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Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
Published on: March 22, 2012
[Recent advances of serodiagnosis for systemic fungal infections]
1Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School, Okayama, Japan.
Abstract:
Serological surrogate tests for invasive fungal infection have been used practically in Japan. The Aspergillus galactomannan antigen detection kit by enzyme linked immunosorbent assay is the most reliable test for making a diagnosis of invasive aspergillosis. But in recent years, occurrences of false positive and negative results have also been reported by several investigators. Therefore, evaluation of the results of this assay should be done carefully in the clinical stage. Moreover, some other methods to detect the Aspergillus antigen or anti Aspergillus antibody in serum have also been reported. The problem of false positive results due to the frequent occurrence of non-specific reaction in the alkaline treatment, chromogenic automated kinetic assay to measure (1-->3)-beta-D-glucan had been noticed in Japan. But this important problem was resolved by improvement of the pretreatment reagent in this kit in July 2005. In this manuscript, I describe recent trends of serological surrogate tests for Aspergillus infection and the process of improvement of the (1-->3)-beta-D-glucan measurement kit.
Insights
Serological tests for invasive fungal infections, like Aspergillus galactomannan, are crucial but can yield false results. Improvements in (1-->3)-beta-D-glucan kits have enhanced accuracy for diagnosing invasive aspergillosis.
Area of Science:
- Mycology
- Clinical Diagnostics
- Immunology
Context:
- Serological surrogate tests are vital for diagnosing invasive fungal infections, particularly in Japan.
- The Aspergillus galactomannan antigen enzyme-linked immunosorbent assay (ELISA) is a primary diagnostic tool for invasive aspergillosis.
- Recent reports highlight challenges with false positive and negative results, necessitating careful clinical interpretation.
Purpose:
- To review recent advancements in serological surrogate tests for Aspergillus infections.
- To detail the improvements made to the (1-->3)-beta-D-glucan measurement kit, addressing false positive results.
- To emphasize the importance of careful evaluation of diagnostic assay results in clinical settings.
Summary:
- The Aspergillus galactomannan antigen ELISA is a reliable marker for invasive aspergillosis, though accuracy concerns exist.
- False positive results in (1-->3)-beta-D-glucan assays, linked to non-specific reactions, were resolved by reagent improvements in 2005.
- Current trends focus on refining these serological methods for more accurate fungal infection diagnosis.
Impact:
- Enhanced accuracy of diagnostic tools for invasive fungal infections.
- Improved clinical decision-making through more reliable serological test results.
- Potential for earlier and more precise diagnosis of invasive aspergillosis, leading to better patient outcomes.
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