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Mota SM, Girling SJ, Cole G, Brown D, Johnson G, Naylor AD. APPLICATION OF A NOVEL ASPERGILLUS LATERAL-FLOW DEVICE IN THE DIAGNOSIS OF ASPERGILLOSIS IN CAPTIVE GENTOO PENGUINS ( PYGOSCELIS PAPUA PAPUA). J Zoo Wildl Med 2023; 54:360-366. [PMID: 37428700 DOI: 10.1638/2021-0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2022] [Indexed: 07/12/2023] Open
Abstract
Aspergillosis is the primary fungal disease affecting captive penguins globally. Its diagnosis remains challenging, and currently no tests are both sensitive and specific for the detection of early infection. The present study evaluated a recently developed Aspergillus lateral-flow device (AspLFD) for the detection of Aspergillus spp. antigen in plasma and glottis mucus from captive penguins. In a pilot retrospective study, banked frozen plasma samples from captive penguins were reviewed: samples from 11 gentoo penguins (Pygoscelis papua papua) and 4 king penguins (Aptenodytes patagonicus) fulfilled the inclusion criteria and were used in the analysis. Positive plasma AspLFD test results were found in 80% (four of five) of the aspergillosis-positive cases tested. All of the aspergillosis-negative cases tested negative (10 of 10) on the AspLFD test. In a cohort prospective study, paired plasma and glottis swab samples were opportunistically and nonrandomly collected from captive gentoo penguins. In total, 26 penguins were tested. In the negative control group, AspLFD test was negative on plasma and swab in 100% of birds (14 of 14). In the aspergillosis-positive group, AspLFD test was positive on plasma samples from 33% (4 of 12) of birds, on swab samples from 50% (6 of 12) of birds, and on either plasma or swab samples from 75% (9 of 12) of birds. The AspLFD is currently used for the diagnosis of aspergillosis in humans and also shows promise for use in penguins. Larger prospective studies are recommended.
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Affiliation(s)
- Stéphanie M Mota
- Veterinary Department, Royal Zoological Society of Scotland (RZSS), Edinburgh Zoo, Edinburgh, EH12 6TS, United Kingdom,
| | - Simon J Girling
- Veterinary Department, Royal Zoological Society of Scotland (RZSS), Edinburgh Zoo, Edinburgh, EH12 6TS, United Kingdom
| | - Georgina Cole
- Veterinary Department, Royal Zoological Society of Scotland (RZSS), Edinburgh Zoo, Edinburgh, EH12 6TS, United Kingdom
| | - Donna Brown
- Veterinary Department, Royal Zoological Society of Scotland (RZSS), Edinburgh Zoo, Edinburgh, EH12 6TS, United Kingdom
| | - Gemma Johnson
- OLM Diagnostics, Newcastle upon Tyne, NE4 5TF, United Kingdom
| | - Adam D Naylor
- Veterinary Department, Royal Zoological Society of Scotland (RZSS), Edinburgh Zoo, Edinburgh, EH12 6TS, United Kingdom
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Lian X, Scott-Thomas A, Lewis JG, Bhatia M, MacPherson SA, Zeng Y, Chambers ST. Monoclonal Antibodies and Invasive Aspergillosis: Diagnostic and Therapeutic Perspectives. Int J Mol Sci 2022; 23:ijms23105563. [PMID: 35628374 PMCID: PMC9146623 DOI: 10.3390/ijms23105563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 12/13/2022] Open
Abstract
Invasive aspergillosis (IA) is a life-threatening fungal disease that causes high morbidity and mortality in immunosuppressed patients. Early and accurate diagnosis and treatment of IA remain challenging. Given the broad range of non-specific clinical symptoms and the shortcomings of current diagnostic techniques, most patients are either diagnosed as “possible” or “probable” cases but not “proven”. Moreover, because of the lack of sensitive and specific tests, many high-risk patients receive an empirical therapy or a prolonged treatment of high-priced antifungal agents, leading to unnecessary adverse effects and a high risk of drug resistance. More precise diagnostic techniques alongside a targeted antifungal treatment are fundamental requirements for reducing the morbidity and mortality of IA. Monoclonal antibodies (mAbs) with high specificity in targeting the corresponding antigen(s) may have the potential to improve diagnostic tests and form the basis for novel IA treatments. This review summarizes the up-to-date application of mAb-based approaches in assisting IA diagnosis and therapy.
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Affiliation(s)
- Xihua Lian
- Department of Pathology and Biomedical Science, University of Otago, Christchurch 8140, New Zealand; (X.L.); (A.S.-T.); (J.G.L.); (M.B.); (S.A.M.)
- Department of Medical Imaging, The Second Clinical Medical School of Fujian Medical University, Quanzhou 362000, China
| | - Amy Scott-Thomas
- Department of Pathology and Biomedical Science, University of Otago, Christchurch 8140, New Zealand; (X.L.); (A.S.-T.); (J.G.L.); (M.B.); (S.A.M.)
| | - John G. Lewis
- Department of Pathology and Biomedical Science, University of Otago, Christchurch 8140, New Zealand; (X.L.); (A.S.-T.); (J.G.L.); (M.B.); (S.A.M.)
- Steroid and Immunobiochemistry Laboratory, Canterbury Health Laboratories, Christchurch 8140, New Zealand
| | - Madhav Bhatia
- Department of Pathology and Biomedical Science, University of Otago, Christchurch 8140, New Zealand; (X.L.); (A.S.-T.); (J.G.L.); (M.B.); (S.A.M.)
| | - Sean A. MacPherson
- Department of Pathology and Biomedical Science, University of Otago, Christchurch 8140, New Zealand; (X.L.); (A.S.-T.); (J.G.L.); (M.B.); (S.A.M.)
- Haematology Department, Christchurch Hospital, Christchurch 8011, New Zealand
| | - Yiming Zeng
- Department of Internal Medicine (Pulmonary and Critical Care Medicine), The Second Clinical Medical School of Fujian Medical University, Quanzhou 362000, China;
| | - Stephen T. Chambers
- Department of Pathology and Biomedical Science, University of Otago, Christchurch 8140, New Zealand; (X.L.); (A.S.-T.); (J.G.L.); (M.B.); (S.A.M.)
- Correspondence: ; Tel.: +64-3-364-0649
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Kuzma BA, Pence IJ, Greenfield DA, Ho A, Evans CL. Visualizing and quantifying antimicrobial drug distribution in tissue. Adv Drug Deliv Rev 2021; 177:113942. [PMID: 34437983 DOI: 10.1016/j.addr.2021.113942] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/11/2021] [Accepted: 08/18/2021] [Indexed: 12/15/2022]
Abstract
The biodistribution and pharmacokinetics of drugs are vital to the mechanistic understanding of their efficacy. Measuring antimicrobial drug efficacy has been challenging as plasma drug concentration is used as a surrogate for tissue drug concentration, yet typically does not reflect that at the intended site(s) of action. Utilizing an image-guided approach, it is feasible to accurately quantify the biodistribution and pharmacokinetics within the desired site(s) of action. We outline imaging modalities used in visualizing drug distribution with examples ranging from in vitro cellular drug uptake to clinical treatment of microbial infections. The imaging modalities of interest are: radio-labeling, magnetic resonance, mass spectrometry imaging, computed tomography, fluorescence, and Raman spectroscopy. We outline the progress, limitations, and future outlook for each methodology. Further advances in these optical approaches would benefit patients and researchers alike, as non-invasive imaging could yield more profound insights with a lower clinical burden than invasive measurement approaches used today.
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Affiliation(s)
- Benjamin A Kuzma
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA
| | - Isaac J Pence
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA
| | - Daniel A Greenfield
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA
| | - Alexander Ho
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA
| | - Conor L Evans
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA.
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Gunzer M, Thornton CR, Beziere N. Advances in the In Vivo Molecular Imaging of Invasive Aspergillosis. J Fungi (Basel) 2020; 6:jof6040338. [PMID: 33291706 PMCID: PMC7761943 DOI: 10.3390/jof6040338] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 02/07/2023] Open
Abstract
Invasive pulmonary aspergillosis (IPA) is a life-threatening infection of immunocompromised patients with Aspergillus fumigatus, a ubiquitous environmental mould. While there are numerous functioning antifungal therapies, their high cost, substantial side effects and fear of overt resistance development preclude permanent prophylactic medication of risk-patients. Hence, a fast and definitive diagnosis of IPA is desirable, to quickly identify those patients that really require aggressive antimycotic treatment and to follow the course of the therapeutic intervention. However, despite decades of research into this issue, such a diagnostic procedure is still not available. Here, we discuss the array of currently available methods for IPA detection and their limits. We then show that molecular imaging using positron emission tomography (PET) combined with morphological computed tomography or magnetic imaging is highly promising to become a future non-invasive approach for IPA diagnosis and therapy monitoring, albeit still requiring thorough validation and relying on further acceptance and dissemination of the approach. Thereby, our approach using the A. fumigatus-specific humanized monoclonal antibody hJF5 labelled with 64Cu as PET-tracer has proven highly effective in pre-clinical models and hence bears high potential for human application.
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Affiliation(s)
- Matthias Gunzer
- Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, 45147 Essen, Germany
- Leibniz-Institut für Analytische Wissenschaften-ISAS-e.V., 44227 Dortmund, Germany
- Correspondence: (M.G.); (N.B.); Tel.: +49-201-183-6640 (M.G.); +49-7071-29-87511 (N.B.)
| | - Christopher R. Thornton
- ISCA Diagnostics Ltd. and Biosciences, College of Life & Environmental Sciences, University of Exeter, Exeter EX4 4PY, UK;
| | - Nicolas Beziere
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University Tübingen, 72076 Tübingen, Germany
- Correspondence: (M.G.); (N.B.); Tel.: +49-201-183-6640 (M.G.); +49-7071-29-87511 (N.B.)
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Thornton CR. Detection of the 'Big Five' mold killers of humans: Aspergillus, Fusarium, Lomentospora, Scedosporium and Mucormycetes. ADVANCES IN APPLIED MICROBIOLOGY 2019; 110:1-61. [PMID: 32386603 DOI: 10.1016/bs.aambs.2019.10.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Fungi are an important but frequently overlooked cause of morbidity and mortality in humans. Life-threatening fungal infections mainly occur in immunocompromised patients, and are typically caused by environmental opportunists that take advantage of a weakened immune system. The filamentous fungus Aspergillus fumigatus is the most important and well-documented mold pathogen of humans, causing a number of complex respiratory diseases, including invasive pulmonary aspergillosis, an often fatal disease in patients with acute leukemia or in immunosuppressed bone marrow or solid organ transplant recipients. However, non-Aspergillus molds are increasingly reported as agents of disseminated diseases, with Fusarium, Scedosporium, Lomentospora and mucormycete species now firmly established as pathogens of immunosuppressed and immunocompetent individuals. Despite well-documented risk factors for invasive fungal diseases, and increased awareness of the risk factors for life-threatening infections, the number of deaths attributable to molds is likely to be severely underestimated driven, to a large extent, by the lack of readily accessible, cheap, and accurate tests that allow detection and differentiation of infecting species. Early diagnosis is critical to patient survival but, unlike Aspergillus diseases, where a number of CE-marked or FDA-approved biomarker tests are now available for clinical diagnosis, similar tests for fusariosis, scedosporiosis and mucormycosis remain experimental, with detection reliant on insensitive and slow culture of pathogens from invasive bronchoalveolar lavage fluid, tissue biopsy, or from blood. This review examines the ecology, epidemiology, and contemporary methods of detection of these mold pathogens, and the obstacles to diagnostic test development and translation of novel biomarkers to the clinical setting.
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Hoenigl M, Orasch T, Faserl K, Prattes J, Loeffler J, Springer J, Gsaller F, Reischies F, Duettmann W, Raggam RB, Lindner H, Haas H. Triacetylfusarinine C: A urine biomarker for diagnosis of invasive aspergillosis. J Infect 2019; 78:150-157. [PMID: 30267801 PMCID: PMC6361682 DOI: 10.1016/j.jinf.2018.09.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/20/2018] [Accepted: 09/11/2018] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Early diagnosis of invasive aspergillosis (IA) remains challenging, with available diagnostics being limited by inadequate sensitivities and specificities. Triacetylfusarinine C, a fungal siderophore that has been shown to accumulate in urine in animal models, is a potential new biomarker for diagnosis of IA. METHODS We developed a method allowing absolute and matrix-independent mass spectrometric quantification of TAFC. Urine TAFC, normalized to creatinine, was determined in 44 samples from 24 patients with underlying hematologic malignancies and probable, possible or no IA according to current EORTC/MSG criteria and compared to other established biomarkers measured in urine and same-day blood samples. RESULTS TAFC/creatinine sensitivity, specificity, positive and negative likelihood ratio for probable versus no IA (cut-off ≥ 3) were 0.86, 0.88, 6.86, 0.16 per patient. CONCLUSION For the first time, we provide proof for the occurrence of TAFC in human urine. TAFC/creatinine index determination in urine showed promising results for diagnosis of IA offering the advantages of non-invasive sampling. Sensitivity and specificity were similar as reported for GM determination in serum and bronchoalveolar lavage, the gold standard mycological criterion for IA diagnosis.
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Affiliation(s)
- Martin Hoenigl
- Section of Infectious Diseases and Tropical Medicine, Medical University of Graz, Graz, Austria; CBmed Center for Biomarker Research in Medicine, Graz, Austria; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Thomas Orasch
- Division of Molecular Biology, Medical University of Innsbruck, Innrain 80/82, 6020 Innsbruck, Austria
| | - Klaus Faserl
- Division of Clinical Biochemistry, Medical University of Innsbruck, Innrain 80/82, 6020 Innsbruck, Austria
| | - Juergen Prattes
- Section of Infectious Diseases and Tropical Medicine, Medical University of Graz, Graz, Austria; CBmed Center for Biomarker Research in Medicine, Graz, Austria
| | - Juergen Loeffler
- Department for Internal Medicine II, University of Wuerzburg Medical Centre, Wuerzburg, Germany
| | - Jan Springer
- Department for Internal Medicine II, University of Wuerzburg Medical Centre, Wuerzburg, Germany
| | - Fabio Gsaller
- Division of Molecular Biology, Medical University of Innsbruck, Innrain 80/82, 6020 Innsbruck, Austria
| | - Frederike Reischies
- Section of Infectious Diseases and Tropical Medicine, Medical University of Graz, Graz, Austria
| | - Wiebke Duettmann
- Section of Infectious Diseases and Tropical Medicine, Medical University of Graz, Graz, Austria
| | - Reinhard B Raggam
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria; Division of Angiology, Medical University of Graz, Graz, Austria
| | - Herbert Lindner
- Division of Clinical Biochemistry, Medical University of Innsbruck, Innrain 80/82, 6020 Innsbruck, Austria.
| | - Hubertus Haas
- Division of Molecular Biology, Medical University of Innsbruck, Innrain 80/82, 6020 Innsbruck, Austria.
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7
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Patterson TF, Donnelly JP. New Concepts in Diagnostics for Invasive Mycoses: Non-Culture-Based Methodologies. J Fungi (Basel) 2019; 5:E9. [PMID: 30658509 PMCID: PMC6463019 DOI: 10.3390/jof5010009] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/14/2019] [Accepted: 01/15/2019] [Indexed: 12/22/2022] Open
Abstract
Non-culture-based diagnostics have been developed to help establish an early diagnosis of invasive fungal infection. Studies have shown that these tests can significantly impact the diagnosis of infection in high risk patients. Aspergillus galactomannan EIA testing is well-recognized as an important adjunct to the diagnosis of invasive aspergillosis and can be detected in serum, bronchoalveolar lavage and other fluids. Galactomannan testing used along with PCR testing has been shown to be effective when integrated into care paths for high risk patients for both diagnoses and as a surrogate marker for outcome when used in serial testing. Beta-d-glucan assays are non-specific for several fungal genera including Aspergillus and Candida and in high risk patients have been an important tool to augment the diagnosis. Lateral flow technology using monoclonal antibodies to Aspergillus are available that allow rapid testing of clinical samples. While standard PCR for Candida remains investigational, T2 magnetic resonance allows for the rapid diagnosis of Candida species from blood cultures. Aspergillus PCR has been extensively validated with standardized approaches established for these methods and will be included in the diagnostic criteria in the revised European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC-MSG) definitions. Finally, these non-culture-based tests can be used in combination to significantly increase the detection of invasive mycoses with the ultimate aim of establishing an early diagnosis of infection.
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Affiliation(s)
- Thomas F Patterson
- Division of Infectious Diseases, San Antonio Center for Medical Mycology, The University of Texas Health Science Center at San Antonio and the South Texas Veterans Health Care System, 7703 Floyd Curl Drive-MSC 7881, San Antonio, TX 78229-3900, USA.
| | - J Peter Donnelly
- Division of Infectious Diseases, San Antonio Center for Medical Mycology, The University of Texas Health Science Center at San Antonio and the South Texas Veterans Health Care System, 7703 Floyd Curl Drive-MSC 7881, San Antonio, TX 78229-3900, USA.
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8
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Savelieff MG, Pappalardo L, Azmanis P. The current status of avian aspergillosis diagnoses: Veterinary practice to novel research avenues. Vet Clin Pathol 2018; 47:342-362. [DOI: 10.1111/vcp.12644] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
| | - Lucia Pappalardo
- Department of Biology, Chemistry and Environmental Sciences; American University of Sharjah; Sharjah United Arab Emirates
| | - Panagiotis Azmanis
- Dubai Falcon Hospital/Wadi Al Safa Wildlife Center; Dubai United Arab Emirates
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9
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Thornton CR. Molecular Imaging of Invasive Pulmonary Aspergillosis Using ImmunoPET/MRI: The Future Looks Bright. Front Microbiol 2018; 9:691. [PMID: 29686661 PMCID: PMC5900000 DOI: 10.3389/fmicb.2018.00691] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 03/23/2018] [Indexed: 12/19/2022] Open
Abstract
Invasive pulmonary aspergillosis (IPA) is a life-threatening lung disease of immuno-compromised humans caused by the ubiquitous environmental mold Aspergillus. Biomarker tests for the disease lack sensitivity and specificity, and culture of the fungus from invasive lung biopsy is slow, insensitive, and undesirable in critically ill patients. A computed tomogram (CT) of the chest offers a simple non-intrusive diagnostic procedure for rapid decision making, and so is used in many hematology units to drive antifungal treatment. However, radiological indicators that raise the suspicion of IPA are either transient signs in the early stages of the disease or not specific for Aspergillus infection, with other angio-invasive molds or bacterial pathogens producing comparable radiological manifestations in a chest CT. Improvements to the specificity of radiographic imaging of IPA have been attempted by coupling CT and positron emission tomography (PET) with [18F]fluorodeoxyglucose ([18F]FDG), a marker of metabolic activity well suited to cancer imaging, but with limited use in invasive fungal disease diagnostics due to its inability to differentiate between infectious etiologies, cancer, and inflammation. Bioluminescence imaging using single genetically modified strains of Aspergillus fumigatus has enabled in vivo monitoring of IPA in animal models of disease. For in vivo detection of Aspergillus lung infections in humans, radiolabeled Aspergillus-specific monoclonal antibodies, and iron siderophores, hold enormous potential for clinical diagnosis. This review examines the different experimental technologies used to image IPA, and recent advances in state-of-the-art molecular imaging of IPA using antibody-guided PET/magnetic resonance imaging (immunoPET/MRI).
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Affiliation(s)
- Christopher R Thornton
- Department of Biosciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom.,ISCA Diagnostics Ltd., Exeter, United Kingdom
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10
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Davies G, Rolle AM, Maurer A, Spycher PR, Schillinger C, Solouk-Saran D, Hasenberg M, Weski J, Fonslet J, Dubois A, Boschetti F, Denat F, Gunzer M, Eichner M, Ryder LS, Jensen M, Schibli R, Pichler BJ, Wiehr S, Thornton CR. Towards Translational ImmunoPET/MR Imaging of Invasive Pulmonary Aspergillosis: The Humanised Monoclonal Antibody JF5 Detects Aspergillus Lung Infections In Vivo. Am J Cancer Res 2017; 7:3398-3414. [PMID: 28912884 PMCID: PMC5596432 DOI: 10.7150/thno.20919] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 07/04/2017] [Indexed: 01/07/2023] Open
Abstract
Invasive pulmonary aspergillosis (IPA) is a life-threatening lung disease of hematological malignancy or bone marrow transplant patients caused by the ubiquitous environmental fungus Aspergillus fumigatus. Current diagnostic tests for the disease lack sensitivity as well as specificity, and culture of the fungus from invasive lung biopsy, considered the gold standard for IPA detection, is slow and often not possible in critically ill patients. In a previous study, we reported the development of a novel non-invasive procedure for IPA diagnosis based on antibody-guided positron emission tomography and magnetic resonance imaging (immunoPET/MRI) using a [64Cu]DOTA-labeled mouse monoclonal antibody (mAb), mJF5, specific to Aspergillus. To enable translation of the tracer to the clinical setting, we report here the development of a humanised version of the antibody (hJF5), and pre-clinical imaging of lung infection using a [64Cu]NODAGA-hJF5 tracer. The humanised antibody tracer shows a significant increase in in vivo biodistribution in A. fumigatus infected lungs compared to its radiolabeled murine counterpart [64Cu]NODAGA-mJF5. Using reverse genetics of the pathogen, we show that the antibody binds to the antigenic determinant β1,5-galactofuranose (Galf) present in a diagnostic mannoprotein antigen released by the pathogen during invasive growth in the lung. The absence of the epitope Galf in mammalian carbohydrates, coupled with the enhanced imaging capabilities of the hJF5 antibody, means that the [64Cu]NODAGA-hJF5 tracer developed here represents an ideal candidate for the diagnosis of IPA and translation to the clinical setting.
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Abstract
Fungal organisms are ubiquitous in the environment. Pathogenic fungi, although relatively few in the whole gamut of microbial pathogens, are able to cause disease with varying degrees of severity in individuals with normal or impaired immunity. The disease state is an outcome of the fungal pathogen's interactions with the host immunity, and therefore, it stands to reason that deep/invasive fungal diseases be amenable to immunotherapy. Therefore, antifungal immunotherapy continues to be attractive as an adjunct to the currently available antifungal chemotherapy options for a number of reasons, including the fact that existing antifungal drugs, albeit largely effective, are not without limitations, and that morbidity and mortality associated with invasive mycoses are still unacceptably high. For several decades, intense basic research efforts have been directed at development of fungal immunotherapies. Nevertheless, this approach suffers from a severe bench-bedside disconnect owing to several reasons: the chemical and biological peculiarities of the fungal antigens, the complexities of host-pathogen interactions, an under-appreciation of the fungal disease landscape, the requirement of considerable financial investment to bring these therapies to clinical use, as well as practical problems associated with immunizations. In this general, non-exhaustive review, we summarize the features of ongoing research efforts directed towards devising safe and effective immunotherapeutic options for mycotic diseases, encompassing work on antifungal vaccines, adoptive cell transfers, cytokines, antimicrobial peptides (AMPs), monoclonal antibodies (mAbs), and other agents.
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Affiliation(s)
- Kausik Datta
- a Division of Infectious Diseases , Johns Hopkins University School of Medicine , Baltimore , MD , USA , and
| | - Mawieh Hamad
- b Department of Medical Laboratory Sciences and the Sharjah Institute for Medical Research , University of Sharjah , Sharjah , UAE
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12
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Pluhacek T, Petrik M, Luptakova D, Benada O, Palyzova A, Lemr K, Havlicek V. Aspergillus
infection monitored by multimodal imaging in a rat model. Proteomics 2016; 16:1785-92. [DOI: 10.1002/pmic.201500487] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 03/20/2016] [Accepted: 03/30/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Tomas Pluhacek
- Institute of Microbiology of the CAS; v.v.i; Prague Czech Republic
- Regional Centre of Advanced Technologies and Materials; Department of Analytical Chemistry; Faculty of Science; Palacky University; Olomouc Czech Republic
| | - Milos Petrik
- Institute of Molecular and Translational Medicine; Faculty of Medicine and Dentistry; Palacky University; Olomouc Czech Republic
| | - Dominika Luptakova
- Institute of Microbiology of the CAS; v.v.i; Prague Czech Republic
- Department of Pharmacology; Jessenius Faculty of Medicine; Comenius University Bratislava; BioMed Martin Slovakia
| | - Oldrich Benada
- Institute of Microbiology of the CAS; v.v.i; Prague Czech Republic
| | - Andrea Palyzova
- Institute of Microbiology of the CAS; v.v.i; Prague Czech Republic
| | - Karel Lemr
- Institute of Microbiology of the CAS; v.v.i; Prague Czech Republic
- Regional Centre of Advanced Technologies and Materials; Department of Analytical Chemistry; Faculty of Science; Palacky University; Olomouc Czech Republic
| | - Vladimir Havlicek
- Institute of Microbiology of the CAS; v.v.i; Prague Czech Republic
- Regional Centre of Advanced Technologies and Materials; Department of Analytical Chemistry; Faculty of Science; Palacky University; Olomouc Czech Republic
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Abstract
A gathering body of evidence has repeatedly revealed associations between indoor fungi and initiation, promotion, and exacerbation of allergic respiratory disease. The relationship between the exposure and outcome are complicated by the difficulties in measuring both exposure and outcome, the multifactorial nature of the disease, and the wide range of potential confounders. New technologies are becoming available that may enable better measurement of exposure and tighter case definitions so as to build more confidence in the associations discovered. The growing strength of the evidence base will aid the design of future public health interventions and generate new hypotheses on the cause of the rapid increase in allergic respiratory disease prevalence.
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Abstract
Infektiöse Lungenerkrankungen oder Pneumonien sind die Haupttodesursache innerhalb der Infektionskrankheiten in Deutschland. Hierbei ist die bakterielle Verursachung am häufigsten. Die Form der Entzündung wird meist durch das schädigende Agens bestimmt, jedoch sind häufig verschiedene Reaktionen anzutreffen. Morphologisch kann nur in wenigen Fällen der Erreger konkret bestimmt werden, sodass meist eine zusätzliche mikrobiologische Erregerdiagnostik notwendig ist. Klinisch erfolgt eine Einteilung in ambulant erworbene und nosokomiale Pneumonien, Pneumonien bei Immunsuppression und die Mykobakteriosen. Histologisch ist eine Einteilung gemäß der bevorzugten Ausbreitung in alveoläre und interstitielle bzw. in lobäre und herdförmige Pneumonien möglich.
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15
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Haas H, Petrik M, Decristoforo C. An iron-mimicking, Trojan horse-entering fungi--has the time come for molecular imaging of fungal infections? PLoS Pathog 2015; 11:e1004568. [PMID: 25634225 PMCID: PMC4310729 DOI: 10.1371/journal.ppat.1004568] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Hubertus Haas
- Division of Molecular Biology/Biocenter, Innsbruck Medical University, Innsbruck, Austria
- * E-mail: (HH); (CD)
| | - Milos Petrik
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Clemens Decristoforo
- Clinical Department of Nuclear Medicine, Innsbruck Medical University, Innsbruck, Austria
- * E-mail: (HH); (CD)
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