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Mould-reactive T cells for the diagnosis of invasive mould infection-A prospective study

Angela Steinbach1,2,3, Oliver A Cornely1,2,3,4,5, Hilmar Wisplinghoff6,7,8

  • 1Faculty of Medicine, Department I of Internal Medicine, University of Cologne, Cologne, Germany.

Mycoses
|April 30, 2019
PubMed

Insights

Diagnosing invasive mould infections (IMI) in immunocompromised patients is challenging. A new assay monitoring mould-reactive T cells shows promise for early IMI detection, aiding targeted antifungal treatment.

Area of Science:

  • Medical Mycology
  • Immunology
  • Clinical Diagnostics

Background:

  • Invasive mould infections (IMI) pose a significant diagnostic challenge in immunocompromised individuals.
  • Current diagnostic methods often lack the speed and specificity required for timely intervention.
  • Minimally invasive tests for reliable pathogen identification are critically needed.

Purpose of the Study:

  • To validate a previously developed assay for diagnosing acute IMI.
  • To assess the utility of monitoring mould-reactive CD4+ T cells in peripheral blood.
  • To evaluate the assay's performance in an independent patient cohort.

Main Methods:

  • Peripheral blood cells from at-risk patients were stimulated with Aspergillus spp. and Mucorales lysates.
  • Mould-reactive CD4/CD69/CD154 positive lymphocytes were quantified using flow cytometry.
  • The assay's sensitivity and specificity for IMI detection were determined.

Main Results:

  • The mould-reactive lymphocyte assay was evaluable in 77% of patients.
  • A sensitivity of 100% and specificity of 81% were observed for IMI detection.
  • The assay correctly identified all patients with proven IMI, but applicability was limited by low T cell counts.

Conclusions:

  • The mould-reactive lymphocyte assay demonstrates high sensitivity for diagnosing IMI.
  • This assay can potentially support early, tailored treatment decisions for invasive mould infections.
  • Further validation is needed, especially in patients with severe bone marrow suppression.
Keywords:
CD154CD4+lymphocytesaspergillosisdiagnosisflow cytometryfungus-reactive T cellsmucormycosiszygomycosis

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