Table 1.

Summary of Fungal Biomarkers and Their Use for Diagnosis, Prognosis, or as Surrogate End Points in Clinical Trials

Fungus	Diagnostic Biomarkers	Prognostic Biomarkers	Surrogate End Points for Treatment Trials
Cryptococcus	CrAg, PCR	CrAg titer Quantitative CSF culture CSF BDG	Early fungicidal activity of serial quantitative CSF cultures is an established end point
Candida	PCR, T2Candida BDG (nonspecific)	None validated	Possible: change in BDG, change in PCR Ct value, or time to T2Candida negativity
Aspergillus	Blood galactomannan, blood LFA for galactomannan, BDG, PCR	Quantitative galactomannan value	Possible: change in blood galactomannan
Other molds	None	None	None
Blastomyces	Serum or urine antigen	Quantitative antigen possible	Possible: change in antigen or CRP
Coccidioides	Serology, PCR, antigen	CF IgG titer	Possible: change in CF IgG titer
Histoplasma	Serum or urine antigen	Quantitative antigen	Possible: change in antigen titer
Paracoccidioides	IgG detection, antigen	IgG titer	Possible: change in IgG titer
Sporothrix	PCR	None	None
Talaromyces	Serum or urine antigen PCR	Quantitative blood culture	Early fungicidal activity based on serial quantitative blood cultures

Abbreviations: BDG, 1,3-β-D-glucan; CF, complement fixation; CrAg, cryptococcal antigen; CRP, c-reactive protein; IgG, immunoglobulin G; LFA, lateral flow assay; PCR, polymerase chain reaction.