Humoral Responses to Pneumocystis carinii in Patients with Acquired Immunodeficiency Syndrome and in Immunocompromised Homosexual Men

Hofmann, Bo; Ødum, Niels; Platz, P.; Ryder, Lars P.; Svejgaard, A.; Nielsen, Peder Bo; Holten-Andersen, Winnie; Gersloft, Jan; Nielsen, Jens; Mojon, M

doi:10.1093/infdis/152.4.838

Cited by 33 publications

(11 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In light of the impaired B cell function in HIV infection and the low or absent IgM antibodies to P. jirovecii antigens in previous reports [13], [16], [36]–[37], the presence of elevated antibody levels in the present study is somewhat unusual and unexpected. However, we previously showed that HIV+ patients with single or recurrent episodes of PcP can develop active IgM and/or IgG responses to crude P. carinii antigens, and that the secondary anti-IgM antibody, which was essentially the same product as used here, was μ-specific [11].…”

Section: Discussionsupporting

confidence: 49%

Serum Antibody Levels to the Pneumocystis jirovecii Major Surface Glycoprotein in the Diagnosis of P. jirovecii Pneumonia in HIV+ Patients

et al. 2010

View full text Add to dashboard Cite

Background Pneumocystis jirovecii remains an important cause of fatal pneumonia (Pneumocystis pneumonia or PcP) in HIV+ patients and other immunocompromised hosts. Despite many previous attempts, a clinically useful serologic test for P. jirovecii infection has never been developed.Methods/Principal FindingsWe analyzed serum antibody responses to the P. jirovecii major surface glycoprotein recombinant fragment C1 (MsgC1) in 110 HIV+ patients with active PcP (cases) and 63 HIV+ patients with pneumonia due to other causes (controls) by an enzyme-linked immunosorbent assay (ELISA). The cases had significantly higher IgG and IgM antibody levels to MsgC1 than the controls at hospital admission (week 0) and intervals up to at least 1 month thereafter. The sensitivity, specificity and positive predictive value (PPV) of IgG antibody levels increased from 57.2%, 61.7% and 71.5% at week 0 to 63.4%, 100%, and 100%, respectively, at weeks 3–4. The sensitivity, specificity and PPV of IgM antibody levels rose from 59.7%, 61.3%, and 79.3% at week 0 to 74.6%, 73.7%, and 89.8%, respectively, at weeks 3–4. Multivariate analysis revealed that a diagnosis of PcP was the only independent predictor of high IgG and IgM antibody levels to MsgC1. A high LDH level, a nonspecific marker of lung damage, was an independent predictor of low IgG antibody levels to MsgC1.Conclusions/SignificanceThe results suggest that the ELISA shows promise as an aid to the diagnosis of PCP in situations where diagnostic procedures cannot be performed. Further studies in other patient populations are needed to better define the usefulness of this serologic test.

show abstract

Section: Discussionsupporting

confidence: 49%

Serum Antibody Levels to the Pneumocystis jirovecii Major Surface Glycoprotein in the Diagnosis of P. jirovecii Pneumonia in HIV+ Patients

et al. 2010

View full text Add to dashboard Cite

show abstract

“…There have been few studies evaluating IgM serologic responses to P. jirovecii in HIV-positive compared to HIV-negative individuals. Of these, the majority have found low or absent IgM responses to Pneumocystis antigen in HIV-positive individuals [7], [8], [34], [35], consistent with our results. The diminished IgM responses seen in those with HIV and more severe immunosuppression could very well reflect typical immunoglobulin class switching from IgM predominant B cell responses to IgG predominant responses.…”

Section: Discussionsupporting

confidence: 91%

Serologic Responses to Recombinant Pneumocystis jirovecii Major Surface Glycoprotein among Ugandan Patients with Respiratory Symptoms

et al. 2012

View full text Add to dashboard Cite

BackgroundLittle is known about the serologic responses to Pneumocystis jirovecii major surface glycoprotein (Msg) antigen in African cohorts, or the IgM responses to Msg in HIV-positive and HIV-negative persons with respiratory symptoms.MethodsWe conducted a prospective study of 550 patients, both HIV-positive (n = 467) and HIV-negative (n = 83), hospitalized with cough ≥2 weeks in Kampala, Uganda, to evaluate the association between HIV status, CD4 cell count, and other clinical predictors and antibody responses to P. jirovecii. We utilized ELISA to measure the IgM and IgG serologic responses to three overlapping recombinant fragments that span the P. jirovecii major surface glycoprotein: MsgA (amino terminus), MsgB (middle portion) and MsgC1 (carboxyl terminus), and to three variations of MsgC1 (MsgC3, MsgC8 and MsgC9).ResultsHIV-positive patients demonstrated significantly lower IgM antibody responses to MsgC1, MsgC3, MsgC8 and MsgC9 compared to HIV-negative patients. We found the same pattern of low IgM antibody responses to MsgC1, MsgC3, MsgC8 and MsgC9 among HIV-positive patients with a CD4 cell count <200 cells/µl compared to those with a CD4 cell count ≥200 cells/µl. HIV-positive patients on PCP prophylaxis had significantly lower IgM responses to MsgC3 and MsgC9, and lower IgG responses to MsgA, MsgC1, MsgC3, and MsgC8. In contrast, cigarette smoking was associated with increased IgM antibody responses to MsgC1 and MsgC3 but was not associated with IgG responses. We evaluated IgM and IgG as predictors of mortality. Lower IgM responses to MsgC3 and MsgC8 were both associated with increased in-hospital mortality.ConclusionsHIV infection and degree of immunosuppression are associated with reduced IgM responses to Msg. In addition, low IgM responses to MsgC3 and MsgC8 are associated with increased mortality.

show abstract

“…In several previous studies, the serum IgG responses to P. carinii in patients and controls did not differ significantly (10,11). Nevertheless, other authors found reduced IgG antibody activities in HIV-infected patients with Pcp (4).…”

Section: Discussionmentioning

confidence: 86%

Decreased Production of Local Immunoglobulin A toPneumocystis cariniiin Bronchoalveolar Lavage Fluid from Human Immunodeficiency Virus-Positive Patients

Jalil¹,

Moja²,

Lambert³

et al. 2000

Infect Immun

View full text Add to dashboard Cite

An enzyme-linked immunosorbent assay and a Western blot analysis were developed to study the antibody response to Pneumocystis carinii in serum and bronchoalveolar lavage fluid from 27 human immunodeficiency virus 27 (HIV)-infected patients with P. carinii pneumonia (Pcp), 32 patients without Pcp, and 51 HIV-negative controls. Urea was used for the correct dilution of epithelial lining fluid, and albumin was used to evaluate transudation from plasma for the assessment of local production of antibodies to P. carinii. By contrast with those of immunoglobulin G (IgG), IgA responses to P. carinii were increased in serum from HIV-positive patients compared to negative controls. Local production of antibodies to P. carinii, especially IgA, was decreased in patients with Pcp. In a study of 10 patients of each group, IgG and IgA responses to gp116 from P. carinii were lower in patients with Pcp than in other groups. These results suggest that, in addition to alveolar macrophages, local antibodies may play a role in host defense against P. carinii.

show abstract

Humoral Responses to Pneumocystis carinii in Patients with Acquired Immunodeficiency Syndrome and in Immunocompromised Homosexual Men

Cited by 33 publications

References 6 publications

Serum Antibody Levels to the Pneumocystis jirovecii Major Surface Glycoprotein in the Diagnosis of P. jirovecii Pneumonia in HIV+ Patients

Serum Antibody Levels to the Pneumocystis jirovecii Major Surface Glycoprotein in the Diagnosis of P. jirovecii Pneumonia in HIV+ Patients

Serologic Responses to Recombinant Pneumocystis jirovecii Major Surface Glycoprotein among Ugandan Patients with Respiratory Symptoms

Decreased Production of Local Immunoglobulin A toPneumocystis cariniiin Bronchoalveolar Lavage Fluid from Human Immunodeficiency Virus-Positive Patients

Contact Info

Product

Resources

About