Miami, Division of Comparative Pathology, Department of Pathology and Laboratory Medicine, Miller School of Medicine, Miami, FL - USA
| | - Eric D Jensen
- U.S. Navy Marine Mammal Program, San Diego, CA - USA
| | - Jennifer E Flower
- Mystic Aquarium, a division of Sea Research Foundation Inc., Mystic, CT - USA
| | - Randall Wells
- Chicago Zoological Society's Sarasota Dolphin Research Program, c/o Mote Marine Laboratory, Sarasota, FL - USA
| | - Gregory D Bossart
- University of Miami, Division of Comparative Pathology, Department of Pathology and Laboratory Medicine, Miller School of Medicine, Miami, FL - USA.,Georgia Aquarium, Atlanta, GA - USA
| | - Carolyn Cray
- University of Miami, Division of Comparative Pathology, Department of Pathology and Laboratory Medicine, Miller School of Medicine, Miami, FL - USA
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18
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Abstract
Purpose of Review To understand the role of antibody detection in the diagnosis of infections caused by filamentous fungi (molds). Rapid and accurate profiling of infection-causing fungal pathogens remains a significant challenge in modern health care. Classical fungal culture and serology continue to be relevant even though over the past few decades, antigen (biomarker) assays such as ELISA and lateral flow devices have been developed and validated. Recent Findings This article reviews the current antibody detection systems (serological tests) for the diagnosis of mold infections associated with pulmonary disease and introduces new developments. Classic and more recently developed serological techniques and their performance characteristics, including immunodiffusion, complement fixation, and ELISA. Summary The diseases covered are allergic bronchopulmonary aspergillosis, chronic pulmonary aspergillosis, invasive aspergillosis, mucormycosis, diseases caused by filamentous basidiomycetes, infection caused by Talaromyces marneffei and pythiosis. Serology remains a cornerstone for fungal diagnostic testing.
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19
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Desoubeaux G, CHAUVIN D, Piqueras MDC, BRONSON E, BHATTACHARYA SK, SIRPENSKI G, BAILLY E, CRAY C. Translational proteomic study to address host protein changes during aspergillosis. PLoS One 2018; 13:e0200843. [PMID: 30040865 PMCID: PMC6057647 DOI: 10.1371/journal.pone.0200843] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 07/03/2018] [Indexed: 12/14/2022] Open
Abstract
Aspergillosis is a fungal disease due to Aspergillus molds that can affect both humans and animals. As routine diagnosis remains difficult, improvement of basic knowledge with respect to its pathophysiology is critical to search for new biomarkers of infection and new therapeutic targets. Large-scale proteomics allows assessment of protein changes during various disease processes. In the present study, mass spectrometry iTRAQ® (isobaric tags for relative and absolute quantitation) protocol was used for direct identification and relative quantitation of host proteins in diseased fluids and tissues collected from an experimental rat model challenged with Aspergillus, as well as in blood obtained from naturally-infected penguins. In all, mass spectrometry analysis revealed that proteome during aspergillosis was mostly represented by proteins that usually express role in metabolic processes and biological process regulation. Ten and 17 proteins were significantly ≥4.0-fold overrepresented in blood of Aspergillus-diseased rats and penguins, respectively, while five and 39 were negatively ≥4.0-fold depleted within the same samples. In rat lungs, 33 proteins were identified with positive or negative relative changes versus controls and were quite different from those identified in the blood. Except for some zinc finger proteins, kinases, and histone transferases, and while three pathways were common (Wnt, cadherin and FGF), great inter-species variabilities were observed regarding the identity of the differentially-represented proteins. Thus, this finding confirmed how difficult it is to define a unique biomarker of infection. iTRAQ® protocol appears as a convenient proteomic tool that is greatly suited to ex vivo exploratory studies and should be considered as preliminary step before validation of new diagnostic markers and new therapeutic targets in humans.
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Affiliation(s)
- Guillaume Desoubeaux
- University of Miami, Division of Comparative Pathology, Department of Pathology & Laboratory Medicine, Miller School of Medicine, Miami, FL, United States of America
- CHU de Tours, Parasitologie, Mycologie, Médecine tropicale, Tours, France
- Université de Tours, CEPR—INSERM U1100 / Équipe 3, Faculté de Médecine, Tours, France
| | - David CHAUVIN
- Université de Tours, CEPR—INSERM U1100 / Équipe 3, Faculté de Médecine, Tours, France
| | - Maria del Carmen Piqueras
- University of Miami, Mass Spectrometry Core Facility, Miller School of Medicine, Miami, FL, United States of America
| | - Ellen BRONSON
- Maryland Zoo in Baltimore, Baltimore, MD, United States of America
| | - Sanjoy K. BHATTACHARYA
- University of Miami, Mass Spectrometry Core Facility, Miller School of Medicine, Miami, FL, United States of America
| | | | - Eric BAILLY
- CHU de Tours, Parasitologie, Mycologie, Médecine tropicale, Tours, France
| | - Carolyn CRAY
- University of Miami, Division of Comparative Pathology, Department of Pathology & Laboratory Medicine, Miller School of Medicine, Miami, FL, United States of America
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20
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Desoubeaux G, Cray C. Animal Models of Aspergillosis. Comp Med 2018; 68:109-123. [PMID: 29663936 PMCID: PMC5897967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 03/29/2017] [Accepted: 07/09/2017] [Indexed: 06/08/2023]
Abstract
Aspergillosis is an airborne fungal disease caused by Aspergillus spp., a group of ubiquitous molds. This disease causes high morbidity and mortality in both humans and animals. The growing importance of this infection over recent decades has created a need for practical and reproducible models of aspergillosis. The use of laboratory animals provides a platform to understand fungal virulence and pathophysiology, assess diagnostic tools, and evaluate new antifungal drugs. In this review, we describe the fungus, various Aspergillus-related diseases in humans and animals and various experimental animal models. Overall, we highlight the advantages and limitations of the animal models, the experimental variables that can affect the course of the disease and the reproducibility of infection, and the critical need for standardization of the species, immunosuppressive drugs, route of infection, and diagnostic criteria to use.
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Affiliation(s)
- Guillaume Desoubeaux
- Department of Pathology and Laboratory Medicine, Division of Comparative Pathology, Miller School of Medicine, University of Miami, Miami, Florida, USA; Parasitology-Mycology Service, Tropical Medicine Program, University Hospital of Tours, CEPR - Inserm U1100, Medical Faculty, François Rabelais University, Tours, France
| | - Carolyn Cray
- Department of Pathology and Laboratory Medicine, Division of Comparative Pathology, Miller School of Medicine, University of Miami, Miami, Florida, USA.,
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Carsin A, Romain T, Ranque S, Reynaud‐Gaubert M, Dubus J, Mège J, Vitte J. Aspergillus fumigatus in cystic fibrosis: An update on immune interactions and molecular diagnostics in allergic bronchopulmonary aspergillosis. Allergy 2017; 72:1632-1642. [PMID: 28513848 DOI: 10.1111/all.13204] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2017] [Indexed: 12/13/2022]
Abstract
A wide spectrum of pathological conditions may result from the interaction of Aspergillus fumigatus and the immune system of its human host. Allergic bronchopulmonary aspergillosis is one of the most severe A. fumigatus-related diseases due to possible evolution toward pleuropulmonary fibrosis and respiratory failure. Allergic bronchopulmonary aspergillosis occurs almost exclusively in cystic fibrosis or asthmatic patients. An estimated 8%-10% of patients with cystic fibrosis experience this condition. The diagnosis of allergic bronchopulmonary aspergillosis relies on criteria first established in 1977. Progress in the understanding of host-pathogen interactions in A. fumigatus and patients with cystic fibrosis and the ongoing validation of novel laboratory tools concur to update and improve the diagnosis of allergic bronchopulmonary aspergillosis.
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Affiliation(s)
- A. Carsin
- Aix‐Marseille Univ APHM Hôpital Timone Enfants Pneumo‐pédiatrie Centre de Ressources et de Compétences en Mucoviscidose Marseille France
- Aix‐Marseille Univ INSERM UMR 1067 CNRS UMR 7333 Marseille France
| | - T. Romain
- Aix‐Marseille Univ APHM Hôpital de La Conception Laboratoire d'Immunologie Marseille France
| | - S. Ranque
- Aix‐Marseille Univ APHM Hôpital Timone Laboratoire de Parasitologie Marseille France
- Aix‐Marseille Univ INSERM U1095 CNRS U7278 IRD 198 URMITE Marseille France
| | - M. Reynaud‐Gaubert
- Aix‐Marseille Univ INSERM U1095 CNRS U7278 IRD 198 URMITE Marseille France
- Aix‐Marseille Univ APHM Hôpital Nord Centre de Ressources et de Compétences en Mucoviscidose Marseille France
| | - J.‐C. Dubus
- Aix‐Marseille Univ APHM Hôpital Timone Enfants Pneumo‐pédiatrie Centre de Ressources et de Compétences en Mucoviscidose Marseille France
- Aix‐Marseille Univ INSERM U1095 CNRS U7278 IRD 198 URMITE Marseille France
| | - J.‐L. Mège
- Aix‐Marseille Univ APHM Hôpital de La Conception Laboratoire d'Immunologie Marseille France
- Aix‐Marseille Univ INSERM U1095 CNRS U7278 IRD 198 URMITE Marseille France
| | - J. Vitte
- Aix‐Marseille Univ INSERM UMR 1067 CNRS UMR 7333 Marseille France
- Aix‐Marseille Univ APHM Hôpital de La Conception Laboratoire d'Immunologie Marseille France
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22
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Mishra M, Tiwari S, Gomes AV. Protein purification and analysis: next generation Western blotting techniques. Expert Rev Proteomics 2017; 14:1037-1053. [PMID: 28974114 DOI: 10.1080/14789450.2017.1388167] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Western blotting is one of the most commonly used techniques in molecular biology and proteomics. Since western blotting is a multistep protocol, variations and errors can occur at any step reducing the reliability and reproducibility of this technique. Recent reports suggest that a few key steps, such as the sample preparation method, the amount and source of primary antibody used, as well as the normalization method utilized, are critical for reproducible western blot results. Areas covered: In this review, improvements in different areas of western blotting, including protein transfer and antibody validation, are summarized. The review discusses the most advanced western blotting techniques available and highlights the relationship between next generation western blotting techniques and its clinical relevance. Expert commentary: Over the last decade significant improvements have been made in creating more sensitive, automated, and advanced techniques by optimizing various aspects of the western blot protocol. New methods such as single cell-resolution western blot, capillary electrophoresis, DigiWest, automated microfluid western blotting and microchip electrophoresis have all been developed to reduce potential problems associated with the western blotting technique. Innovative developments in instrumentation and increased sensitivity for western blots offer novel possibilities for increasing the clinical implications of western blot.
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Affiliation(s)
- Manish Mishra
- a Department of Physiology , University of Saskatchewan College of Medicine , Saskatoon , SK , Canada
| | - Shuchita Tiwari
- b Department of Neurobiology, Physiology, and Behavior , University of California , Davis , CA , USA
| | - Aldrin V Gomes
- b Department of Neurobiology, Physiology, and Behavior , University of California , Davis , CA , USA.,c Department of Physiology and Membrane Biology , University of California , Davis , CA , USA
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23
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Marguet C, Lémée L, Morisse-Pradier H, Couderc L. [Infections in cystic fibrosis: Up-to-date]. Arch Pediatr 2017; 23:12S33-12S38. [PMID: 28231891 DOI: 10.1016/s0929-693x(17)30060-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This review focused on the news in CF airways infection. International guidelines were provided for the care of non tuberculous mycobacteria, and recent studies stressed on the benefit effect of azithromycin or combined antibiotics. The identification of multiresistant environmental bacteria in airways made to account for little-known consequences. Early diagnosis and eradication of Pseudomonas aeruginosa and Staphylococcus aureus methi-R were still a concern, and reports were proposed. However, the studies on staphylococcus methi-R should be interpreted as regards the European or American continent. Thus, levofloxacine has demonstrated its efficacy without enhancing the efficiency. This drug will increase the choice for treating the patient, but no study were provided on the expected modification of the patient microbiota and the known risk of emergent resistance to antibiotics. Lastly, this review underlined that the CF practitioner was encouraged to search and not underestimate the presence of fungus, of which the not so well studied Aspergillus fumigatus.
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Affiliation(s)
- C Marguet
- Unité de Pneumologie et Allergologie pédiatrique & CRCM mixte, Département de pédiatrie médicale, Hôpital Universitaire Charles Nicolle, Université de Rouen, France; Groupe de Recherche sur les antimicrobiens et les microorganismes (GRAM-02), UPRES EA 2656, UFR Médecine Pharmacie, Université de Rouen, France.
| | - L Lémée
- Groupe de Recherche sur les antimicrobiens et les microorganismes (GRAM-02), UPRES EA 2656, UFR Médecine Pharmacie, Université de Rouen, France; Département de Microbiologie, Hôpital Universitaire Charles Nicolle, Université de Rouen, France
| | - H Morisse-Pradier
- CRCM-mixte, Service de pneumologie, Hôpital Universitaire Charles Nicolle, Université de Rouen, France
| | - L Couderc
- Unité de Pneumologie et Allergologie pédiatrique & CRCM mixte, Département de pédiatrie médicale, Hôpital Universitaire Charles Nicolle, Université de Rouen, France
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Desoubeaux G, Pantin A, Peschke R, Joachim A, Cray C. Application of Western blot analysis for the diagnosis of Encephalitozoon cuniculi infection in rabbits: example of a quantitative approach. Parasitol Res 2016; 116:743-750. [PMID: 27966020 DOI: 10.1007/s00436-016-5343-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 11/29/2016] [Indexed: 11/30/2022]
Abstract
Diagnosis of Encephalitozoon cuniculi infection in rabbits remains a major veterinary issue. ELISA or immunofluorescence assays are the current reference standards of serological tests. However, these conventional techniques suffer from a lack of accuracy for distinguishing active from past infections, as a positive serostatus is common in clinically normal rabbits. In this study, we assessed the diagnostic performance of Western blot (WB) to detect both anti-E. cuniculi immunoglobulin G (IgG) and immunoglobulin M (IgM) in comparison with ELISA and to address the intensity of the immune response through a quantitative approach. Positive WB results were highly correlated with the E. cuniculi-related diseased status (P < 0.0001). Although it was more labor intensive and less standardized, quantitative WB provided detailed comparable analysis regarding the humoral response and diagnostic performance similar to ELISA testing with statistically higher sensitivity (88.4 vs. 76.1% for IgG detection and 84.3 vs. 70.4% for IgM, P < 0.01). Several specific WB bands were shown to be significantly associated with concomitant clinical signs, like the one located at 50 kDa (OR = 8.2, [2.4-27.7], P = 0.0008) for IgG and (OR = 27.9, [4.2-187.9], P = 0.0006) for IgM. Therefore, the quantitative WB may have application in veterinary diagnostic laboratories to increase the accuracy of the clinical diagnosis of E. cuniculi infection. In addition, this tool may help to further understand the development and function of the humoral immune response to this infectious agent.
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Affiliation(s)
- Guillaume Desoubeaux
- Division of Comparative Pathology, Department of Pathology and Laboratory Medicine, Miller School of Medicine, University of Miami, Miami, FL, 33136, USA.
- Service de Parasitologie, Mycologie, Médecine tropicale, CHU de Tours, Tours, 37044, France.
- CEPR-INSERM U1100/Équipe 3, Faculté de Médecine, Université François-Rabelais, Tours, 37032, France.
| | - Ana Pantin
- Division of Comparative Pathology, Department of Pathology and Laboratory Medicine, Miller School of Medicine, University of Miami, Miami, FL, 33136, USA
| | - Roman Peschke
- Institute of Parasitology, Department of Pathobiology, University of Veterinary Medicine, Vienna, 1210, Austria
| | - Anja Joachim
- Institute of Parasitology, Department of Pathobiology, University of Veterinary Medicine, Vienna, 1210, Austria
| | - Carolyn Cray
- Division of Comparative Pathology, Department of Pathology and Laboratory Medicine, Miller School of Medicine, University of Miami, Miami, FL, 33136, USA
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25
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Akroum S. Antifungal activity of acetone extracts from Punica granatum L., Quercus suber L. and Vicia faba L. J Mycol Med 2016; 27:83-89. [PMID: 27856170 DOI: 10.1016/j.mycmed.2016.10.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 10/18/2016] [Accepted: 10/20/2016] [Indexed: 01/31/2023]
Abstract
Human and animal mycoses become more frequent and more resistant to traditional treatments. In this work, we tested the in vitro antifungal activity of acetonic extracts of Punica granatum L., Quercus suber L. and Vicia faba L. against seven pathogen fungi and the in vivo antifungal activity against Candida albicans and Trichophyton mentagrophytes. The phytochemical screening was also carried out and showed that the extracts contained mainly proanthocyanidins. Other polyphenols were also present but in low quantity. The acetone extract of V. faba L. gave a good in vitro inhibition of yeasts and was the most active for treating candidiasis in mice. It decreased the percentage of mortality with only 20μg. But the in vivo antifungal activity of this extract on T. mentagrophytes was low. It only showed a small diminution of crusting and erythema after the administration of 100μg. On the contrary, the acetone extracts of P. granatum L. had a poor activity against yeasts and a better one against moulds. It gave the best in vivo antifungal activity against T. mentagrophytes by healing animals with 40μg. The extract of P. granatum L. gave also an interesting in vivo antifungal activity against T. mentagrophytes with an active dose of 80μg.
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Affiliation(s)
- S Akroum
- Applied Microbiological and Food Sciences Department, Faculty of Natural and Life Sciences, University of Jijel, BP 98 Ouled Aissa, Jijel 18000, Algeria.
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26
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Richardson MD, Page ID. Aspergillus serology: Have we arrived yet? Med Mycol 2016; 55:48-55. [PMID: 27816904 DOI: 10.1093/mmy/myw116] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 08/07/2016] [Accepted: 10/12/2016] [Indexed: 12/11/2022] Open
Abstract
Aspergillosis presents in various clinical forms, among them chronic pulmonary aspergillosis, which is a spectrum of disease entities including aspergilloma, chronic cavitary pulmonary aspergillosis, and chronic fibrosing pulmonary aspergillosis. Aspergillus also contributes to fungal allergy and sensitization. Analysis of the immune response to Aspergillus and its antigens is an integral part of the diagnosis of these diseases. Over the past half century, the techniques used to determine antibody titers have evolved from testing for precipitating and agglutinating antibodies by agar gel double diffusion and immunolectrophoresis to enzyme-linked immunosorbent assays using recombinant proteins as capture antigens. A resurgence of interest in the detection of immunoglobulins, primarily Aspergillus-specific IgG, has hinted at the possibility of distinguishing between colonization and invasion in immunocompromised patients with invasive aspergillosis. Even though there appears to be a greater degree of discrimination between the clinical forms of aspergillosis there is still a long way to travel. This review presents illustrative examples of where new diagnostic platforms and technologies have been applied to this intriguing spectrum of diseases.
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Affiliation(s)
- Malcolm D Richardson
- Mycology Reference Centre Manchester, University Hospital of South Manchester, Manchester, UK .,National Aspergillosis Center, University Hospital of South Manchester.,Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, UK
| | - Iain D Page
- National Aspergillosis Center, University Hospital of South Manchester.,Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, UK
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Persat F, Hennequin C, Gangneux J. Aspergillusantibody detection: diagnostic strategy and technical considerations from the Société Française de Mycologie Médicale (French Society for Medical Mycology) expert committee. Med Mycol 2016; 55:302-307. [DOI: 10.1093/mmy/myw078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 07/01/2016] [Indexed: 01/08/2023] Open
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Burgel PR, Paugam A, Hubert D, Martin C. Aspergillus fumigatus in the cystic fibrosis lung: pros and cons of azole therapy. Infect Drug Resist 2016; 9:229-238. [PMID: 27703383 PMCID: PMC5036609 DOI: 10.2147/idr.s63621] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Aspergillus fumigatus is the main fungus cultured in the airways of patients with cystic fibrosis (CF). Allergic bronchopulmonary aspergillosis occurs in ~10% of CF patients and is clearly associated with airway damage and lung function decline. The effects of A. fumigatus colonization in the absence of allergic bronchopulmonary aspergillosis are less well established. Retrospective clinical studies found associations of A. fumigatus-positive cultures with computed tomography scan abnormalities, greater risk of CF exacerbations and hospitalizations, and/or lung function decline. These findings were somewhat variable among studies and provided only circumstantial evidence for a role of A. fumigatus colonization in CF lung disease progression. The availability of a growing number of oral antifungal triazole drugs, together with the results of nonrandomized case series suggesting positive effects of azole therapies, makes it tempting to treat CF patients with these antifungal drugs. However, the only randomized controlled trial that has used itraconazole in CF patients showed no significant benefit. Because triazoles may have significant adverse effects and drug interactions, and because their prolonged use has been associated with the emergence of azole-resistant A. fumigatus isolates, it remains unclear whether or not CF patients benefit from azole therapy.
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Affiliation(s)
- Pierre-Régis Burgel
- Department of Respiratory Medicine, Cochin Hospital, Assistance Publique - Hôpitaux de Paris; Université Paris Descartes, Sorbonne Paris Cité
| | - André Paugam
- Université Paris Descartes, Sorbonne Paris Cité; Parasitology-Mycology Laboratory, Cochin Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Dominique Hubert
- Department of Respiratory Medicine, Cochin Hospital, Assistance Publique - Hôpitaux de Paris; Université Paris Descartes, Sorbonne Paris Cité
| | - Clémence Martin
- Department of Respiratory Medicine, Cochin Hospital, Assistance Publique - Hôpitaux de Paris; Université Paris Descartes, Sorbonne Paris Cité
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Agarwal R, Dua D, Choudhary H, Aggarwal AN, Sehgal IS, Dhooria S, Garg M, Behera D, Chakrabarti A. Role ofAspergillus fumigatus-specific IgG in diagnosis and monitoring treatment response in allergic bronchopulmonary aspergillosis. Mycoses 2016; 60:33-39. [DOI: 10.1111/myc.12541] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 07/08/2016] [Accepted: 07/09/2016] [Indexed: 01/28/2023]
Affiliation(s)
- Ritesh Agarwal
- Department of Pulmonary Medicine; Postgraduate Institute of Medical Education and Research (PGIMER); Chandigarh India
| | - Devika Dua
- Department of Pulmonary Medicine; Postgraduate Institute of Medical Education and Research (PGIMER); Chandigarh India
| | - Hansraj Choudhary
- Department of Pulmonary Medicine; Postgraduate Institute of Medical Education and Research (PGIMER); Chandigarh India
| | - Ashutosh N. Aggarwal
- Department of Pulmonary Medicine; Postgraduate Institute of Medical Education and Research (PGIMER); Chandigarh India
| | - Inderpaul S. Sehgal
- Department of Pulmonary Medicine; Postgraduate Institute of Medical Education and Research (PGIMER); Chandigarh India
| | - Sahajal Dhooria
- Department of Pulmonary Medicine; Postgraduate Institute of Medical Education and Research (PGIMER); Chandigarh India
| | - Mandeep Garg
- Department of Radiodiagnosis and Imaging; Postgraduate Institute of Medical Education and Research (PGIMER); Chandigarh India
| | - Digambar Behera
- Department of Pulmonary Medicine; Postgraduate Institute of Medical Education and Research (PGIMER); Chandigarh India
| | - Arunaloke Chakrabarti
- Department of Medical Microbiology; Postgraduate Institute of Medical Education and Research (PGIMER); Chandigarh India
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Hayes GE, Novak-Frazer L. Chronic Pulmonary Aspergillosis-Where Are We? and Where Are We Going? J Fungi (Basel) 2016; 2:jof2020018. [PMID: 29376935 PMCID: PMC5753080 DOI: 10.3390/jof2020018] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 05/19/2016] [Accepted: 06/01/2016] [Indexed: 02/06/2023] Open
Abstract
Chronic pulmonary aspergillosis (CPA) is estimated to affect 3 million people worldwide making it an under recognised, but significant health problem across the globe, conferring significant morbidity and mortality. With variable disease forms, high levels of associated respiratory co-morbidity, limited therapeutic options and prolonged treatment strategies, CPA is a challenging disease for both patients and healthcare professionals. CPA can mimic smear-negative tuberculosis (TB), pulmonary histoplasmosis or coccidioidomycosis. Cultures for Aspergillus are usually negative, however, the detection of Aspergillus IgG is a simple and sensitive test widely used in diagnosis. When a fungal ball/aspergilloma is visible radiologically, the diagnosis has been made late. Sometimes weight loss and fatigue are predominant symptoms; pyrexia is rare. Despite the efforts of the mycology community, and significant strides being taken in optimising the care of these patients, much remains to be learnt about this patient population, the disease itself and the best use of available therapies, with the development of new therapies being a key priority. Here, current knowledge and practices are reviewed, and areas of research priority highlighted.
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Affiliation(s)
- Gemma E Hayes
- The University of Manchester, Oxford Road, Manchester M13 9PL, UK.
- Manchester Academic Health Science Centre, 46 Grafton Street, Manchester M13 9NT, UK.
- National Aspergillosis Centre, 2nd Floor Education and Research Centre, University Hospital of South Manchester, Southmoor Road, Manchester M23 9LT, UK.
| | - Lilyann Novak-Frazer
- The University of Manchester, Oxford Road, Manchester M13 9PL, UK.
- Manchester Academic Health Science Centre, 46 Grafton Street, Manchester M13 9NT, UK.
- The University of Manchester, Manchester Academic Health Science Centre, 2nd Floor Education and Research Centre, University Hospital of South Manchester, Southmoor Road, Manchester M23 9LT, UK.
- Mycology Reference Centre, Manchester, 2nd Floor Education and Research Centre, University Hospital of South Manchester, Southmoor Road, Manchester M23 9LT, UK.
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Prospective Evaluation of a New Aspergillus IgG Enzyme Immunoassay Kit for Diagnosis of Chronic and Allergic Pulmonary Aspergillosis. J Clin Microbiol 2016; 54:1236-42. [PMID: 26888904 DOI: 10.1128/jcm.03261-15] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 02/10/2016] [Indexed: 12/29/2022] Open
Abstract
Anti-Aspergillus IgG antibodies are important biomarkers for the diagnosis of chronic pulmonary aspergillosis (CPA) and allergic bronchopulmonary aspergillosis (ABPA). We compared the performance of a new commercial enzyme immunoassay (EIA) (Bordier Affinity Products) with that of the Bio-Rad and Virion\Serion EIAs. This assay is novel in its association of two recombinant antigens with somatic and metabolic antigens of Aspergillus fumigatus In a prospective multicenter study, 436 serum samples from 147 patients diagnosed with CPA (136 samples/104 patients) or ABPA (94 samples/43 patients) and from 205 controls (206 samples) were tested. We obtained sensitivities of 97%, 91.7%, and 86.1%, and specificities of 90.3%, 91.3%, and 81.5% for the Bordier, Bio-Rad, and Virion\Serion tests, respectively. The Bordier kit was more sensitive than the Bio-Rad kit (P < 0.01), which was itself more sensitive than the Virion\Serion kit (P = 0.04). The Bordier and Bio-Rad kits had similar specificity (P = 0.8), both higher than that of the Virion\Serion kit (P = 0.02). The area under the receiver operating characteristic (ROC) curves confirmed the superiority of the Bordier kit over the Bio-Rad and the Virion\Serion kits (0.977, 0.951, and 0.897, respectively; P < 0.01 for each comparison). In a subset analysis of 279 serum samples tested with the Bordier and Bio-Rad kits and an in-house immunoprecipitin assay (IPD), the Bordier kit had the highest sensitivity (97.7%), but the IPD tended to be more specific (71.2 and 84.7%, respectively; P = 0.10). The use of recombinant, somatic, and metabolic antigens in a single EIA improved the balance of sensitivity and specificity, resulting in an assay highly suitable for use in the diagnosis of chronic and allergic aspergillosis.
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New Commercially Available IgG Kits and Time-Resolved Fluorometric IgE Assay for Diagnosis of Allergic Bronchopulmonary Aspergillosis in Patients with Cystic Fibrosis. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2015; 23:196-203. [PMID: 26698651 DOI: 10.1128/cvi.00498-15] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 12/08/2015] [Indexed: 12/14/2022]
Abstract
Allergic bronchopulmonary aspergillosis (ABPA) is difficult to diagnose; diagnosis relies on clinical, radiological, pathological, and serological criteria. Our aim was to assess the performance of two new commercially available kits and a new in-house assay: an Aspergillus fumigatus enzyme-linked immunosorbent assay (ELISA) IgG kit (Bordier Affinity Products), an Aspergillus Western blotting IgG kit (LDBio Diagnostics), and a new in-house time-resolved fluorometric IgE assay (dissociation-enhanced lanthanide fluorescent immunoassay, or DELFIA) using recombinant proteins from an Aspergillus sp. recently developed by our laboratory for ABPA diagnosis in a retrospective study that included 26 cystic fibrosis patients. Aspergillus fumigatus-specific IgG levels measured by a commercial ELISA kit were in accordance with the level of precipitins currently used in our lab. The ELISA kit could accelerate and help standardize ABPA diagnosis. Aspergillus fumigatus-specific IgE levels measured by ImmunoCAP (Phadia) with A. fumigatus M3 antigen and by DELFIA with a purified protein extract of A. fumigatus were significantly correlated (P < 10(-6)). The results with recombinant antigens glucose-6-phosphate isomerase and mannitol-1-phosphate dehydrogenase were encouraging but must be confirmed with sera from more patients. The DELFIA is an effective tool that can detect specific IgE against more fungal allergens than can be detected with other commercially available tests.
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