D-arabinitol versus mannan antigen and candidal protein antigen as a serum marker forCandida pyelonephritis

Tokunaga, Shuji; Ohkawa, Mitsuo; Takashima, Mitsuhiro; Seto, Chikashi; Nakamura, Shinichi

doi:10.1007/bf02111869

Cited by 13 publications

(5 citation statements)

References 14 publications

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“…Table 8 summarizes the results of several clinical studies that have evaluated D-arabinitol as a diagnostic marker for candidiasis. The early studies in which serum arabinitol concentrations were determined by GC and GC-MS (105,180), a study in which serum arabinitol/creatinine ratios were determined by GC (74), studies that used enzymatic assays to determine serum D-arabinitol/creatinine ratios (67,204,205,219) and studies that used GC-MS to determine the serum or urine D-/Larabinitol ratios (41,117,179) all support the usefulness of D-arabinitol, both as an initial diagnostic marker and for mon- (51,52,58,136). Some of these results can be explained by analytical artifacts (235), others could not be reproduced when they were examined in greater detail (232,237), and some unfavorable results remain unexplained.…”

Section: D-arabinitol In Candida Infectionsmentioning

confidence: 99%

Current Status of Nonculture Methods for Diagnosis of Invasive Fungal Infections

2002

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The incidence of invasive fungal infections has increased dramatically in recent decades, especially among immunocompromised patients. However, the diagnosis of these infections in a timely fashion is often very difficult. Conventional microbiologic and histopathologic approaches generally are neither sensitive nor specific, and they often do not detect invasive fungal infection until late in the course of disease. Since early diagnosis may guide appropriate treatment and prevent mortality, there has been considerable interest in developing nonculture approaches to diagnosing fungal infections. These approaches include detection of specific host immune responses to fungal antigens, detection of specific macromolecular antigens using immunologic reagents, amplification and detection of specific fungal nucleic acid sequences, and detection and quantitation of specific fungal metabolite products. This work reviews the current status and recent developments as well as problems in the design of nonculture diagnostic methods for invasive fungal infections

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Section: D-arabinitol In Candida Infectionsmentioning

confidence: 99%

Current Status of Nonculture Methods for Diagnosis of Invasive Fungal Infections

2002

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“…Serum samples from patients suffering from fatal illnesses (none with Candida infections), with or without renal dysfunction, were subjected to this enzymatic assay, and the results correlated well with DA concentrations determined by GC ( r =0·94) [15]. To our knowledge, the only commercially available enzymatic assay is the fluorimetric test developed by Soyama & Ono [14,16].…”

Section: Methodsmentioning

confidence: 77%

“…Although the fluorimetric enzyme test [12,13] is relatively non‐specific, and the diagnostic criteria used may not be completely strict and adequate, Tokunaga et al . [16] applied this method and found elevated DA/Cr ratios in nine (82%) out of eleven patients with invasive candidiasis and in seven (78%) out of nine patients with Candida pyelonephritis. However, as many as 7 and 13% of uninfected controls and patients with asymptomatic candiduria, respectively, were false positives.…”

Section: Diagnosismentioning

confidence: 99%

D-arabinitol - a marker for invasive candidiasis

Christensson¹,

Sigmundsdóttir²,

Larsson³

2008

Med Mycol

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The five‐carbon sugar alcohol D‐arabinitol (DA) is a metabolite of most pathogenic Candida species, in vitro as well as in vivo, and can be determined by gas chromatography or enzymatic analysis. Endogenous DA and L‐arabinitol (LA) are present in human body fluids, and serum DA and LA increase in renal dysfunction. In prospective clinical studies, elevated DA/LA or DA/creatine ratios in serum or urine have been found in immunocompromised, usually neutropenic, patients with invasive candidiasis. In addition, positive DA results have been obtained several days to weeks before positive blood cultures, and the normalization of DA levels has been correlated with therapeutic response in both humans and animals. However, to date, only a few prospective studies have been conducted in which adequate analytical methods were used. Thus, further investigation of various patient groups is needed to establish the applicability of the ‘arabinitol method’ in the diagnostic battery for invasive Candida infections.

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“…The test was prognostic and uctuations could be used to monitor the therapeutic response. About the same time, Tokunaga et al [24] evaluated the enzymatic-uorometric kit method in patients with disseminated candidiasis, pyelonephritis, or urinary tract colonization. Their units differed from those used by Walsh et al [26], but they found elevated DA:Cr in nine of 11 (81%) patients with disseminated candidiasis.…”

Section: Enzymatic Metho D Fo R D -Arabinitolmentioning

confidence: 99%

Non-culture based diagnostic tests for mycotic infections

Reiss¹,

Obayashi²,

Orle³

et al. 2000

Med. Mycology

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Non-culture methods being developed and evaluated for mycotic infections include polymerase chain reaction (PCR), galactomannan (GM) antigenemia, Western blot (WB) to detect antibodies, and detection of the fungal metabolites D-arabinitol and (1,3)-b -D-glucan. Sample preparation for PCR from blood specimens depends on fractionation of peripheral blood, its pre-incubation in blood culture broth, or a total DNA method, which does not rely on fractionation, or pre-incubation. Targets for PCR of fungi in the 18S or ITS2 subunits of the ribosomal RNA genes facilitated the design of Aspergillus and Candida genus and species probes. Amplicons were identi ed using PCR-enzyme linked immunosorbent assay (ELISA) or reverse lineblot formats. A pilot study indicated that PCR tests on blood specimens were positive at least once in patients with con rmed invasive aspergillosis (IA). When serum-PCR and serum-GM tests were compared in IA patients, antigenemia was more often positive. PCR detected Aspergillus DNA in bronchoalveolar lavage specimens from patients at risk even when cultures were negative. D-Arabinitol can be detected as a marker of candidiasis with gas chromatography-mass spectrometry or enzyme dependent-uorometry. Each method can differentiate the microbial Dand host L-enantiomers. (1,3)-b -D-Glucan is produced by most genera of pathogenic fungi and can be detected in plasma by the 'G-test'. In patients with febrile neutropenia the ef cacy of azole therapy correlated with plasma (1,3)-b -D-glucan concentrations of ]10 pg ml ¼1 . The diagnosis of early acute pulmonary histoplasmosis can be improved by a WB test utilizing deglycosylated M antigen, a 94-kDa glycoprotein. The identity of M antigen as a catalase was deduced from the sequence of the cloned gene. PCR identi cation of Histoplasma capsulatum cultures was accomplished with primer pairs selected from H and M antigen gene sequences.

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D-arabinitol versus mannan antigen and candidal protein antigen as a serum marker forCandida pyelonephritis

Cited by 13 publications

References 14 publications

Current Status of Nonculture Methods for Diagnosis of Invasive Fungal Infections

Current Status of Nonculture Methods for Diagnosis of Invasive Fungal Infections

D-arabinitol - a marker for invasive candidiasis

Non-culture based diagnostic tests for mycotic infections

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