Evaluation of an Aspergillus IgG/IgM lateral flow assay for serodiagnosis of fungal asthma in Uganda

Kwizera, Richard; Bongomin, Felix; Olum, Ronald; Worodria, William; Bwanga, Freddie; Meya, David B.; Kirenga, Bruce; Gore, Robin; Denning, David W.; Fowler, Stephen J.

doi:10.1371/journal.pone.0252553

Cited by 9 publications

(12 citation statements)

References 31 publications

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“…The LDBIO Aspergillus ICT LFA (LDBIO Diagnostics, Lyon, France) is a commercially available LFA for detecting Aspergillus-specific antibodies and has similar sensitivity and specificity to the EIA. [101][102][103] Also, IMMY (Norman, OK) has an LFD for Aspergillus immunoglobulins.…”

Section: Chronic Pulmonary Aspergillosismentioning

confidence: 99%

Microbiological Diagnosis of Pulmonary Aspergillus Infections

Aerts,

Feys,

Mercier

et al. 2024

Semin Respir Crit Care Med

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As microbiological tests play an important role in our diagnostic algorithms and clinical approach towards patients at-risk for pulmonary aspergillosis, a good knowledge of the diagnostic possibilities and especially their limitations is extremely important. In this review, we aim to reflect critically on the available microbiological diagnostic modalities for diagnosis of pulmonary aspergillosis and formulate some future prospects. Timely start of adequate antifungal treatment leads to a better patient outcome, but overuse of antifungals should be avoided. Current diagnostic possibilities are expanding, and are mainly driven by enzyme immunoassays and lateral flow device tests for the detection of Aspergillus antigens. Most of these tests are directed towards similar antigens, but new antibodies towards different targets are under development. For chronic forms of pulmonary aspergillosis, anti-Aspergillus IgG antibodies and precipitins remain the cornerstone. More studies on the possibilities and limitations of molecular testing including targeting resistance markers are ongoing. Also, metagenomic next-generation sequencing is expanding our future possibilities. It remains important to combine different test results and interpret them in the appropriate clinical context to improve performance. Test performances may differ according to the patient population and test results may be influenced by timing, the tested matrix, and prophylactic and empiric antifungal therapy. Despite the increasing armamentarium, a simple blood or urine test for the diagnosis of aspergillosis in all patient populations at-risk is still lacking. Research on diagnostic tools is broadening from a pathogen focus on biomarkers related to the patient and its immune system.

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Section: Chronic Pulmonary Aspergillosismentioning

confidence: 99%

Microbiological Diagnosis of Pulmonary Aspergillus Infections

Aerts,

Feys,

Mercier

et al. 2024

Semin Respir Crit Care Med

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“…Lower specificities (72%) have been documented in some studies and in patients with bronchiectasis in the absence of aspergillosis (82%) [34,35]. Sensitivity of the LFA for the diagnosis of ABPA and severe asthma with fungal sensitization (SAFS) may be low (< 7%) [36]. A meta-analysis of this assay for the diagnosis of CPA generated pooled sensitivity and specificity of 90% and 91%, respectively, generating positive and negative likelihood ratios of 10 and 0.11, indicating that the test is useful for both confirming and excluding CPA [37].…”

Section: Lateral Flow Assaysmentioning

confidence: 99%

Developments in Fungal Serology

White

2023

Curr Fungal Infect Rep

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Purpose of Review The true incidence of fungal disease is hampered by conventionally poor diagnostic tests, limited access to advanced diagnostics, and limited surveillance. The availability of serological testing has been available for over two decades and generally underpins the modern diagnosis of the most common forms of fungal disease. This review will focus on technical developments of serological tests for the diagnosis of fungal disease, describing advances in clinical performance when available. Recent Findings Despite their longevity, technical, clinical, and performance limitations remain, and tests specific for fungal pathogens outside the main pathogens are lacking. The availability of LFA and automated systems, capable of running multiple different tests, represents significant developments, but clinical performance data is variable and limited. Summary Fungal serology has significantly advanced the diagnosis of the main fungal infections, with LFA availability increasing accessibility to testing. Combination testing has the potential to overcome performance limitations.

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“…[12][13][14][15] Two previous studies (one each in England and Africa) that evaluated LFA in ABPA found contrasting results. 13,16 The primary objective of this study was to assess the diagnostic performance of LDBio-LFA for diagnosing ABPA using the ISHAM-ABPA working group criteria as the reference standard (reference standard 1, Table 1). The secondary outcome was to compare the diagnostic performance of LDBio-LFA and A. fumigatus-specific IgG (at cut-offs of 27 and 40 mgA/L) using the MDT diagnosis of ABPA (reference standard 2, Table 1).…”

Section: Introductionmentioning

confidence: 99%

Sensitivity and specificity of LDBioAspergillusICT lateral flow assay for diagnosing allergic bronchopulmonary aspergillosis in adult asthmatics

Sehgal,

Muthu,

Dhooria

et al. 2024

Mycoses

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BackgroundAspergillus fumigatus‐specific IgG estimation is crucial for diagnosing allergic bronchopulmonary aspergillosis (ABPA). A point‐of‐care LDBio immunochromatographic lateral flow assay (LFA) had 0%–90% sensitivity to detect IgG/IgM antibodies against A. fumigatus.ObjectiveTo assess the accuracy of LDBio‐LFA in diagnosing ABPA, using the modified ISHAM‐ABPA working group criteria as the reference standard. The secondary objective was to compare the diagnostic performance between LDBio‐LFA and A. fumigatus‐specific IgG (cut‐offs, 27 and 40 mgA/L), using a multidisciplinary team (blinded to A. fumigatus‐IgG and LDBio‐LFA results) diagnosis of ABPA as the reference standard.MethodsWe prospectively enrolled adult subjects with asthma and ABPA. We performed the LDBio‐LFA per the manufacturer's recommendations. We used the commercially available automated fluorescent enzyme immunoassay for measuring serum A. fumigatus‐specific IgG. We used the same serum sample to perform both index tests. The tests were performed by technicians blinded to the results of other tests and clinical diagnoses.ResultsWe included 123 asthmatic and 166 ABPA subjects, with a mean ± SD age of 37.4 ± 14.4 years. Bronchiectasis and high‐attenuation mucus were seen in 93.6% (146/156) and 24.3% (38/156) of the ABPA subjects. The sensitivity and specificity of LDBio‐LFA in diagnosing ABPA were 84.9% and 82.9%, respectively. The sensitivity of serum A. fumigatus‐specific IgG ≥27 mgA/L was 13% better than LDBio‐LFA, with no difference in specificity. There was no significant difference in sensitivity and specificity between LDBio‐LFA and serum A. fumigatus‐IgG ≥40 mgA/L.ConclusionLDBio‐LFA is a valuable test for diagnosing ABPA. However, a negative test should be confirmed using an enzyme immunoassay.

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Evaluation of an Aspergillus IgG/IgM lateral flow assay for serodiagnosis of fungal asthma in Uganda

Cited by 9 publications

References 31 publications

Microbiological Diagnosis of Pulmonary Aspergillus Infections

Microbiological Diagnosis of Pulmonary Aspergillus Infections

Developments in Fungal Serology

Sensitivity and specificity of LDBioAspergillusICT lateral flow assay for diagnosing allergic bronchopulmonary aspergillosis in adult asthmatics

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