Immune Parameters for Diagnosis and Treatment Monitoring in Invasive Mold Infection
Jeffrey D Jenks1,2, Stephen A Rawlings2,3, Carol Garcia-Vidal4
1Department of Medicine, University of California San Diego, San Diego, CA 92103, USA.
Abstract:
Infections caused by invasive molds, including Aspergillus spp., can be difficult to diagnose and remain associated with high morbidity and mortality. Thus, early diagnosis and targeted systemic antifungal treatment remains the most important predictive factor for a successful outcome in immunocompromised individuals with invasive mold infections. Diagnosis remains difficult due to low sensitivities of diagnostic tests including culture and other mycological tests for mold pathogens, particularly in patients on mold-active antifungal prophylaxis. As a result, antifungal treatment is rarely targeted and reliable markers for treatment monitoring and outcome prediction are missing. Thus, there is a need for improved markers to diagnose invasive mold infections, monitor response to treatment, and assist in determining when antifungal therapy should be escalated, switched, or can be stopped. This review focuses on the role of immunologic markers and specifically cytokines in diagnosis and treatment monitoring of invasive mold infections.
Insights
Diagnosing invasive mold infections is challenging. This review explores immunologic markers, like cytokines, for better diagnosis and treatment monitoring in immunocompromised patients.
Area of Science:
- Medical Mycology
- Immunology
- Infectious Diseases
Background:
- Invasive mold infections, particularly Aspergillus spp., present significant diagnostic challenges and high mortality rates in immunocompromised individuals.
- Current diagnostic methods (culture, mycological tests) have low sensitivity, especially in patients receiving antifungal prophylaxis, hindering targeted treatment.
- Reliable markers for monitoring treatment response and predicting outcomes in invasive mold infections are lacking.
Purpose of the Study:
- To review the role of immunologic markers, specifically cytokines, in the diagnosis of invasive mold infections.
- To evaluate the utility of cytokines as markers for monitoring treatment response and predicting outcomes.
- To highlight the need for improved diagnostic and monitoring tools for invasive mold infections.
Main Methods:
- Literature review focusing on studies investigating immunologic markers, particularly cytokines.
- Analysis of diagnostic performance and prognostic value of various cytokines in invasive mold infections.
- Synthesis of current evidence on cytokine-based biomarkers for patient management.
Main Results:
- Cytokines show potential as early diagnostic markers for invasive mold infections.
- Certain cytokine profiles correlate with treatment response and patient outcomes.
- Immunologic markers may help guide antifungal therapy escalation, switching, or discontinuation.
Conclusions:
- Immunologic markers, especially cytokines, offer a promising avenue for improving the diagnosis and management of invasive mold infections.
- Further research is needed to validate these markers for routine clinical use.
- Cytokine-based monitoring could personalize antifungal treatment strategies and improve patient outcomes.
