Predictive value of serologic tests in the diagnosis and follow-up of patients with paracoccidioidomycosis

Cano, Luz Elena; Restrepo, Ángela

doi:10.1590/s0036-46651987000500003

Cited by 47 publications

(35 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The detection of antibody by serological methods plays an important role in the diagnosis of PCM (2,3,17,32,36). However, the complexity of the antigens traditionally used meant that regardless of the methodology employed, it almost invariably resulted in problems associated with a lack of antigen standardization and specificity (17,36).…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, serological testing is an important tool not only for disease diagnosis but also for monitoring patients' responses to treatment (7,25,32). Antibodies to P. brasiliensis can be detected in patients' sera by serological techniques, such as complement fixation, immunodiffusion, and immunoenzymatic assays (2,3,38). Historically, the use of complex mixtures of undefined antigens has imposed important limitations on such tests; cross-reactivity has been a problem, as has the absence of antigen standardization (17).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Combined Use of Paracoccidioides brasiliensis Recombinant 27-Kilodalton and Purified 87-Kilodalton Antigens in an Enzyme-Linked Immunosorbent Assay for Serodiagnosis of Paracoccidioidomycosis

et al. 2003

Self Cite

View full text Add to dashboard Cite

The diagnosis of paracoccidioidomycosis (PCM) has relied on the identification of the host's humoral response by using a variety of immunological methods, such as complement fixation and immunodiffusion. Although these approaches are useful, historically their sensitivity and specificity have often been compromised by the use of complex mixtures of undefined antigens. The use of combinations of purified, wellcharacterized antigens appears preferable and may yield optimum results. Accordingly an indirect enzymelinked immunosorbent assay (ELISA) using combinations of the previously described 27-kDa recombinant antigen and the 87-kDa heat shock protein were used for diagnosis and follow-up of patients with PCM. A total of 37 patients classified according to their clinical presentations (7 with the acute or subacute form of the disease, 22 with the chronic form of the disease, and 8 with the chronic unifocal form) were studied. Eighteen of these patients were also evaluated at every follow-up appointment. Forty serum samples from patients with other diseases and 50 serum samples from healthy individuals were also studied. Detection of anti-27-kDa and anti-87-kDa antibodies in sera of patients with PCM by ELISA using a combination of the two purified proteins showed a sensitivity of 92% with a specificity of 88% in comparison with normal human sera and 90% in comparison with the heterologous sera. These results demonstrated a significant increase in sensitivity and specificity compared to results when the antigens were used separately. Thus, the use of combinations of well-defined antigens appears to offer clear advantages over the use of single antigens when diagnosing PCM.Paracoccidioidomycosis (PCM), one of the most prevalent systemic fungal mycoses in Latin America, is caused by Paracoccidioides brasiliensis, a thermally dimorphic fungus (1, 36).

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Combined Use of Paracoccidioides brasiliensis Recombinant 27-Kilodalton and Purified 87-Kilodalton Antigens in an Enzyme-Linked Immunosorbent Assay for Serodiagnosis of Paracoccidioidomycosis

et al. 2003

Self Cite

View full text Add to dashboard Cite

show abstract

“…Immunodiffusion During the last years, immunodiffusion has been the test of choice for the initial diagnosis of suspected patients of PCM. The ID test has high specificity and sensitivity may vary from 65 to 100% depending on the kind of antigen used [14,17]. Recently, the Ag7 was tested in ID by a multinational group of researchers, with the aim of providing regional laboratories, within the endemic areas, with an accurate yet simple test to promptly diagnose PCM [18].…”

Section: Antibody Detectionmentioning

confidence: 99%

“…Tests based on ID are generally considered to have high specificity in the diagnosis of PCM, but lack in sensitivity. Estimates of the sensitivity of immunodiffusion-based tests vary from 65% to 100% [17] depending of the kind of antigen preparation used. On the other hand, tests with higher sensitivity, such as immunoenzymatic assays, present problems associated with specificity due to cross-reactivity with heterologous sera, i.e., patients with non-PCM fungal infections.…”

Section: Antigen Detectionmentioning

confidence: 99%

Serology of paracoccidioidomycosis

Camargo

2008

Mycopathologia

113

View full text Add to dashboard Cite

This review provides the background for understanding the role of a battery of diagnostic methods in paracoccidioidomycosis (PCM). This systemic mycosis is a disease endemic in many regions of Latin America, with sporadic cases also occurring throughout the world (mycosis of importation). Although excellent laboratory methods for diagnosis are available, there are deficiencies that must be met by continued research. Understanding the uses and limitations of a battery of laboratory methods is essential to diagnose PCM. Clinicians and laboratory directors must be familiar with the uses and limitations of a battery of serologic and mycological tests to accurately diagnose of PCM. Antibody and antigen detections are valuable adjuncts to histopathology and culture. More recently, the gp43 and gp70 antigen detection assay have improved the methodology of diagnosis of this mycosis, which improves reproducibility and facilitates monitoring antigen clearance during antifungal treatment. Furthermore, detection of antigen in cerebrospinal fluid and in bronchoalveolar lavage fluid increases the sensitivity for diagnosis of PCM in central nervous system and in pulmonary infections, respectively.

show abstract

“…In addition, antibodies to P. brasiliensis can be detected in patient sera by serological techniques, such as complement fixation, immunodiffusion, and immunoenzymatic assays (4,5,30,36). However, these tests have certain important limitations: cross-reactivity is a problem, and there are profound difficulties encountered in the proper standardization of the various tests and reagents used (16).…”

mentioning

confidence: 99%

Paracoccidioides brasiliensis 87-Kilodalton Antigen, a Heat Shock Protein Useful in Diagnosis: Characterization, Purification, and Detection in Biopsy Material via Immunohistochemistry

et al. 2002

Self Cite

View full text Add to dashboard Cite

The 87-kDa antigen derived from the fungal pathogen Paracoccidioides brasiliensis can be detected in the sera of infected patients, and its levels have been shown to correlate well with response to treatment and with clinical cure. Despite its potential importance, the antigen has been poorly characterized. The 87-kDa antigen was purified to homogeneity via preparative gel electrophoresis; N-terminal amino acid sequencing revealed substantial homology with heat shock proteins (hsps) from a variety of organisms. A monoclonal antibody (MAb) raised against a Histoplasma capsulatum 80-kDa hsp showed cross-reactivity to the purified 87-kDa antigen via Western blotting, and the 87-kDa-specific MAb P1B demonstrated that the antigen was expressed at higher levels in yeast than in mycelia by the same technique. Enzyme-linked immunosorbent assay and immunofluorescence reactivity using P1B confirmed increased expression of the 87-kDa antigen during the temperature-induced transformation of mycelia to yeast. Yeast-to-mycelium transformation was accompanied by a fall in expression, although the 87-kDa antigen was clearly constitutively expressed in both phases. Immunochemical staining of tissues from patients with MAb P1B who were infected with P. brasiliensis confirmed in vivo expression of the 87-kDa antigen by yeasts, and identification of this antigen via this method appears to be a useful adjunct to other methods used to diagnose paracoccidioidomycosis.

show abstract

Predictive value of serologic tests in the diagnosis and follow-up of patients with paracoccidioidomycosis

Abstract: A serologic study was undertaken in a gtoup of 4A patients with active pe lacoscidioidomycosis who were treated in the same foÍm (ketoconazole

Cited by 47 publications

References 8 publications

Combined Use of Paracoccidioides brasiliensis Recombinant 27-Kilodalton and Purified 87-Kilodalton Antigens in an Enzyme-Linked Immunosorbent Assay for Serodiagnosis of Paracoccidioidomycosis

Combined Use of Paracoccidioides brasiliensis Recombinant 27-Kilodalton and Purified 87-Kilodalton Antigens in an Enzyme-Linked Immunosorbent Assay for Serodiagnosis of Paracoccidioidomycosis

Serology of paracoccidioidomycosis

Paracoccidioides brasiliensis 87-Kilodalton Antigen, a Heat Shock Protein Useful in Diagnosis: Characterization, Purification, and Detection in Biopsy Material via Immunohistochemistry

Contact Info

Product

Resources

About