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Heydari M, Rezayi M, Ruscica M, Jpamialahamdi T, Johnston TP, Sahebkar A. The ins and outs of lipoprotein(a) assay methods. Arch Med Sci Atheroscler Dis 2023; 8:e128-e139. [PMID: 38283929 PMCID: PMC10811544 DOI: 10.5114/amsad/176653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 12/08/2023] [Indexed: 01/30/2024] Open
Abstract
Pathophysiological, epidemiological and genetic studies convincingly showed lipoprotein(a) (Lp(a)) to be a causal mediator of atherosclerotic cardiovascular disease (ASCVD). This happens through a myriad of mechanisms including activation of innate immune cells, endothelial cells as well as platelets. Although these certainties whether or not Lp(a) is ready for prime-time clinical use remain debated. Thus, remit of the present review is to provide an overview of different methods that have been employed for the measurement of Lp(a). The methods include dynamic light scattering, multi-angle light scattering analysis, near-field imaging, sedimentation, gel filtration, and electron microscopy. The development of multiple Lp(a) detection methods is vital for improved prediction of ASCVD risk.
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Affiliation(s)
- Maryam Heydari
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Rezayi
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Biotechnology and Nanotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Massimiliano Ruscica
- Department of Pharmacological and Biomolecular Science, Università degli Studi di Milano, Milan, Italy
| | - Tannaz Jpamialahamdi
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Thomas P. Johnston
- Division of Pharmacology and Pharmaceutical Science, School of Pharmacy, University of Missouri-Kansas City, Kansas City, MI, USA
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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2
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Wilopo BAP, Hunter ES, Richardson MD, Denning DW. Optimising the cut-off of the Bordier Aspergillus IgG ELISA for the diagnosis of chronic pulmonary aspergillosis. J Microbiol Methods 2020; 176:106021. [PMID: 32795637 DOI: 10.1016/j.mimet.2020.106021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/23/2020] [Accepted: 07/23/2020] [Indexed: 10/23/2022]
Abstract
Aspergillus IgG detection is an essential tool in the diagnosis and treatment of chronic pulmonary aspergillosis (CPA), and is often positive in allergic bronchopulmonary aspergillosis and Aspergillus bronchitis. The Bordier ELISA had an 83.3% sensitivity (identical to ImmunoCap at a cut-off of 40mgA/L) and 97.3% specificity using a cut-off of 0.9 and a diagnostic accuracy of 90.9%.
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Affiliation(s)
- Bayu A P Wilopo
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom; Division of Microbiology, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Elizabeth Stucky Hunter
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Malcolm D Richardson
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom; Mycology Reference Centre Manchester, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - David W Denning
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom; National Aspergillosis Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
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3
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Agarwal R, Sehgal IS, Dhooria S, Aggarwal AN. Developments in the diagnosis and treatment of allergic bronchopulmonary aspergillosis. Expert Rev Respir Med 2016; 10:1317-1334. [PMID: 27744712 DOI: 10.1080/17476348.2016.1249853] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Allergic bronchopulmonary aspergillosis (ABPA) is a complex pulmonary disorder characterized by recurrent episodes of wheezing, fleeting pulmonary opacities and bronchiectasis. It is the most prevalent of the Aspergillus disorders with an estimated five million cases worldwide. Despite six decades of research, the pathogenesis, diagnosis and treatment of this condition remains controversial. The International Society for Human and Animal Mycology has formed a working group to resolve the controversies around this entity. In the year 2013, this group had proposed new criteria for diagnosis and staging, and suggested a treatment protocol for the management of this disorder. Since then, several pieces of new evidence have been published in the investigation and therapeutics of this condition. Areas covered: A non-systematic review of the available literature was performed. We summarize the current evidence in the evaluation and treatment of this enigmatic disorder. We suggest modifications to the existing criteria and propose a new scoring system for the diagnosis of ABPA. Expert commentary: All patients with asthma and cystic fibrosis should routinely be screened for ABPA using A. fumigatus-specific IgE levels. Glucocorticoids should be used as the first-line of therapy in ABPA, and itraconazole reserved in those with recurrent exacerbations and glucocorticoid-dependent disease.
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Affiliation(s)
- Ritesh Agarwal
- a Department of Pulmonary Medicine , Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh , India
| | - Inderpaul S Sehgal
- a Department of Pulmonary Medicine , Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh , India
| | - Sahajal Dhooria
- a Department of Pulmonary Medicine , Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh , India
| | - Ashutosh N Aggarwal
- a Department of Pulmonary Medicine , Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh , India
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4
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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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Page ID, Richardson M, Denning DW. Antibody testing in aspergillosis--quo vadis? Med Mycol 2015; 53:417-39. [PMID: 25980000 DOI: 10.1093/mmy/myv020] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 02/09/2015] [Indexed: 12/19/2022] Open
Abstract
Humans are constantly exposed to airborne Aspergillus spores. Most develop Aspergillus-specific antibodies by adulthood. Persons with chronic lung disease or Aspergillus airway colonization often have raised levels of Aspergillus-specific immunoglobululin G (IgG). It is not known whether this signifies an increased risk of future aspergillosis.Chronic and allergic forms of pulmonary aspergillosis are estimated to affect over three million people worldwide. Antibody testing is central to diagnosis of these conditions, with raised Aspergillus-specific IgG in chronic pulmonary aspergillosis and raised Aspergillus-specific IgE in allergic aspergillosis. Antibody levels are also used to monitor treatment response in these syndromes. Acute invasive disease is less common. There is a more limited role for antibody testing in this setting as immunosuppression often results in delayed or absent antibody response.Many methods exist to detect Aspergillus-specific antibodies, but there are limited published data regarding comparative efficacy and reproducibility. We discuss the comparative merits of the available tests in the various clinical settings and their suitability for use in the resource-poor settings where the majority of cases of aspergillosis are thought to occur. We summarize the gaps in existing knowledge and opportunities for further study that could allow optimal use of antibody testing in this field.
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Affiliation(s)
- Iain D Page
- Institute of Inflammation and Repair, The University of Manchester, UK Manchester Academic Health Science Centre, UK National Aspergillosis Center and Mycology Reference Centre, University Hospital South Manchester, UK
| | - Malcolm Richardson
- Institute of Inflammation and Repair, The University of Manchester, UK Manchester Academic Health Science Centre, UK National Aspergillosis Center and Mycology Reference Centre, University Hospital South Manchester, UK
| | - David W Denning
- Institute of Inflammation and Repair, The University of Manchester, UK Manchester Academic Health Science Centre, UK National Aspergillosis Center and Mycology Reference Centre, University Hospital South Manchester, UK
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Baxter CG, Denning DW, Jones AM, Todd A, Moore CB, Richardson MD. Performance of two Aspergillus IgG EIA assays compared with the precipitin test in chronic and allergic aspergillosis. Clin Microbiol Infect 2013; 19:E197-204. [PMID: 23331929 DOI: 10.1111/1469-0691.12133] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2012] [Revised: 12/14/2012] [Accepted: 12/16/2012] [Indexed: 12/25/2022]
Abstract
Detection of Aspergillus IgG antibodies is important in the diagnosis of chronic pulmonary aspergillosis and allergic bronchopulmonary aspergillosis. Immunoprecipitation techniques to detect these antibodies appear to lack sensitivity and accurate quantitation compared with enzyme immunoassays (EIA). This study assessed the performance of two commercial EIAs compared with counterimmunoelectrophoresis (CIE). This was a prospective cohort study of 175 adult patients with chronic or allergic pulmonary aspergillosis. Aspergillus IgG antibodies were detected using CIE, Phadia ImmunoCap Aspergillus IgG and Bio-Rad Platelia Aspergillus IgG. Inter-assay reproducibility was determined for each method and 25 patients had two serum samples analysed within a 6-month interval. When compared with CIE, both ImmunoCap and Platelia Aspergillus IgG had good sensitivity (97 and 93%, respectively) for detection of Aspergillus IgG antibodies. The level of agreement between the two EIAs for positive results was good, but the concentration of antibodies was not correlated between the tests or with CIE titre. ImmunoCap IgG inter-assay coefficient of variation was 5%, whereas Platelia IgG was 33%. Median ImmunoCap IgG values for CPA and allergic aspergillosis were 95 and 32 mg/L, respectively, whereas Platelia IgG values were >80 and 6 AU/mL. The direction of CIE titre change over 6 months was mirrored by ImmunoCap IgG levels in 92% of patients, and by Platelia IgG in 72% of patients. Both ImmunoCap and Platelia Aspergillus IgG EIAs are sensitive measures of Aspergillus IgG antibodies compared with CIE. However, ImmunoCap appears to have better reproducibility and may be more suitable for monitoring patient disease.
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Affiliation(s)
- C G Baxter
- The National Aspergillosis Centre, University Hospital of South Manchester, Manchester, UK.
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Lau A, Chen S, Sleiman S, Sorrell T. Current status and future perspectives on molecular and serological methods in diagnostic mycology. Future Microbiol 2009; 4:1185-222. [DOI: 10.2217/fmb.09.70] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Invasive fungal infections are an important cause of infectious morbidity. Nonculture-based methods are increasingly used for rapid, accurate diagnosis to improve patient outcomes. New and existing DNA amplification platforms have high sensitivity and specificity for direct detection and identification of fungi in clinical specimens. Since laboratories are increasingly reliant on DNA sequencing for fungal identification, measures to improve sequence interpretation should support validation of reference isolates and quality control in public gene repositories. Novel technologies (e.g., isothermal and PNA FISH methods), platforms enabling high-throughput analyses (e.g., DNA microarrays and Luminex® xMAP™) and/or commercial PCR assays warrant further evaluation for routine diagnostic use. Notwithstanding the advantages of molecular tests, serological assays remain clinically useful for patient management. The serum Aspergillus galactomannan test has been incorporated into diagnostic algorithms of invasive aspergillosis. Both the galactomannan and the serum β-D-glucan test have value for diagnosing infection and monitoring therapeutic response.
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Affiliation(s)
- Anna Lau
- Centre for Infectious Diseases & Microbiology, University of Sydney, Sydney, Australia
| | - Sharon Chen
- Centre for Infectious Diseases & Microbiology, University of Sydney, Sydney, Australia and Centre for Infectious Diseases & Microbiology Laboratory Services, Institute of Clinical Pathology & Medical Research, Westmead Hospital, Westmead, NSW 2145, Australia
| | - Sue Sleiman
- Centre for Infectious Diseases & Microbiology Laboratory Services, Institute of Clinical Pathology & Medical Research, Westmead Hospital, Westmead, NSW 2145, Australia
| | - Tania Sorrell
- Centre for Infectious Diseases & Microbiology, Westmead Hospital, Darcy and Hawkesbury Roads, Westmead, NSW 2145, Australia
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9
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Melinn M, McLaughlin H. Farmers lung: a three year survey and comparison of ELISA and CIEP techniques in antibody detection. Ir J Med Sci 1989; 158:173-4. [PMID: 2599823 DOI: 10.1007/bf02984633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The incidence of detection of antibodies against antigens derived from two thermophilic actinomycetes in patients clinically suspected of having Farmer's Lung was assessed. Approximately 25% of samples submitted over a three year period were found to be positive in either the ELISA test or the CIEP test for antigens derived from M. faeni and T. vulgaris. The ELISA test proved to be more sensitive than the CIEP test in the detection of antibodies directed against both organisms.
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Pamphilon D, Prentice A, Wedzicha J, Woods M, Matthews R, Burnie J. A clinical and serological study of the effect of itraconazole in the management of invasive aspergillosis. ACTA ACUST UNITED AC 1987. [DOI: 10.1016/0888-0786(87)90009-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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11
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Richardson MD, Llewellyn PA, Warnock DW. Antibody to Aspergillus fumigatus antigens in normal sera: influence on positive-negative discrimination in ELISA. JOURNAL OF IMMUNOASSAY 1984; 5:205-20. [PMID: 6397481 DOI: 10.1080/01971528408063008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The response of precipitin-negative sera from non-selected asthmatic patients against a range of somatic and culture filtrate antigens of Aspergillus fumigatus in ELISA for anti-A. fumigatus IgG is described. Antibody to the various antigens was widely distributed but the precise distribution was dependent upon antigen type. To determine how the selection of negative reference sera from precipitin-negative sera can influence the discrimination between precipitin-positive and -negative sera in ELISA, panels of 10 sera were chosen from the extremes of the frequency distribution and by random selection. The closest agreement between precipitin testing and ELISA was seen when randomly-selected negative reference sera were incorporated in the assay, although the degree of correlation was dependent upon the detector antigen. These findings demonstrate the requirement for careful selection of sera included as negative reference sera in ELISA for anti-A. fumigatus IgG.
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12
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Richardson MD, Warnock DW. Enzyme-linked immunosorbent assay and its application to the serological diagnosis of fungal infection. SABOURAUDIA 1983; 21:1-14. [PMID: 6342173 DOI: 10.1080/00362178385380031] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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13
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Richardson MD, Stubbins JM, Warnock DW. Rapid enzyme-linked immunosorbent assay (ELISA) for Aspergillus fumigatus antibodies. J Clin Pathol 1982; 35:1134-7. [PMID: 6813358 PMCID: PMC497897 DOI: 10.1136/jcp.35.10.1134] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A rapid enzyme-linked immunosorbent assay (ELISA) where component incubation periods were shortened to one hour, was compared with agar gel double diffusion (AGDD) and a standard ELISA procedure for detecting antibodies to Aspergillus fumigatus in 28 asthmatic patients with suspected allergic aspergillosis. Using two A fumigatus antigens the rapid ELISA compared well with AGDD and the standard ELISA method. Eleven sera that reacted with both antigens in AGDD were all positive against antigen 1 in both forms of ELISA, but two failed to react with antigen 2 in the standard ELISA and three failed to react with this antigen in the rapid method. Thirteen AGDD-negative sera were also negative in both forms of ELISA. The rapid ELISA provides a sensitive and reproducible test for routine serological investigation of allergic aspergillosis.
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14
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15
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Mantyjärvi RA, Jousilahti P, Katila ML. Antibodies to Aspergillus fumigatus in farmers' lung patients measured by enzyme-linked immunosorbent assay (ELISA). CLINICAL ALLERGY 1980; 10:187-94. [PMID: 6993041 DOI: 10.1111/j.1365-2222.1980.tb02096.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Enzyme-linked immunosorbent assay (ELISA) was used to measure antibodies against Aspergillus fumigatus in farmers' lung patients, various other pulmonary diseases and healthy controls. Both the prevalence and the mean titre of antibodies were significantly higher in farmers' lung patients than in the other groups. There was no difference between controls and patients with bronchial asthma or non-allergic pulmonary diseases. On the other hand, in the group of patients with respiratory diseases of undefined aetiology the mean antibody titre was significantly higher than that of the controls. Comparison of ELISA and the precipitin test showed the higher sensitivity of ELISA, but otherwise the two tests were in a close agreement.
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16
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Tilton RC. Counterimmunoelectrophoresis in biology and medicine. CRC CRITICAL REVIEWS IN CLINICAL LABORATORY SCIENCES 1978; 9:347-65. [PMID: 401375 DOI: 10.3109/10408367809150925] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The review will initially focus on the historical development of counterimmunoelectrophoresis (CIE). A part of the manuscript will be devoted to methodological considerations of CIE as well as a discussion of the antisera used. The body of the review will detail each test procedure for which CIE is applicable and discuss unique elements of technique and limits of detection, as well as clinical interpretation of results. The final section will summarize potential applications of CIE in microbiology.
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Affiliation(s)
- R C Tilton
- Department of Laboratory Medicine, University of Connecticut School of Medicine, Farmington
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17
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Warnock DW. Detection of Aspergillus fumigatus precipitins: a comparison of counter immunoelectrophoresis and double diffusion. J Clin Pathol 1977; 30:388-9. [PMID: 404338 PMCID: PMC476417 DOI: 10.1136/jcp.30.4.388] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A counter immunoelectrophoresis method was compared with a double diffusion test for detecting Aspergillus fumigatus antibodies. Of 70 patients, 23 gave positive results in both tests and the remainder gave negative results. Fifteen patients with proven aspergillosis gave positive results in both tests.
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Abstract
Sera from 35 apparently normal humans, 37 compromised human patients, 30 hedgehogs and 30 sheep, were examined for precipitating antibodies to four opportunistic fungi - Absidia corymbifera, Aspergillus fumigatus, Candida albicans and Rhizopus arrhizus-using counterimmunoelectrophoresis (CIE). Precipitins to A. fumigatus were almost exclusively confined to specimens obtained from the compromised human group (51% of those examined) while Candida precipitating antibodies were detected in the sera of both normal (26%) and compromised (49%) humans and in 10% of the hedgehog specimens. Serum precipitins against the two phycomycetes included in the investigations were rare. Because of the complexity of most fungal antigen extracts, it appears the two phycomycetes included in the investigations were rare. Beause of the complexity of most fungal antigen extracts, it appears essential that sera be tested against a number of different antigen concentrations if CIE is to be used with confidence in fungal serology.
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