Use of (1→3)-β-d-glucan for diagnosis and management of invasive mycoses in HIV-infected patients.

Use of (1→3)-β-d-glucan for diagnosis and management of invasive mycoses in HIV-infected patients.
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DOI:
10.1111/myc.12797
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发表时间:
2018-10
期刊:
影响因子:
4.9
通讯作者:
Routy JP
Routy JP
中科院分区:
医学2区
文献类型:
--
作者:
Farhour Z;Mehraj V;Chen J;Ramendra R;Lu H;Routy JP

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艾滋病毒感染者(PLHIV)由于免疫功能障碍,极易受到侵袭性真菌感染(IFIs)的影响。由于在开始治疗前需要进行深部组织采样以观察和培养真菌,因此IFIs的诊断和治疗仍然具有挑战性。这些技术在资源有限的环境中不太实用,因为它们的成本和相对侵入性程序的要求。因此,需要鉴定用于IFIs的早期诊断和治疗监测的替代标志物。最近的研究表明,(1→3)-β-d-葡聚糖(BDG)是一种主要的真菌细胞壁抗原,是一种很有前途的可溶性标记物,可用于HIV感染患者IFIs的推定诊断和治疗监测。在此,我们回顾BDG检测在IFIs诊断和PLHIV抗真菌治疗监测中的优点。与其他类型的免疫功能低下患者相反,HIV感染与肠道损伤和随后的细菌和真菌易位相关,导致BDG血浆水平升高。
People living with HIV (PLHIV) are highly vulnerable to invasive fungal infections (IFIs) due to their immune dysfunction. Diagnosis and treatment of IFIs remain challenging due to the requirement of deep tissue sampling to visualise and culture fungi before initiating treatment. Such techniques are less practical in resource‐limited settings due to their cost and requirement of relatively invasive procedures. Hence, identification of surrogate markers for the early diagnosis and therapeutic monitoring of IFIs is required. Recent studies have shown that (1→3)‐β‐d‐glucan (BDG), a major fungal cell wall antigen, represents a promising soluble marker for the presumptive diagnosis and therapeutic monitoring of IFIs in HIV‐infected patients. Herein, we review findings on the merits of BDG assays in the diagnosis of IFIs and monitoring of antifungal therapies for PLHIV. Conversely to other types of immunocompromised patients, HIV infection is associated with gut damage and subsequent bacterial and fungal translocation leading to elevated BDG plasma levels.
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