Anti-gp43 Antibodies in the Cerebrospinal Fluid of Patients With Central Nervous System Involvement by Paracoccidioidomycosis

Abstract

Paracoccidioidomycosis (PCM) is a chronic granulomatous infectious disease, endemic in subtropical areas of Central and South America. The diagnosis of the central nervous system (CNS) involvement with PCM (neuroparacoccidioidomycosis [NPCM]) frequently is difficult. A definitive diagnosis usually is made by visualization or isolation of Paracoccidioides brasiliensis from CNS biopsy or necropsy material. In the present study, we determined the presence of anti-gp43 antibodies in the cerebrospinalfluid (CSF) of patients with CNS involvement in PCM by enzyme-linked immunosorbent assay (ELISA) in 9 cases of NPCM and 15 control cases. ELISA anti-gp43 was compared with double immunodiffusion (DID). ELISA anti-gp43 was positive in 8 (89%) of 9 CSF samples from patients with NPCM and negative in all CSF samples of the control group. DID was negative in all CSF samples from patients with NPCM and control samples. ELISA anti-gp43 in CSF samples is better than DID for the diagnosis of NPCM. It is a sensitive and specific diagnostic method and has high predictive values. To our knowledge, this is thefirst time ELISA anti-gp43 was applied to CSF.

Central nervous system paracoccidioidomycosis: clinical features and laboratorial findings

“…The search for antibodies by DID in the CSF has been negative in the great majority of cases. 26 This makes it important to develop new tests, immunological or by molecular biology, 27 to detect the etiologic agent. A possibility is the search for gp43 antigen or anti-gp43 antibodies.…”

Diagnosis of Neuroparacoccidioidomycosis by Detection of Circulating Antigen and Antibody in Cerebrospinal Fluid

“…However, considering the morbidity related to invasive procedures necessary to obtain a brain biopsy, an accurate serological tool based on specific detection of antigen or antibodies against the fungus is clearly necessary to improve the diagnosis of neuroPCM. In this regard, Almeida et al detected specific anti-gp43 antibody in eight of nine samples of CSF obtained from patients with neuroPCM (1).…”

Fundamentals of paracoccidioidomycosis treatment

“…In 1994, a serologic diagnosis with a high specificity was standardized using a 43-kilodalton (kd) glycoprotein, gp43 [Taborda and Camargo, 1994]. Since then, numerous efforts have been directed in facilitating the diagnosis of paracoccidioidomycosis using serological tests, including immunodiffusion, hemagglutination, enzyme-linked immunosorbent assay (ELISA), Western blot, and immunofluorescence with antigen gp43 as a specific target for diagnosing the disease [Almeida et al, 2002;Maluf et al, 2003;Marques et al, 2006].…”