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Current and Future Pathways in Aspergillus Diagnosis.

Radim Dobiáš1,2, David A Stevens3,4, Vladimír Havlíček5,6

  • 1Department of Bacteriology and Mycology, Public Health Institute in Ostrava, Partyzánské Náměstí 2633/7, 702 00 Ostrava, Czech Republic.

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Summary

Diagnosing invasive aspergillosis requires fungal biomarkers. This review highlights the advantages of detecting fungal products in body fluids over antibody tests, focusing on key biomarkers like beta-D-glucan and galactomannan.

Keywords:
PCRaspergillosisbronchoalveolar lavage fluidgalactomannanlateral flowmetagenomic next-generation sequencingmetallophoreserum assayssiderophoreβ-d-glucan

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Area of Science:

  • Mycology
  • Infectious Diseases
  • Clinical Diagnostics

Background:

  • Aspergillus fumigatus is a critical priority fungal pathogen identified by the WHO.
  • Current diagnostics for aspergillosis often utilize fungal metabolites, including intracellular molecules, cell wall components, and extracellular secretomes.
  • Limitations exist in antibody-based diagnostic tests for aspergillosis.

Purpose of the Study:

  • To review the shortcomings of antibody tests for aspergillosis diagnosis.
  • To highlight the utility of fungal product detection in body fluids.
  • To discuss emerging diagnostic approaches for Aspergillus infections.

Main Methods:

  • Literature review summarizing current diagnostic strategies for aspergillosis.
  • Comparative analysis of antibody tests versus fungal biomarker detection.
  • Discussion of specific biomarkers such as beta-D-glucan, galactomannan, and pentraxin 3.
  • Exploration of nucleic acid detection, next-generation sequencing, and Aspergillus metallophores.

Main Results:

  • Tests detecting fungal products in body fluids show advantages over antibody tests for diagnosing aspergillosis.
  • Beta-D-glucan, galactomannan, and pentraxin 3 are highlighted for their application in bronchoalveolar lavage fluids.
  • Nucleic acid detection and next-generation sequencing offer promising avenues for improved diagnostics.
  • Emerging research on Aspergillus metallophores presents new diagnostic possibilities.

Conclusions:

  • Biomarker-based diagnostics targeting fungal products in body fluids are superior to antibody tests for aspergillosis.
  • Further research into nucleic acid-based methods and novel biomarkers like metallophores is warranted.
  • Improved diagnostic tools are crucial for managing Aspergillus infections, a critical priority pathogen.