Invasive Aspergillosis in Patients with AIDS

Minamoto, Grace Y.; Barlam, Tamar F.; Vander, Nicholas

doi:10.1093/clinids/14.1.66

Cited by 143 publications

(68 citation statements)

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“…Risk factors for invasive aspergillosis are prolonged neutropenia and\or long-term administration of high dose corticosteroids (Denning, 1998). The frequency of invasive aspergillosis has increased 14-fold in the past decade (Groll et al, 1996), mainly due to the greater numbers of bone marrow and organ transplant recipients (Wald et al, 1997), more aggressive cytotoxic chemotherapy used to treat cancer patients (Bodey et al, 1992) and the emergence of the human immunodeficiency syndrome (HIV-AIDS) (Minamoto et al, 1992). There are currently only two antifungal agents used to treat the disease, amphotericin B and itraconazole, and their success rate is only 34 %, even when used prophylactically (Denning, 1998).…”

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confidence: 99%

Differences in sialic acid density in pathogenic and non-pathogenic Aspergillus species

2001

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Aspergillus fumigatus is a ubiquitous soil fungus that causes invasive lung disease in the immunocompromised host. The structure of the conidial wall has not been well characterized although it is thought that adhesins present on the surface are involved in attachment of the conidia to host lung cells and proteins, which is a prerequisite for the establishment of infection. Negatively charged carbohydrates on the conidial surface have been previously identified as the molecules responsible for attachment of conidia to extracellular matrix proteins. The aim of this research was to identify carbohydrates on the conidial surface that contribute to its negative charge. Direct chemical analysis and indirect binding assays have demonstrated that A. fumigatus possesses sialic acids on the conidial surface. Pre-treatment of A. fumigatus conidia with sialidase decreased binding of a sialic acid-specific lectin, Limax flavus agglutinin (LFA), to the conidial surface and decreased adhesion of conidia to the positively charged polymer poly L-lysine. Two other sialic acid-specific lectins, Maackia amurensis agglutinin and Sambucus nigra agglutinin, exhibited negligible binding to A. fumigatus conidia indicating that 2,3-α-and 2,6-α-linked sialic acids are not the major structures found on the conidial surface. Mild acid hydrolysis and purification of conidial wall carbohydrates yielded a product that had the same R F as the Neu5Ac standard when analysed by high-performance thin-layer chromatography. A density of 67W10 5 sialic acid residues per conidium was estimated using a colorimetric assay. Conidia grown on a minimal medium lacking sialic acid also reacted with LFA, indicating that sialic acid biosynthesis occurs de novo. Sialic acid biosynthesis was shown to be regulated by nutrient composition : the density of sialic acids on the surface of conidia grown in minimal media was lower than that observed when conidia were grown on rich, complex media. It has previously been shown that pathogenic Aspergillus species adhere to basal lamina proteins to a greater extent than non-pathogenic Aspergillus species. To determine whether the expression of sialic acid on the conidial surface was correlated with adhesion to basal lamina, conidia from other non-pathogenic Aspergillus species were tested for their reactivity towards LFA. Flow cytometric analysis demonstrated that A. fumigatus had a significantly greater sialic acid density than three non-pathogenic Aspergillus species. Sialic acids on the conidial wall may be involved in adhesion to fibronectin, a component of the basal lamina, as binding of A. fumigatus conidia to fibronectin was strongly inhibited in the presence of a sialylated glycoprotein. (Denning, 1998). In the normal host, Aspergillus species can cause a wide spectrum of diseases ranging from allergic manifestations and superficial infections (Bodey & Vartivarian, 1989), to a lifethreatening invasive disease known as invasive aspergillosis. Initiation of infection begins with the inhalation of conidia, the infect...

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Differences in sialic acid density in pathogenic and non-pathogenic Aspergillus species

2001

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“…Minamotoet al discussed invasive aspergillosis in patients with AIDS, describing the possible risk factors associated with aspergillosis such as leukopenia, use of corticosteroids, and antineoplastic agents (19). In the present case the use of dexamethasone may have aggravated the condition of Aspergillus infection.…”

Section: Discussionmentioning

confidence: 66%

Aspergillus Aneurysm of the Middle Cerebral Artery Causing a Fatal Subarachnoid Hemorrhage.

et al. 1995

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“…1,5 Other possible explanations for infection in patients with HIV disease include the increasing use of corticosteroid treatment, as is used in the treatment of Pneumocystis carinii pneumonia 1,6,7 ; neutropenia-inducing antiretroviral drugs such as zidovudine 1,6 ; and a prolonged life of patients with late-stage HIV disease. 1,6,7 We find 3 interesting features of this case. First, direct spinal invasion by pulmonary aspergillosis, though rare, is not unheard of, as several cases of chest wall invasion with epidural aspergillosis have been documented in the past.…”

Section: Discussionmentioning

confidence: 99%

Spinal Epidural Aspergillosis in a Patient With HIV Resulting From Long-Standing (3 Years) Lung Infection

Murtagh¹,

Post²,

Bruce

et al. 2007

AJNR Am J Neuroradiol

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SUMMARY:We present an unusual case of a man with human immunodeficiency virus (HIV) with pulmonary aspergillosis and spinal invasion and compression of the spinal cord occurring during a long period (3 years), as documented by MR imaging and surgical intervention. Invasive pulmonary aspergillosis with cord compression has been reported in the past, but, to the best of our knowledge, none of these have been in a patient with HIV.

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Invasive Aspergillosis in Patients with AIDS

Cited by 143 publications

References 0 publications

Differences in sialic acid density in pathogenic and non-pathogenic Aspergillus species

Differences in sialic acid density in pathogenic and non-pathogenic Aspergillus species

Aspergillus Aneurysm of the Middle Cerebral Artery Causing a Fatal Subarachnoid Hemorrhage.

Spinal Epidural Aspergillosis in a Patient With HIV Resulting From Long-Standing (3 Years) Lung Infection

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