Aspergillus species are ubiquitous fungi and have been implicated as the causative agents of a variety of lung disorders in humans. These disorders include allergic, saprophytic, and systemic manifestations. The allergic disorders mainly affect atopic persons, and invasive or systemic diseases affect immunosuppressed individuals. Immunodiagnosis can help the practitioner diagnose these diseases. Demonstration of circulating antibodies is a useful criterion, but the lack of dependable and standardized antigens is a limiting factor in the diagnosis of most Aspergillus-induced diseases. Despite this limitation, however, immunodiffusion and enzyme-linked immunosorbent assays have been widely used for the detection of antibodies in the sera of patients with aspergillosis. Similarly, crude and semipurified antigens are being used to demonstrate skin hypersensitivity in patients, and several methods have been useful in the detection of antigenemia in patients with invasive aspergillosis. With a growing number of reports on the incidence of aspergillosis and an increase in the number of immunosuppressed individuals in the population, more rapid methods and more reliable reagents for immunodiagnosis are needed. With recent attempts at obtaining reliable reagents for through hybridoma technology and molecular biological techniques, substantial progress toward efficient immunodiagnosis may be achieved.
The immunopathogenesis of invasive aspergillosis and the role played by cytokines are not fully understood. The roles of interferon (IFN)-gamma and tumor necrosis factor (TNF)-alpha were investigated in BALB/c mice infected intravenously with 5 x 10(5) Aspergillus fumigatus conidia. Eight groups of animals were studied, including 2 control groups (mice only infected with A. fumigatus and those given cortisone acetate and infected with A. fumigatus) and 6 groups of infected mice either treated or not treated with cortisone acetate and given IFN-gamma, anti-IFN-gamma, TNF-alpha, or anti-TNF-alpha. No deaths occurred among the mice treated with IFN-gamma and TNF-alpha, compared with 40%-80% mortality in the other groups. IFN-gamma- and TNF-alpha-treated mice also had fewer organs from which A. fumigatus could be cultured or demonstrated on histologic examination. These observations suggest that IFN-gamma and TNF-alpha have protective roles in invasive aspergillosis.
The in vitro and in vivo effects of IFN-gamma in IA are contingent on many variables, including the route of administration and the specific pathogenesis of infection.
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