Detection of circulating gp43 antigen in serum, cerebrospinal fluid, and bronchoalveolar lavage fluid of patients with paracoccidioidomycosis
Detection of circulating gp43 antigen in serum, cerebrospinal fluid, and bronchoalveolar lavage fluid of patients with paracoccidioidomycosis
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DOI：
10.1128/jcm.41.8.3675-3680.2003
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发表时间：
2003-08-01
影响因子：
9.4
通讯作者：
de Camargo, ZP
中科院分区：
文献类型：
--
作者：
da Silva, SHM;Colombo, AL;de Camargo, ZP
副球孢子菌病（PCM）是一种重要的全身性真菌病，特别是在生活和工作在拉丁美洲的地方性农村地区的个人中，如果没有抗真菌治疗，可能会发生致命的急性或慢性感染。对于此类患者，由于假阴性结果，通过免疫扩散检测抗体应答的价值有限。与此相反，巴西副球孢子菌gp 43循环抗原的检测可能是一个更实用的方法来快速诊断的疾病。因此，开发了抑制酶联免疫吸附测定（inh-ELISA）用于检测掺入种特异性鼠单克隆抗体的43-kDa巴西疟原虫特异性表位。与来自献血者的正常人血清（n = 93）和来自其他慢性真菌感染（组织胞浆菌病[n = 33]和隐球菌病[n = 20]）的患者的血清相比，来自患有急性和慢性形式的疾病的患者的血清（n = 81），发现测试的总体灵敏度为95.1%，而特异性为97.5%。根据患者的临床表现，Inh-ELISA检测到100%的急性PCM患者和95.31%和100%的慢性多灶性和单灶性PCM患者的循环抗原。还对14例神经副球孢子菌病患者的脑脊液和13例肺单灶性PCM患者的支气管肺泡灌洗液样本进行了gp 43检测，检测结果显示100%的敏感性和特异性。这种新的，高度特异性的inh-ELISA代表了一个显着的除了现有的测试诊断PCM。
Paracoccidioidomycosis (PCM) is an important systemic fungal disease, particularly among individuals living and working in rural areas of endemicity in Latin America, who, without antifungal therapy, may develop fatal acute or chronic infection. For such patients, the detection of antibody responses by immunodiffusion is of limited value due to false-negative results. In contrast, the detection of Paracoccidioides brasiliensis gp43 circulating antigen may represent a more practical approach to the rapid diagnosis of the disease. Accordingly, an inhibition enzyme-linked immunosorbent assay (inh-ELISA) was developed for the detection of a 43-kDa P. brasiliensis-specific epitope incorporating a species-specific murine monoclonal antibody. With sera from patients with acute and chronic forms of the disease (n = 81), the overall sensitivity of the test was found to be 95.1%, while specificity was found to be 97.5% compared to that with normal human sera from blood donors (n = 93) and sera from patients with other chronic fungal infections (histoplasmosis [n = 33] and cryptococcosis [n = 20]). The inh-ELISA detected circulating antigen in 100% of patients with the acute form of PCM and in 95.31 and 100% of patients with the chronic multifocal and unifocal forms of PCM according to the patient's clinical presentation. Cerebrospinal fluid from 14 patients with neuroparacoccidioidomycosis and 13 samples of bronchoalveolar lavage fluid from patients with pulmonary unifocal PCM were also tested for gp43 detection, with the test showing 100% sensitivity and specificity. This novel, highly specific inh-ELISA represents a significant addition to the existing tests for the diagnosis of PCM.