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1.
Nat Immunol ; 20(11): 1469-1480, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31591568

RESUMEN

Tissue-resident memory T cells (TRM cells) are crucial mediators of adaptive immunity in nonlymphoid tissues. However, the functional heterogeneity and pathogenic roles of CD4+ TRM cells that reside within chronic inflammatory lesions remain unknown. We found that CD69hiCD103lo CD4+ TRM cells produced effector cytokines and promoted the inflammation and fibrotic responses induced by chronic exposure to Aspergillus fumigatus. Simultaneously, immunosuppressive CD69hiCD103hiFoxp3+ CD4+ regulatory T cells were induced and constrained the ability of pathogenic CD103lo TRM cells to cause fibrosis. Thus, lung tissue-resident CD4+ T cells play crucial roles in the pathology of chronic lung inflammation, and CD103 expression defines pathogenic effector and immunosuppressive tissue-resident cell subpopulations in the inflamed lung.


Asunto(s)
Comunicación Celular/inmunología , Tolerancia Inmunológica , Memoria Inmunológica , Fibrosis Pulmonar/inmunología , Linfocitos T Reguladores/inmunología , Animales , Antígenos CD/metabolismo , Antígenos Fúngicos/inmunología , Aspergillus fumigatus/inmunología , Citocinas/metabolismo , Modelos Animales de Enfermedad , Femenino , Humanos , Cadenas alfa de Integrinas/metabolismo , Pulmón/citología , Pulmón/inmunología , Pulmón/patología , Masculino , Ratones Transgénicos , Fibrosis Pulmonar/patología , Linfocitos T Reguladores/metabolismo
2.
Immunity ; 50(1): 152-165.e8, 2019 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-30611611

RESUMEN

The ability of the immune system to discriminate self from non-self is essential for eradicating microbial pathogens but is also responsible for allograft rejection. Whether it is possible to selectively suppress alloresponses while maintaining anti-pathogen immunity remains unknown. We found that mice deficient in coronin 1, a regulator of naive T cell homeostasis, fully retained allografts while maintaining T cell-specific responses against microbial pathogens. Mechanistically, coronin 1-deficiency increased cyclic adenosine monophosphate (cAMP) concentrations to suppress allo-specific T cell responses. Costimulation induced on microbe-infected antigen presenting cells was able to overcome cAMP-mediated immunosuppression to maintain anti-pathogen immunity. In vivo pharmacological modulation of this pathway or a prior transfer of coronin 1-deficient T cells actively suppressed allograft rejection. These results define a coronin 1-dependent regulatory axis in T cells important for allograft rejection and suggest that modulation of this pathway may be a promising approach to achieve long-term acceptance of mismatched allografts.


Asunto(s)
Rechazo de Injerto/inmunología , Trasplante de Corazón , Infecciones/inmunología , Proteínas de Microfilamentos/metabolismo , Trasplante de Piel , Linfocitos T/inmunología , Aloinjertos/inmunología , Animales , Antígenos Bacterianos/inmunología , Antígenos Fúngicos/inmunología , Antígenos Virales/inmunología , Células Cultivadas , AMP Cíclico/inmunología , Supervivencia de Injerto , Homeostasis/genética , Humanos , Inmunidad , Terapia de Inmunosupresión , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Ratones Noqueados , Transducción de Señal , Tolerancia al Trasplante
3.
Nat Immunol ; 16(6): 642-52, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25915733

RESUMEN

Fungal infection stimulates the canonical C-type lectin receptor (CLR) signaling pathway via activation of the tyrosine kinase Syk. Here we identify a crucial role for the tyrosine phosphatase SHP-2 in mediating CLR-induced activation of Syk. Ablation of the gene encoding SHP-2 (Ptpn11; called 'Shp-2' here) in dendritic cells (DCs) and macrophages impaired Syk-mediated signaling and abrogated the expression of genes encoding pro-inflammatory molecules following fungal stimulation. Mechanistically, SHP-2 operated as a scaffold, facilitating the recruitment of Syk to the CLR dectin-1 or the adaptor FcRγ, through its N-SH2 domain and a previously unrecognized carboxy-terminal immunoreceptor tyrosine-based activation motif (ITAM). We found that DC-derived SHP-2 was crucial for the induction of interleukin 1ß (IL-1ß), IL-6 and IL-23 and anti-fungal responses of the TH17 subset of helper T cells in controlling infection with Candida albicans. Together our data reveal a mechanism by which SHP-2 mediates the activation of Syk in response to fungal infection.


Asunto(s)
Candidiasis/inmunología , Células Dendríticas/fisiología , Péptidos y Proteínas de Señalización Intracelular/metabolismo , Macrófagos/fisiología , Proteína Tirosina Fosfatasa no Receptora Tipo 11/metabolismo , Proteínas Tirosina Quinasas/metabolismo , Linfocitos T Colaboradores-Inductores/inmunología , Células Th17/inmunología , Secuencias de Aminoácidos/genética , Animales , Antígenos Fúngicos/inmunología , Células Cultivadas , Citocinas/metabolismo , Activación Enzimática , Mediadores de Inflamación/metabolismo , Lectinas Tipo C/genética , Lectinas Tipo C/metabolismo , Activación de Linfocitos , Proteínas de la Membrana/genética , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Mutación/genética , Proteína Tirosina Fosfatasa no Receptora Tipo 11/genética , Receptores de IgE/genética , Receptores de IgE/metabolismo , Transducción de Señal , Quinasa Syk
4.
Nature ; 596(7870): 114-118, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-34262174

RESUMEN

Pathogenic fungi reside in the intestinal microbiota but rarely cause disease. Little is known about the interactions between fungi and the immune system that promote commensalism. Here we investigate the role of adaptive immunity in promoting mutual interactions between fungi and host. We find that potentially pathogenic Candida species induce and are targeted by intestinal immunoglobulin A (IgA) responses. Focused studies on Candida albicans reveal that the pathogenic hyphal morphotype, which is specialized for adhesion and invasion, is preferentially targeted and suppressed by intestinal IgA responses. IgA from mice and humans directly targets hyphal-enriched cell-surface adhesins. Although typically required for pathogenesis, C. albicans hyphae are less fit for gut colonization1,2 and we show that immune selection against hyphae improves the competitive fitness of C. albicans. C. albicans exacerbates intestinal colitis3 and we demonstrate that hyphae and an IgA-targeted adhesin exacerbate intestinal damage. Finally, using a clinically relevant vaccine to induce an adhesin-specific immune response protects mice from C. albicans-associated damage during colitis. Together, our findings show that adaptive immunity suppresses harmful fungal effectors, with benefits to both C. albicans and its host. Thus, IgA uniquely uncouples colonization from pathogenesis in commensal fungi to promote homeostasis.


Asunto(s)
Inmunidad Adaptativa , Candida albicans/inmunología , Candida albicans/fisiología , Interacciones Huésped-Patógeno/inmunología , Simbiosis/inmunología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Antígenos Fúngicos/inmunología , Candida albicans/patogenicidad , Colitis/inmunología , Colitis/microbiología , Colitis/patología , Femenino , Vacunas Fúngicas/inmunología , Microbioma Gastrointestinal/inmunología , Humanos , Hifa/inmunología , Inmunoglobulina A/inmunología , Masculino , Ratones , Persona de Mediana Edad , Adulto Joven
5.
PLoS Pathog ; 20(7): e1012220, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38976694

RESUMEN

The fungal infection, cryptococcosis, is responsible for >100,000 deaths annually. No licensed vaccines are available. We explored the efficacy and immune responses of subunit cryptococcal vaccines adjuvanted with Cationic Adjuvant Formulation 01 (CAF01). CAF01 promotes humoral and T helper (Th) 1 and Th17 immune responses and has been safely used in human vaccine trials. Four subcutaneous vaccines, each containing single recombinant Cryptococcus neoformans protein antigens, partially protected mice from experimental cryptococcosis. Protection increased, up to 100%, in mice that received bivalent and quadrivalent vaccine formulations. Vaccinated mice that received a pulmonary challenge with C. neoformans had an influx of leukocytes into the lung including robust numbers of polyfunctional CD4+ T cells which produced interferon gamma (IFNγ), tumor necrosis factor alpha (TNFα), and interleukin (IL)-17 upon ex vivo antigenic stimulation. Cytokine-producing lung CD8+ T cells were also found, albeit in lesser numbers. A significant, durable IFNγ response was observed in the lungs, spleen, and blood. Moreover, IFNγ secretion following ex vivo stimulation directly correlated with fungal control in the lungs. Thus, we have developed multivalent cryptococcal vaccines which protect mice from experimental cryptococcosis using an adjuvant which has been safely tested in humans. These preclinical studies suggest a path towards human cryptococcal vaccine trials.


Asunto(s)
Adyuvantes Inmunológicos , Criptococosis , Cryptococcus neoformans , Vacunas Fúngicas , Vacunas de Subunidad , Criptococosis/inmunología , Criptococosis/prevención & control , Animales , Ratones , Vacunas Fúngicas/inmunología , Vacunas Fúngicas/administración & dosificación , Cryptococcus neoformans/inmunología , Vacunas de Subunidad/inmunología , Vacunas de Subunidad/administración & dosificación , Adyuvantes Inmunológicos/administración & dosificación , Femenino , Ratones Endogámicos C57BL , Adyuvantes de Vacunas/administración & dosificación , Antígenos Fúngicos/inmunología , Modelos Animales de Enfermedad
7.
J Allergy Clin Immunol ; 154(2): 424-434, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38663817

RESUMEN

BACKGROUND: Alternaria alternata is associated with allergic respiratory diseases, which can be managed with allergen extract-based diagnostics and immunotherapy. It is not known how spores and hyphae contribute to allergen content. Commercial allergen extracts are manufactured by extracting proteins without separating the different forms of the fungus. OBJECTIVE: We sought to determine differences between spore and hyphae proteomes and how allergens are distributed in Aalternata. METHODS: Data-independent acquisition mass spectrometry was used to quantitatively compare the proteomes of asexual spores (nongerminating and germinating) with vegetative hyphae. RESULTS: We identified 4515 proteins in nongerminating spores, germinating spores, and hyphae; most known allergens are more abundant in nongerminating spores. On comparing significant protein fold-change differences between nongerminating spores and hyphae, we found that 174 proteins were upregulated in nongerminating spores and 80 proteins in hyphae. Among the spore proteins are ones functionally involved in cell wall synthesis, responding to cellular stress, and maintaining redox balance and homeostasis. On comparing nongerminating and germinating spores, 25 proteins were found to be upregulated in nongerminating spores and 54 in germinating spores. Among the proteins specific to germinating spores were proteases known to be virulence factors. One of the most abundant proteins in the spore proteome is sialidase, which has not been identified as an allergen but may be important in the pathogenicity of this fungus. Major allergen Alt a 1 is present at low levels in spores and hyphae and appears to be largely secreted into growth media. CONCLUSIONS: Spores and hyphae express overlapping but distinct proteomes. Most known allergens are found more abundantly in nongerminating spores.


Asunto(s)
Alérgenos , Alternaria , Proteínas Fúngicas , Proteoma , Esporas Fúngicas , Alternaria/inmunología , Alérgenos/inmunología , Esporas Fúngicas/inmunología , Proteínas Fúngicas/inmunología , Proteínas Fúngicas/metabolismo , Hifa/inmunología , Antígenos Fúngicos/inmunología , Estadios del Ciclo de Vida , Humanos
8.
J Proteome Res ; 23(5): 1634-1648, 2024 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-38572994

RESUMEN

The delay in making a correct diagnosis of Candida auris causes concern in the healthcare system setting, and immunoproteomics studies are important to identify immunoreactive proteins for new diagnostic strategies. In this study, immunocompetent murine systemic infections caused by non-aggregative and aggregative phenotypes of C. auris and by Candida albicans and Candida haemulonii were carried out, and the obtained sera were used to study their immunoreactivity against C. auris proteins. The results showed higher virulence, in terms of infection signs, weight loss, and histopathological damage, of the non-aggregative isolate. Moreover, C. auris was less virulent than C. albicans but more than C. haemulonii. Regarding the immunoproteomics study, 13 spots recognized by sera from mice infected with both C. auris phenotypes and analyzed by mass spectrometry corresponded to enolase, phosphoglycerate kinase, glyceraldehyde-3-phosphate dehydrogenase, and phosphoglycerate mutase. These four proteins were also recognized by sera obtained from human patients with disseminated C. auris infection but not by sera obtained from mice infected with C. albicans or Aspergillus fumigatus. Spot identification data are available via ProteomeXchange with the identifier PXD049077. In conclusion, this study showed that the identified proteins could be potential candidates to be studied as new diagnostic or even therapeutic targets for C. auris.


Asunto(s)
Candida , Candidiasis , Inmunoglobulina G , Animales , Ratones , Candida/inmunología , Candida/patogenicidad , Humanos , Candidiasis/inmunología , Candidiasis/microbiología , Candidiasis/sangre , Inmunoglobulina G/sangre , Antígenos Fúngicos/inmunología , Antígenos Fúngicos/sangre , Proteómica/métodos , Candida albicans/inmunología , Candida albicans/patogenicidad , Proteínas Fúngicas/inmunología , Fosfoglicerato Mutasa/inmunología , Fosfoglicerato Quinasa/inmunología , Gliceraldehído-3-Fosfato Deshidrogenasas/inmunología , Gliceraldehído-3-Fosfato Deshidrogenasas/metabolismo , Anticuerpos Antifúngicos/sangre , Anticuerpos Antifúngicos/inmunología , Femenino , Virulencia
9.
Emerg Infect Dis ; 30(8): 1523-1530, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39043389

RESUMEN

Histoplasmosis is a fungal disease associated with substantial mortality rates among persons with advanced HIV disease. Our systematic review synthesized data on the global prevalence of Histoplasma--caused antigenuria in persons with HIV. We searched PubMed/Medline, Embase, and Scopus databases on January 3, 2023, to identify cross-sectional and cohort studies evaluating Histoplasma antigenuria prevalence among adults with HIV infection. We calculated point estimates and 95% CIs to summarize prevalence. Of 1,294 studies screened, we included 15. We found Histoplasma antigenuria among 581/5,096 (11%; 95% CI 11%-12%) persons with HIV and 483/3,789 persons with advanced HIV disease (13%; 95% CI 12%-14%). Among persons with HIV and symptoms consistent with histoplasmosis, Histoplasma antigenuria prevalence was 14% (95% CI 13%-15%; 502/3,631 participants). We determined that persons with advanced HIV disease, inpatients, and symptomatic persons might benefit from a systematic approach to early detection of histoplasmosis using urine antigen testing.


Asunto(s)
Antígenos Fúngicos , Infecciones por VIH , Histoplasma , Histoplasmosis , Humanos , Histoplasmosis/epidemiología , Histoplasmosis/orina , Histoplasmosis/diagnóstico , Histoplasma/inmunología , Infecciones por VIH/epidemiología , Infecciones por VIH/complicaciones , Prevalencia , Antígenos Fúngicos/orina , Antígenos Fúngicos/inmunología , América Latina/epidemiología , África/epidemiología , Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Infecciones Oportunistas Relacionadas con el SIDA/microbiología , Infecciones Oportunistas Relacionadas con el SIDA/orina
10.
J Clin Microbiol ; 62(1): e0121323, 2024 01 17.
Artículo en Inglés | MEDLINE | ID: mdl-38099670

RESUMEN

Histoplasma and Blastomyces antigen detection assays are commonly used diagnostic tools. However, a high level of cross-reactivity between these antigens prevents definitive pathogen identification by these assays alone. Retrospective analysis of 3,529 patients with Histoplasma and Blastomyces antigen testing performed on the same serum sample yielded an overall percent agreement of 99.3% (3,506 of 3,529; kappa: 0.859) between the two assays, suggesting that use of a single assay to detect both antigens may be an alternative diagnostic approach. We assessed performance of the Gotham BioTech Blastomyces antigen (GBA) enzyme immunoassay (EIA) (Portland, Maine) for detection of Blastomyces and Histoplasma antigens in serum. Comparison to the MiraVista Diagnostics Blastomyces (MVB) EIA showed 100% positive (24 of 24), negative (57 of 57), and overall (81 of 81) percent agreement. Additionally, 171 sera were used to compare the GBA EIA to the MiraVista Diagnostics Histoplasma (MVH) EIA, which showed 91.3% (63 of 69), 98% (100 of 102), and 95.3% (163 of 171) positive, negative, and overall percent agreement, respectively. Among eight patients with discordant GBA/MVH EIA results, seven had additional fungal testing performed, and results suggested that the MVH and GBA results were inaccurate for two and five samples, respectively. Overall, this study suggests that the GBA EIA has a high level of agreement with both of the commonly used, individual Blastomyces and Histoplasma antigen EIAs. By taking advantage of the high level of cross-reactivity between Blastomyces and Histoplasma antigen EIAs, utilization of a single antigen detection assay for these fungi provides an opportunity to optimize test utilization and decrease patient cost while maintaining a high level of diagnostic accuracy.


Asunto(s)
Blastomyces , Histoplasma , Humanos , Estudios Retrospectivos , Antígenos Fúngicos , Técnicas para Inmunoenzimas
11.
Allergy ; 79(5): 1208-1218, 2024 05.
Artículo en Inglés | MEDLINE | ID: mdl-38334146

RESUMEN

BACKGROUND: Component-resolved diagnosis allows detection of IgE sensitization having the advantage of reproducibility and standardization compared to crude extracts. The main disadvantage of the traditional allergen identification methods, 1- or 2-dimensional western blotting and screening of expression cDNA libraries with patients' IgEs, is that the native structure of the protein is not necessarily maintained. METHODS: We used a novel immunoprecipitation technique in combination with mass spectrometry to identify new allergens of Aspergillus fumigatus. Magnetic Dynabeads coupled with anti-human IgE antibodies were used to purify human serum IgE and subsequently allergens from A. fumigatus protein extract. RESULTS: Of the 184 proteins detected by subsequent mass peptide fingerprinting, a subset of 13 were recombinantly expressed and purified. In a panel of 52 A. fumigatus-sensitized people with asthma, 23 non-fungal-sensitized asthmatics and 18 healthy individuals, only the former showed an IgE reaction by immunoblotting and/or ELISA. We discovered 11 proteins not yet described as A. fumigatus allergens, with fructose-bisphosphate aldolase class II (FBA2) (33%), NAD-dependent malate dehydrogenase (31%) and Cu/Zn superoxide dismutase (27%) being the most prevalent. With respect to these three allergens, native versus denatured protein assays indicated a better recognition of the native proteins. Seven of 11 allergens fulfilled the WHO/IUIS criteria and were accepted as new A. fumigatus allergens. CONCLUSION: In conclusion, we introduce a straightforward method of allergen identification from complex allergenic sources such as A. fumigatus by immunoprecipitation combined with mass spectrometry, which has the advantage over traditional methods of identifying allergens by maintaining the structure of the proteins.


Asunto(s)
Alérgenos , Antígenos Fúngicos , Aspergillus fumigatus , Asma , Inmunoglobulina E , Humanos , Aspergillus fumigatus/inmunología , Asma/inmunología , Asma/diagnóstico , Alérgenos/inmunología , Inmunoglobulina E/inmunología , Inmunoglobulina E/sangre , Masculino , Femenino , Antígenos Fúngicos/inmunología , Adulto , Persona de Mediana Edad , Inmunoprecipitación , Proteínas Fúngicas/inmunología , Espectrometría de Masas , Anciano , Adulto Joven
12.
Allergy ; 79(8): 2144-2156, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38818808

RESUMEN

BACKGROUND: We investigated the biological function of the mould allergen Alt a 1 as a carrier of micronutrients, such as the vitamin A metabolite retinoic acid (RA) and the influence of RA binding on its allergenicity in vitro and in vivo. METHODS: Alt a 1-RA complex formation was analyzed in silico and in vitro. PBMCs from Alternaria-allergic donors were stimulated with Alt a 1 complexed with RA (holo-Alt a 1) or empty apo-Alt a 1 and analyzed for cytokine production and CD marker expression. Serum IgE-binding and crosslinking assays to apo- and holo-protein were correlated to B-cell epitope analysis. Female BALB/c mice already sensitized to Alt a 1 were intranasally treated with apo-Alt a 1, holo-Alt a 1 or RA alone before measuring anaphylactic response, serum antibody levels, splenic cytokines and CD marker expression. RESULTS: In silico docking calculations and in vitro assays showed that the extent of RA binding depended on the higher quaternary state of Alt a 1. Holo-Alt a 1 loaded with RA reduced IL-13 released from PBMCs and CD3+CD4+CRTh2 cells. Complexing Alt a 1 to RA masked its IgE B-cell epitopes and reduced its IgE-binding capacity. In a therapeutic mouse model of Alternaria allergy nasal application of holo-Alt a 1, but not of apo-Alt a 1, significantly impeded the anaphylactic response, impaired splenic antigen-presenting cells and induced IL-10 production. CONCLUSION: Holo-Alt a 1 binding to RA was able to alleviate Th2 immunity in vitro, modulate an ongoing Th2 response and prevent anaphylactic symptoms in vivo, presenting a novel option for improving allergen-specific immunotherapy in Alternaria allergy.


Asunto(s)
Alérgenos , Alternaria , Antígenos Fúngicos , Citocinas , Modelos Animales de Enfermedad , Inmunoglobulina E , Ratones Endogámicos BALB C , Células Th2 , Tretinoina , Animales , Células Th2/inmunología , Células Th2/metabolismo , Ratones , Alérgenos/inmunología , Alternaria/inmunología , Femenino , Tretinoina/farmacología , Inmunoglobulina E/inmunología , Humanos , Citocinas/metabolismo , Antígenos Fúngicos/inmunología , Hipersensibilidad/inmunología , Proteínas Fúngicas/inmunología
13.
Int Arch Allergy Immunol ; 185(8): 767-774, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38537619

RESUMEN

INTRODUCTION: Aspergillus fumigatus is the most common airborne allergen of the Aspergillus family. However, allergies to Aspergillus spp. are increasing, and subsequently, allergies to Aspergillus species other than fumigatus are also on the rise. Commercial diagnostic tools are still limited to Aspergillus fumigatus. Hence, there is a need for improved tests. We decided to investigate the correlation between serological sensitization to A. fumigatus and other Aspergillus species. METHODS: Hundred and seven patients with positive skin prick tests to A. fumigatus were included in this study. Immunoglobulin E (IgE) concentrations against A. fumigatus, A. terreus, A. niger, A. flavus, and A. versicolor were measured from specimens by fluorescent enzyme-linked immunoassays. RESULTS: Patients showed considerably higher IgE concentrations against A. fumigatus (6.00 ± 15.05 kUA/L) than A. versicolor (0.30 ± 1.01 kUA/L), A. niger (0.62 ± 1.59 kUA/L), A. terreus (0.45 ± 1.12 kUA/L), or A. flavus (0.41 ± 0.97 kUA/L). Regression analysis yielded weak positive correlations for all Aspergillus spp., but low r2 values and heteroscedastic distribution indicate an overall poor fit of the calculated models. CONCLUSION: Serological sensitization against A. fumigatus does not correlate with sensitization against other Aspergillus spp. To detect sensitization against these, other diagnostic tools like a skin prick test solution of different Aspergillus spp. are needed.


Asunto(s)
Anticuerpos Antifúngicos , Aspergillus fumigatus , Aspergillus , Reacciones Cruzadas , Inmunoglobulina E , Pruebas Cutáneas , Humanos , Inmunoglobulina E/sangre , Inmunoglobulina E/inmunología , Reacciones Cruzadas/inmunología , Aspergillus fumigatus/inmunología , Masculino , Femenino , Aspergillus/inmunología , Adulto , Persona de Mediana Edad , Anticuerpos Antifúngicos/sangre , Anticuerpos Antifúngicos/inmunología , Anciano , Alérgenos/inmunología , Antígenos Fúngicos/inmunología , Adolescente , Adulto Joven , Aspergilosis/diagnóstico , Aspergilosis/inmunología
14.
Eur J Clin Microbiol Infect Dis ; 43(9): 1815-1823, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39012550

RESUMEN

PURPOSE: This study aimed to develop a double antigen sandwich ELISA (DAgS-ELISA) method for more efficient, accurate, and quantitative detection of total antibodies against Candida albicans enolase1 (CaEno1) for diagnosing invasive candidiasis (IC). METHODS: DAgS-ELISA was developed using recombinant CaEno1 and a monoclonal antibody as the standard. Performance evaluation included limit of detection, accuracy, and repeatability. Dynamic changes in antibody levels against CaEno1 in serum from systemic candidiasis mice were analyzed using DAgS-ELISA. Patient serum samples from IC, Candida colonization, bacterial infections, and healthy controls were analyzed with DAgS-ELISA and indirect ELISA. RESULTS: DAgS-ELISA outperformed indirect ELISA in terms of linear range and test background. In systemic candidiasis mice, a distinctive 'double-peak' pattern in dynamic antibody levels was observed. Additionally, there was a high level of consistency in the positive rates of CaEno1 antibodies detected by both DAgS-ELISA and indirect ELISA. While the positivity rates differed among patient groups, no significant variations in antibody levels were detected among the various positive patient groups. CONCLUSIONS: DAgS-ELISA offers a reliable novel approach for IC diagnosis, enabling rapid, accurate, and quantitative detection of CaEno1 antibodies. Further validation and optimization are needed for its clinical application and effectiveness.


Asunto(s)
Anticuerpos Antifúngicos , Candida albicans , Ensayo de Inmunoadsorción Enzimática , Fosfopiruvato Hidratasa , Ensayo de Inmunoadsorción Enzimática/métodos , Animales , Fosfopiruvato Hidratasa/inmunología , Fosfopiruvato Hidratasa/sangre , Candida albicans/inmunología , Anticuerpos Antifúngicos/sangre , Ratones , Humanos , Candidiasis Invasiva/diagnóstico , Candidiasis Invasiva/inmunología , Candidiasis Invasiva/sangre , Femenino , Candidiasis/diagnóstico , Candidiasis/sangre , Candidiasis/inmunología , Antígenos Fúngicos/inmunología , Antígenos Fúngicos/sangre , Sensibilidad y Especificidad , Proteínas Fúngicas/inmunología , Anticuerpos Monoclonales/inmunología , Ratones Endogámicos BALB C
15.
Eur J Clin Microbiol Infect Dis ; 43(6): 1221-1229, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38625450

RESUMEN

PURPOSE: Cancer patients are at heightened risk for invasive aspergillosis (IA), a condition associated with elevated mortality risk. The JF5-based Aspergillus Galactomannoprotein Lateral Flow Device (AspLFD) offers rapid point-of-care testing (POCT) for IA. This study evaluated the diagnostic performance of AspLFD in cancer populations. METHODS: This retrospective study examined cancer patient bronchoalveolar lavage fluid (BALF) and serum samples collected between September 2021 and January 2023. Both AspLFD and galactomannan (GM) assays were conducted, and the results were analysed by two independent researchers. RESULTS: This study included 242 samples from 218 cancer patients, with 58 BALF and 184 serum samples. The overall agreement between AspLFD and GM assay results was 92.1%, with a kappa value of 0.552. AspLFD diagnosed proven/probable IA with a sensitivity and specificity of 91.7% and 95.3%, respectively, whereas GM exhibited sensitivity and specificity values of 83.3% and 93.7%, respectively. There were no statistical differences in the sensitivity and specificity between the two methods (P > 0.05). For serum analyses, AspLFD and GM exhibited similar sensitivity (66.7% vs. 66.7%, P > 0.05) and specificity (98.6% vs. 96.6%, P > 0.05) values. However, the sensitivity of the AspLFD was superior to the GM assay (100% vs. 88.9%) in BALF analyses but the difference was not statistically significant (P > 0.05), with no difference in specificity (83.7% vs. 83.7%, P > 0.05). In the solid-tumour cohort, both the AspLFD and GM assay exhibited high sensitivity (100% for both) and specificity (94.2% vs. 92.8%, P > 0.05). CONCLUSION: The AspLFD demonstrated good performance in diagnosing IA in cancer patients, especially those with solid tumours. The AspLFD is thus an alternative POCT, particularly when GM evaluations are not readily available.


Asunto(s)
Aspergillus , Líquido del Lavado Bronquioalveolar , Galactosa , Mananos , Neoplasias , Sensibilidad y Especificidad , Humanos , Estudios Retrospectivos , Neoplasias/complicaciones , Persona de Mediana Edad , Femenino , Masculino , Líquido del Lavado Bronquioalveolar/microbiología , Líquido del Lavado Bronquioalveolar/química , Galactosa/análogos & derivados , Mananos/sangre , Mananos/análisis , Anciano , Aspergillus/aislamiento & purificación , Adulto , Pruebas en el Punto de Atención , Aspergilosis Pulmonar Invasiva/diagnóstico , Anciano de 80 o más Años , Antígenos Fúngicos/sangre , Antígenos Fúngicos/análisis
16.
Med Mycol ; 62(7)2024 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-38702848

RESUMEN

Antigen testing is an important diagnostic tool for histoplasmosis but has limited availability globally. We evaluated the OIDx urine lateral flow antigen assay among 204 persons suspected to have histoplasmosis. Among patients with proven histoplasmosis, sensitivity was 33.3% (3/9, 95% CI 7.5%-70.1%) and specificity 80.5% (157/195, 95% CI 74.3%-85.8%). The MiraVista urine antigen test had better specificity (96.9%) and equal sensitivity. The OIDx test demonstrated 33.3% (3/9) positive agreement and 84.0% (163/194) negative agreement with the MiraVista test. These results should be considered in the context of our low HIV prevalence population with a mixture of pulmonary and disseminated disease.


We evaluated a new lateral flow antigen test for the diagnosis of histoplasmosis. Proven/probable cases were mostly pulmonary disease making antigen tests likely to be less sensitive in this population. The test had similar sensitivity to the established antigen test but was less specific.


Asunto(s)
Antígenos Fúngicos , Histoplasma , Histoplasmosis , Sensibilidad y Especificidad , Histoplasmosis/diagnóstico , Histoplasmosis/orina , Humanos , Antígenos Fúngicos/orina , Histoplasma/aislamiento & purificación , Masculino , Femenino , Adulto , Persona de Mediana Edad , Inmunoensayo/métodos
17.
Med Mycol ; 62(9)2024 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-39237463

RESUMEN

Several false positive low serum cryptococcal antigen (SCrAg) reports by lateral flow assay (LFA) were identified in late 2016 at our tertiary care hospital. After the recall and correction of the problem in the reagent, we studied the significance of SCrAg LFA ≤ 1:10 from January 2017 to October 2023. Of 20 patients with 31 samples of SCrAg LFA ≤ 1:10, 14 patients (70%) were classified as true positives, four (20%) were indeterminate, and only two (10%) patients were false positives. If a new SCrAg LFA ≤ 1:10 is detected, it should be repeated, and additional workup should be pursued.


We studied the significance of low serum cryptococcal antigen (SCrAg) titer lateral flow assay (LFA) ≤ 1:10 from January 2017 to October 2023. Of 20 patients with SCrAg LFA ≤ 1:10, only two patients (10%) were false positives. If a new SCrAg ≤ 1:10 is detected, it should be repeated, and additional workup should be done.


Asunto(s)
Antígenos Fúngicos , Criptococosis , Cryptococcus , Centros de Atención Terciaria , Humanos , Antígenos Fúngicos/sangre , Antígenos Fúngicos/inmunología , Criptococosis/diagnóstico , Criptococosis/sangre , Masculino , Femenino , Cryptococcus/inmunología , Persona de Mediana Edad , Reacciones Falso Positivas , Adulto , Anciano , Estudios Retrospectivos
18.
Med Mycol ; 62(7)2024 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-38871943

RESUMEN

In the present study, we validate and compare the second-generation Miravista Coccidioides IgG and IgM enzyme immunoassays (EIA) (MiraVista Diagnostics [MVD] Ab EIA) to Meridian Diagnostics Coccidioides IgG and IgM EIA (Meridian Ab EIA), immunodiffusion (ID) and complement fixation (CF). We also evaluated whether the addition of Coccidioides antigen testing to anti-Coccidioides antibody testing increased the sensitivity for the diagnosis of currently active coccidioidomycosis. We retrospectively studied 555 patients evaluated at Valleywise Health Medical Center between January 2013 and May 2017 for whom coccidioidomycosis was suspected and samples were submitted to MVD for testing. Specimens were tested for antigen in the MVD antigen enzyme immunoassay (MVD Ag EIA) and for IgG and IgM antibodies with MVD and Meridian Diagnostics EIAs. ID and CF were obtained from medical records. Sensitivity and specificity were 83.0% and 91.1% or MVD Ab EIA, 69.3% and 99.7% for Meridian Ab EIA, 85.4% and 100% for ID and 65.5% and 100% for CF. Combined MVD antigen and antibody detection by EIA and ID resulted in increased sensitivity in disseminated and pulmonary disease (MVD Ag/MVD Ab: 100%, 88.3%; MVD Ag/Meridian Ab: 98.2%, 78.6%; and MVD Ag/ID: 100%, 91.7%). The detection of antibodies by MVD EIA was more sensitive than Meridian EIA or CF but similar to ID. This study supports the use of antigen testing in immunocompromised patients and those with suspected disseminated disease. Furthermore, the addition of antigen detection by EIA to antibody detection resulted in higher sensitivity of all serological tests.


The most common methods for the diagnosis of moderate or severe coccidioidomycosis rely on the detection of antibodies or antigens. Here we present the validation of a new Miravista Coccidioides antibody detection test combined with antigen detection and compare it to other immunodiagnostics.


Asunto(s)
Anticuerpos Antifúngicos , Antígenos Fúngicos , Coccidioides , Coccidioidomicosis , Técnicas para Inmunoenzimas , Inmunoglobulina G , Inmunoglobulina M , Sensibilidad y Especificidad , Humanos , Coccidioidomicosis/diagnóstico , Coccidioidomicosis/inmunología , Antígenos Fúngicos/inmunología , Antígenos Fúngicos/sangre , Inmunoglobulina M/sangre , Estudios Retrospectivos , Inmunoglobulina G/sangre , Coccidioides/inmunología , Técnicas para Inmunoenzimas/métodos , Anticuerpos Antifúngicos/sangre , Masculino , Persona de Mediana Edad , Femenino , Anciano , Adulto , Adolescente , Adulto Joven , Niño , Anciano de 80 o más Años , Preescolar , Inmunodifusión , Lactante
19.
Med Mycol ; 62(8)2024 Aug 02.
Artículo en Inglés | MEDLINE | ID: mdl-39122658

RESUMEN

Cryptococcus neoformans is a widely distributed opportunistic pathogenic fungus. While C. neoformans commonly infects immunocompromised individuals, it can also affect those who are immunocompetent. Transmission of C. neoformans primarily occurs through the respiratory tract, leading to the development of meningitis. The mortality rate of Cryptococcal meningitis is high, and treatment options are limited. Cryptococcus neoformans infections pose a significant public health threat and currently lack targeted and effective response strategies. This study aimed to screen T lymphocyte (cytotoxic T lymphocyte and helper T lymphocyte) and B lymphocyte epitopes derived from four C. neoformans antigens and develop two multi-epitope vaccines by combining them with various adjuvants. Molecular docking results demonstrated that the vaccines bind stably to Toll-like receptor 4 ( and induce innate immunity. The credibility of the molecular docking results was validated through subsequent molecular dynamics simulations. Furthermore, the results of immune simulation analyses underscored the multi-epitope vaccine's capability to effectively induce robust humoral and cellular immune responses within the host organism. These two vaccines have demonstrated theoretical efficacy against C. neoformans infection as indicated by computer analysis. Nevertheless, additional experimental validation is essential to substantiate the protective efficacy of the vaccines.


A multi-epitope Cryptococcus neoformans vaccine covering the most common A and D phenotypes was designed using bioinformatics methods.


Asunto(s)
Biología Computacional , Cryptococcus neoformans , Epítopos de Linfocito B , Epítopos de Linfocito T , Vacunas Fúngicas , Simulación del Acoplamiento Molecular , Cryptococcus neoformans/inmunología , Cryptococcus neoformans/química , Vacunas Fúngicas/inmunología , Epítopos de Linfocito T/inmunología , Epítopos de Linfocito B/inmunología , Humanos , Criptococosis/inmunología , Criptococosis/prevención & control , Receptor Toll-Like 4/inmunología , Antígenos Fúngicos/inmunología , Simulación de Dinámica Molecular , Adyuvantes Inmunológicos , Inmunoinformática
20.
Med Mycol ; 62(4)2024 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-38479779

RESUMEN

Definitive diagnosis of histoplasmosis relies on culture and/or cytology/histopathology; however, these procedures have limited sensitivity and cultures are time-consuming. Antibodies detection by immunodiffusion has low sensitivity in immunocompromised individuals and uses histoplasmin (HMN), a crude antigenic extract, as reagent. Novel protein antigen candidates have been recently identified and produced by DNA-recombinant techniques to obtain standardized and specific reagents for diagnosing histoplasmosis. To compare the analytical performance of novel enzyme-linked immunosorbent assays (ELISAs) for antibodies testing for diagnosing histoplasmosis using different Histoplasma capsulatum antigens as reagents. The H. capsulatum 100 kDa protein (Hcp100), the M antigen and its immunoreactive fragment F1 were produced by DNA-recombinant techniques. Galactomannan was purified from both the yeast and mycelial cell walls (yGM and mGM, respectively). The analytical performance of the ELISA tests for the serological detection of antibodies against these antigens was evaluated and compared with those obtained using HMN as reagent. Antibodies detection by the Hcp100 ELISA demonstrated 90.0% sensitivity and 92.0% specificity, versus 43.3% sensitivity and 95.0% specificity of the M ELISA, 33.3% sensitivity and 84.0% specificity of the F1 ELISA, 96.7% sensitivity and 94.0% specificity of the yGM ELISA, 83.3% sensitivity and 88.0% specificity of the mGM ELISA, and 70.0% sensitivity and 86.0% specificity for the HMN ELISA. In summary, Hcp100 is proposed as the most promising candidate for the serodiagnosis of histoplasmosis. The primary immunoreactive element in HMN proved to be GM rather than the M antigen. Nevertheless, a higher incidence of cross-reactions was noted with GM compared to M.


Hcp100 is a promising serodiagnostic candidate for histoplasmosis, boasting high sensitivity and specificity. Notably, GM, rather than M antigen, emerged as the primary immunoreactive element in HMN, despite a higher incidence of cross-reactions with GM compared to M.


Asunto(s)
Histoplasmosis , Humanos , Histoplasmosis/diagnóstico , Histoplasmosis/veterinaria , Histoplasma/genética , Anticuerpos Antifúngicos , Técnicas para Inmunoenzimas , Antígenos Fúngicos , Anticuerpos , Inmunodifusión/veterinaria , Saccharomyces cerevisiae , ADN
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