Abstract
AIM: To develop a polymerase chain reaction enzyme immunoassay (PCR-EIA) to measure levels of circulating aspergillus DNA in invasive aspergillosis caused by Aspergillus fumigatus. METHODS: The PCR reaction was based on primers from the 18s rRNA gene. Binding of the product to a streptavidin coated microtitration plate was mediated by a biotinylated capture probe. The product was digoxigenylated during PCR and this was the tag to which antibody was bound in the subsequent EIA. RESULTS: The optical density (OD) endpoint was < 0.1 in 10 sera from neutropenic patients with no evidence of invasive aspergillosis, and in 10 sera from nonneutropenic patients with bacterial pneumonia (group 1). The OD from five of 12 patients with allergic bronchopulmonary aspergillosis (ABPA) (group 2), three with an aspergilloma (group 3), and five with possible invasive aspergillosis (group 4) was > or = 0.1. In 63 sera from 33 cases of proven invasive aspergillosis (group 5) an OD > or = 0.1 was achieved in 48 sera from 30 patients. The maximum OD was 0.510. The level fell in survivors and gradually rose in fatal cases. CONCLUSIONS: This assay validated the concept of diagnosing invasive aspergillosis by measuring levels of circulating fungal DNA in serum.
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Selected References
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- Andriole V. T. Aspergillus infections: problems in diagnosis and treatment. Infect Agents Dis. 1996 Jan;5(1):47–54. [PubMed] [Google Scholar]
- Ansorg R., Heintschel von Heinegg E., Rath P. M. Aspergillus antigenuria compared to antigenemia in bone marrow transplant recipients. Eur J Clin Microbiol Infect Dis. 1994 Jul;13(7):582–589. doi: 10.1007/BF01971310. [DOI] [PubMed] [Google Scholar]
- Bretagne S., Costa J. M., Marmorat-Khuong A., Poron F., Cordonnier C., Vidaud M., Fleury-Feith J. Detection of Aspergillus species DNA in bronchoalveolar lavage samples by competitive PCR. J Clin Microbiol. 1995 May;33(5):1164–1168. doi: 10.1128/jcm.33.5.1164-1168.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bretagne S., Marmorat-Khuong A., Kuentz M., Latgé J. P., Bart-Delabesse E., Cordonnier C. Serum Aspergillus galactomannan antigen testing by sandwich ELISA: practical use in neutropenic patients. J Infect. 1997 Jul;35(1):7–15. doi: 10.1016/s0163-4453(97)90833-1. [DOI] [PubMed] [Google Scholar]
- Burnie J. P. Antigen detection in invasive aspergillosis. J Immunol Methods. 1991 Oct 25;143(2):187–195. doi: 10.1016/0022-1759(91)90044-g. [DOI] [PubMed] [Google Scholar]
- Burnie J. P., Coke A., Matthews R. C. Restriction endonuclease analysis of Aspergillus fumigatus DNA. J Clin Pathol. 1992 Apr;45(4):324–327. doi: 10.1136/jcp.45.4.324. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Burnie J. P., Golbang N., Matthews R. C. Semiquantitative polymerase chain reaction enzyme immunoassay for diagnosis of disseminated candidiasis. Eur J Clin Microbiol Infect Dis. 1997 May;16(5):346–350. doi: 10.1007/BF01726361. [DOI] [PubMed] [Google Scholar]
- Denning D. W., Evans E. G., Kibbler C. C., Richardson M. D., Roberts M. M., Rogers T. R., Warnock D. W., Warren R. E. Guidelines for the investigation of invasive fungal infections in haematological malignancy and solid organ transplantation. British Society for Medical Mycology. Eur J Clin Microbiol Infect Dis. 1997 Jun;16(6):424–436. doi: 10.1007/BF02471906. [DOI] [PubMed] [Google Scholar]
- Denning D. W. Invasive aspergillosis. Clin Infect Dis. 1998 Apr;26(4):781–805. doi: 10.1086/513943. [DOI] [PubMed] [Google Scholar]
- Einsele H., Hebart H., Roller G., Löffler J., Rothenhofer I., Müller C. A., Bowden R. A., van Burik J., Engelhard D., Kanz L. Detection and identification of fungal pathogens in blood by using molecular probes. J Clin Microbiol. 1997 Jun;35(6):1353–1360. doi: 10.1128/jcm.35.6.1353-1360.1997. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hashimoto A., Yamakami Y., Mizunoe S., Yamagata E., Nagaoka H., Nagai H., Nasu M. [Detection of Aspergillus species DNA in serum samples of the patients with non-invasive pulmonary aspergillosis]. Kansenshogaku Zasshi. 1997 Mar;71(3):255–259. doi: 10.11150/kansenshogakuzasshi1970.71.255. [DOI] [PubMed] [Google Scholar]
- Haynes K. A., Tuinstra P., Hughes T. A., Wijnands L. M., Rogers T. R., Allen A. K. Purification and characterization of a 93 kDa Aspergillus fumigatus antigen with diagnostic potential. J Med Vet Mycol. 1996 Nov-Dec;34(6):421–426. [PubMed] [Google Scholar]
- Haynes K., Rogers T. R. Retrospective evaluation of a latex agglutination test for diagnosis of invasive aspergillosis in immunocompromised patients. Eur J Clin Microbiol Infect Dis. 1994 Aug;13(8):670–674. doi: 10.1007/BF01973998. [DOI] [PubMed] [Google Scholar]
- Heid C. A., Stevens J., Livak K. J., Williams P. M. Real time quantitative PCR. Genome Res. 1996 Oct;6(10):986–994. doi: 10.1101/gr.6.10.986. [DOI] [PubMed] [Google Scholar]
- Hopwood V., Johnson E. M., Cornish J. M., Foot A. B., Evans E. G., Warnock D. W. Use of the Pastorex aspergillus antigen latex agglutination test for the diagnosis of invasive aspergillosis. J Clin Pathol. 1995 Mar;48(3):210–213. doi: 10.1136/jcp.48.3.210. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Horvath J. A., Dummer S. The use of respiratory-tract cultures in the diagnosis of invasive pulmonary aspergillosis. Am J Med. 1996 Feb;100(2):171–178. doi: 10.1016/s0002-9343(97)89455-7. [DOI] [PubMed] [Google Scholar]
- Jones M. E., Fox A. J., Barnes A. J., Oppenheim B. A., Balagopal P., Morgenstern G. R., Scarffe J. H. PCR-ELISA for the early diagnosis of invasive pulmonary aspergillus infection in neutropenic patients. J Clin Pathol. 1998 Sep;51(9):652–656. doi: 10.1136/jcp.51.9.652. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kanda Y., Akiyama H., Onozawa Y., Motegi T., Yamagata-Murayama S., Yamaguchi H. Aspergillus endocarditis in a leukemia patient diagnosed by a PCR assay. Kansenshogaku Zasshi. 1997 Mar;71(3):269–272. doi: 10.11150/kansenshogakuzasshi1970.71.269. [DOI] [PubMed] [Google Scholar]
- Kappe R., Schulze-Berge A. New cause for false-positive results with the Pastorex Aspergillus antigen latex agglutination test. J Clin Microbiol. 1993 Sep;31(9):2489–2490. doi: 10.1128/jcm.31.9.2489-2490.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kobayashi H., Debeaupuis J. P., Bouchara J. P., Latge J. P. An 88-kilodalton antigen secreted by Aspergillus fumigatus. Infect Immun. 1993 Nov;61(11):4767–4771. doi: 10.1128/iai.61.11.4767-4771.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- López-Medrano R., Ovejero M. C., Calera J. A., Puente P., Leal F. An immunodominant 90-kilodalton Aspergillus fumigatus antigen is the subunit of a catalase. Infect Immun. 1995 Dec;63(12):4774–4780. doi: 10.1128/iai.63.12.4774-4780.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- López-Medrano R., Ovejero M. C., Calera J. A., Puente P., Leal F. Immunoblotting patterns in the serodiagnosis of aspergilloma: antibody response to the 90kDa Aspergillus fumigatus antigen. Eur J Clin Microbiol Infect Dis. 1996 Feb;15(2):146–152. doi: 10.1007/BF01591488. [DOI] [PubMed] [Google Scholar]
- Manso E., Montillo M., De Sio G., D'Amico S., Discepoli G., Leoni P. Value of antigen and antibody detection in the serological diagnosis of invasive aspergillosis in patients with hematological malignancies. Eur J Clin Microbiol Infect Dis. 1994 Sep;13(9):756–760. doi: 10.1007/BF02276061. [DOI] [PubMed] [Google Scholar]
- Melchers W. J., Verweij P. E., van den Hurk P., van Belkum A., De Pauw B. E., Hoogkamp-Korstanje J. A., Meis J. F. General primer-mediated PCR for detection of Aspergillus species. J Clin Microbiol. 1994 Jul;32(7):1710–1717. doi: 10.1128/jcm.32.7.1710-1717.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Reddy L. V., Kumar A., Kurup V. P. Specific amplification of Aspergillus fumigatus DNA by polymerase chain reaction. Mol Cell Probes. 1993 Apr;7(2):121–126. doi: 10.1006/mcpr.1993.1016. [DOI] [PubMed] [Google Scholar]
- Rohrlich P., Sarfati J., Mariani P., Duval M., Carol A., Saint-Martin C., Bingen E., Latge J. P., Vilmer E. Prospective sandwich enzyme-linked immunosorbent assay for serum galactomannan: early predictive value and clinical use in invasive aspergillosis. Pediatr Infect Dis J. 1996 Mar;15(3):232–237. doi: 10.1097/00006454-199603000-00011. [DOI] [PubMed] [Google Scholar]
- Spreadbury C., Holden D., Aufauvre-Brown A., Bainbridge B., Cohen J. Detection of Aspergillus fumigatus by polymerase chain reaction. J Clin Microbiol. 1993 Mar;31(3):615–621. doi: 10.1128/jcm.31.3.615-621.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sulahian A., Tabouret M., Ribaud P., Sarfati J., Gluckman E., Latgé J. P., Derouin F. Comparison of an enzyme immunoassay and latex agglutination test for detection of galactomannan in the diagnosis of invasive aspergillosis. Eur J Clin Microbiol Infect Dis. 1996 Feb;15(2):139–145. doi: 10.1007/BF01591487. [DOI] [PubMed] [Google Scholar]
- Tang C. M., Holden D. W., Aufauvre-Brown A., Cohen J. The detection of Aspergillus spp. by the polymerase chain reaction and its evaluation in bronchoalveolar lavage fluid. Am Rev Respir Dis. 1993 Nov;148(5):1313–1317. doi: 10.1164/ajrccm/148.5.1313. [DOI] [PubMed] [Google Scholar]
- Urata T., Kobayashi M., Imamura J., Tanaka Y., Muneishi H., Iwahara Y., Uemura Y., Taguchi H., Miyoshi I. Polymerase chain reaction amplification of Asp f I and alkaline protease genes from fungus balls: clinical application in pulmonary aspergillosis. Intern Med. 1997 Jan;36(1):19–27. doi: 10.2169/internalmedicine.36.19. [DOI] [PubMed] [Google Scholar]
- Van Burik J. A., Myerson D., Schreckhise R. W., Bowden R. A. Panfungal PCR assay for detection of fungal infection in human blood specimens. J Clin Microbiol. 1998 May;36(5):1169–1175. doi: 10.1128/jcm.36.5.1169-1175.1998. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Verweij P. E., Latgé J. P., Rijs A. J., Melchers W. J., De Pauw B. E., Hoogkamp-Korstanje J. A., Meis J. F. Comparison of antigen detection and PCR assay using bronchoalveolar lavage fluid for diagnosing invasive pulmonary aspergillosis in patients receiving treatment for hematological malignancies. J Clin Microbiol. 1995 Dec;33(12):3150–3153. doi: 10.1128/jcm.33.12.3150-3153.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Verweij P. E., Rijs A. J., De Pauw B. E., Horrevorts A. M., Hoogkamp-Korstanje J. A., Meis J. F. Clinical evaluation and reproducibility of the Pastorex Aspergillus antigen latex agglutination test for diagnosing invasive aspergillosis. J Clin Pathol. 1995 May;48(5):474–476. doi: 10.1136/jcp.48.5.474. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Verweij P. E., Stynen D., Rijs A. J., de Pauw B. E., Hoogkamp-Korstanje J. A., Meis J. F. Sandwich enzyme-linked immunosorbent assay compared with Pastorex latex agglutination test for diagnosing invasive aspergillosis in immunocompromised patients. J Clin Microbiol. 1995 Jul;33(7):1912–1914. doi: 10.1128/jcm.33.7.1912-1914.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wald A., Leisenring W., van Burik J. A., Bowden R. A. Epidemiology of Aspergillus infections in a large cohort of patients undergoing bone marrow transplantation. J Infect Dis. 1997 Jun;175(6):1459–1466. doi: 10.1086/516480. [DOI] [PubMed] [Google Scholar]
- White M. H., Anaissie E. J., Kusne S., Wingard J. R., Hiemenz J. W., Cantor A., Gurwith M., Du Mond C., Mamelok R. D., Bowden R. A. Amphotericin B colloidal dispersion vs. amphotericin B as therapy for invasive aspergillosis. Clin Infect Dis. 1997 Apr;24(4):635–642. [PubMed] [Google Scholar]
- Yamakami Y., Hashimoto A., Tokimatsu I., Nasu M. PCR detection of DNA specific for Aspergillus species in serum of patients with invasive aspergillosis. J Clin Microbiol. 1996 Oct;34(10):2464–2468. doi: 10.1128/jcm.34.10.2464-2468.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]