Diagnostic efficacy of serum cytokines and chemokines in fungal bloodstream infection in febrile patients

Wang, Qi; Yang, Ming; Wang, Chi; Cui, Jiayue; Li, Xinjun; Wang, Chengbin

doi:10.1002/jcla.23149

Cited by 8 publications

(7 citation statements)

References 55 publications

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“…Their use as immunological markers in the assessment of treatment response could be helpful to reduce overtreatment in high-risk patients and on the other hand allow prompt escalation of antifungal treatment, for example, in the case of persistently high IL-6 levels. 145 Mould-active prophylaxis could be better targeted to the individual host characteristics, leading to a targeted prophylaxis (as opposed to universal antifungal prophylaxis) in patients with known immunological profiles associated with high susceptibility for IA (e.g., PTX3, TLR or dectin-1 deficiencies).…”

Section: Discussionmentioning

confidence: 99%

Future challenges and chances in the diagnosis and management of invasive mould infections in cancer patients

et al. 2020

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Diagnosis, treatment, and management of invasive mould infections (IMI) are challenged by several risk factors, including local epidemiological characteristics, the emergence of fungal resistance and the innate resistance of emerging pathogens, the use of new immunosuppressants, as well as off-target effects of new oncological drugs. The presence of specific host genetic variants and the patient's immune system status may also influence the establishment of an IMI and the outcome of its therapy. Immunological components can thus be expected to play a pivotal role not only in the risk assessment and diagnosis, but also in the treatment of IMI. Cytokines could improve the reliability of an invasive aspergillosis diagnosis by serving as biomarkers as do serological and molecular assays, since they can be easily measured, and the turnaround time is short. The use of immunological markers in the assessment of treatment response could be helpful to reduce overtreatment in high risk patients and allow prompt escalation of antifungal treatment. Mould-active prophylaxis could be better targeted to individual host needs, leading to a targeted prophylaxis in patients with known immunological profiles associated with high susceptibility for IMI, in particular invasive aspergillosis. The alteration of cellular antifungal immune response through oncological drugs and immunosuppressants heavily influences the outcome and may be even more important than the choice of the antifungal treatment. There is a need for the development of new antifungal strategies, including individualized approaches for prevention and treatment of IMI that consider genetic traits of the patients. Lay Abstract Anticancer and immunosuppressive drugs may alter the ability of the immune system to fight invasive mould infections and may be more important than the choice of the antifungal treatment. Individualized approaches for prevention and treatment of invasive mold infections are needed.

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Section: Discussionmentioning

confidence: 99%

Future challenges and chances in the diagnosis and management of invasive mould infections in cancer patients

et al. 2020

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“…Aspergillus species (spp.) and other molds [11,12] have been studied singularly or in combination as diagnostic markers for invasive fungal infections [13]. In addition, some studies suggest that increased or decreased concentrations of certain cytokines or chemokines in serum are associated with an heightened risk of IA, so they could be used as a trigger to initiate diagnostic investigation or as potential biomarkers for an early antifungal treatment [14].…”

Section: Cytokines and Chemokines Which Are Centrally Involved In Pro...mentioning

confidence: 99%

Circulatory inflammatory proteins as early diagnostic biomarkers for invasive aspergillosis in patients with hematologic malignancies

Aerts,

Ponce,

Bruno

et al. 2023

Preprint

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Objectives Invasive aspergillosis (IA) is a major cause of mortality in immunocompromised patients and it is difficult to diagnose because of the lack of reliable highly sensitive diagnostics. We aimed to identify circulating immunological markers that could be useful for an early diagnosis of IA. Methods We collected longitudinally serum samples from 33 cases with probable/proven IA and two matched control cohorts without IA (one with microbiological and clinical evidence of bacterial or viral non-fungal pneumonia and one without evidence of infection, all matched for neutropenia, primary underlying disease, and receipt of corticosteroids/other immunosuppressants) at a tertiary university hospital. In addition, samples from an independent cohort (n = 20 cases of proven/probable IA and 20 matched controls without infection) were obtained. A panel of 92 circulating proteins involved in inflammation was measured by proximity extension assay. A random forest model was used to predict the development of IA using biomarkers measured before diagnosis. Results Concentrations of 30 inflammatory biomarkers were different between cases and non-infected controls, of which nine were independently replicated: PD-L1, MMP-10, Interleukin(IL)-10, IL-15RA, IL-18, IL-18R1, CDCP1, CCL19 and IL-17C. From the differential abundance analysis of serum samples collected more than 10 days before diagnosis and at diagnosis, increased IL-17C concentrations in IA patients were replicated in the independent cohort. Conclusions An increased circulating concentration of IL-17C was detected both in the discovery and independent cohort, both at the time of diagnosis and in samples 10 days before the diagnosis of IA, suggesting it could be an (early) biomarker of infection.

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“…Inflammation caused by a bacterial infection will elevate the cytokines IL‐1β, TNF‐α, IL‐6 and IL‐8 25 . Inflammation caused by a fungal infection will elevate the cytokines TNF‐α, IL‐6, IL‐8 and interferon‐γ 26 . Inflammation caused by a viral infection will elevate the cytokines IL‐1β, TNF‐α, IL‐6, IL‐8, IL‐12, interferon‐α and interferon‐γ 27 .…”

Section: Type Iv—inflammation Caused By a Pathogen Infectionmentioning

confidence: 99%

“…25 Inflammation caused by a fungal infection will elevate the cytokines TNFα, IL-6, IL-8 and interferon-γ. 26 Inflammation caused by a viral infection will elevate the cytokines IL-1β, TNF-α, IL-6, IL-8, IL-12, interferon-α and interferon-γ. 27 Inflammation caused by a protozoan parasite infection will elevate the cytokines IL-1β and TNF-α.…”

Section: T Ype Iv-inflammation Caused By a Pathogen Infectionmentioning

confidence: 99%

An inflammation classification system using cytokine parameters

Roe¹

2020

Scand J Immunol

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Inflammation can be created by several different causes, including a blood clot, an immune system disorder, a cancer, an infection, a chemical exposure, a physical injury, or a neurological condition, such as Alzheimer's or depression. In particular, many infections by viral, bacterial, fungal and protozoan pathogens can cause inflammation. Inflammations can have far‐reaching medical consequences, because chronic or frequent inflammation can assist cancers and initiate autoimmune diseases. Determining the cause of an inflammation can be essential for the medical treatment of an individual, and a classification system can be a useful tool to help a diagnosis, confirm a diagnosis and to determine the most appropriate treatment. However, at present there is no classification system for the different causes of inflammation. This paper describes a classification system that uses seven distinct cytokine parameters to enable the determination of the cause of an inflammation. This classification system is expandable, and it can help determine whether an inflammation is caused by an ischaemia, an immune system disorder, a cancer, an infection, a chemical, a physical injury, or a neurological condition. In some cases, this classification system can help enable a quick primary or secondary determination of an urgent medical emergency when other medical diagnostic resources are unavailable.

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Diagnostic efficacy of serum cytokines and chemokines in fungal bloodstream infection in febrile patients

Cited by 8 publications

References 55 publications

Future challenges and chances in the diagnosis and management of invasive mould infections in cancer patients

Future challenges and chances in the diagnosis and management of invasive mould infections in cancer patients

Circulatory inflammatory proteins as early diagnostic biomarkers for invasive aspergillosis in patients with hematologic malignancies

An inflammation classification system using cytokine parameters

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