Standardization and Prevalence of the Booster Phenomenon: Evaluation Using a Two-Step Skin Test with 43 kDa Glycoprotein in Individuals from an Endemic Region of Paracoccidioidomycosis

Marques, Ana Maria Campos; Oliveira, Sandra Maria V. L.; Rezende, Grazielli Rocha de; Melo, Dayane A.; Fernandes-Fitts, Sonia M.; Pontes, Elenir Rose Jardim Cury; Bonecini-Almeida, Maria da Glória; Camargo, Zoilo Pires de; Mendes, Rinaldo Pôncio; Paniago, Anamaria Mello Miranda

doi:10.1007/s11046-017-0159-z

Cited by 2 publications

(2 citation statements)

References 41 publications

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“…Of the remaining 31 surveys, 18 presented no significant differences between genders [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ], 3 displayed higher rates of positive tests in women [ 35 , 36 , 37 ], and 10 identified higher rates in men [ 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ]. However, of the latter ten surveys, three mentioned a difference, but none of them provided statistical analysis nor detailed data to allow statistical manipulation; three actually showed no statistically significant difference; and, notably, of the remaining four surveys that showed a statistical difference, in one of them the percentage of positive tests in men was around only twice that of women (data not shown).…”

Section: Resultsmentioning

confidence: 99%

A Case-Control Study of Paracoccidioidomycosis in Women: The Hormonal Protection Revisited

Brito

Taborda

Provenci

et al. 2021

JoF

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Clinical observations have long suggested that women are protected against paracoccidioidomycosis. 17β-estradiol, the main female estrogen, inhibits conidia-to-yeast transformation (C-to-Y), which is required for the infection establishment. However, experiments in murine models have yielded conflicting results, suggesting that C-to-Y inhibition, alone, fails to explain the female-associated protection and that sexual hormones may also act by modulating the host’s immune responses. Therefore, this issue remains unsolved. Strikingly, no studies have compared the severity of paracoccidioidomycosis between men and women. This retrospective case-control study compared 36 women with 72 age-matched men for clinical–demographic, laboratory, and chest imaging findings. Overall, paracoccidioidomycosis in women presented the main features described in the acute/subacute and chronic forms seen in men. Women also showed similar demographic features and clinical–laboratory and imaging severity scores as men. We additionally reviewed 58 paracoccidioidin skin test surveys undertaken by volunteers from endemic areas. Data accumulated from 10.873 tests showed that females and males are infected with similar magnitudes (21.9% vs. 25.2%) and that reactivity steadily increased with age, peaking after the age of 60. We discuss the paradox of similar infection rates but much lower disease prevalence in women, considering the current pathogenetic views of paracoccidioidomycosis, and we raise alternative hypotheses to account for this paradox.

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Section: Resultsmentioning

confidence: 99%

A Case-Control Study of Paracoccidioidomycosis in Women: The Hormonal Protection Revisited

Brito

Taborda

Provenci

et al. 2021

JoF

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“…Antigens employed in DTH tests are usually 'in-house' products [24,[27][28][29][30][31][32][33][34], sometimes without the same quality control as a commercial antigen. Therefore, contamination risks and potential adverse effects [35,36] are eliminated by replacing DTH with ELISA. Besides, some individuals may experience a decrease in antigenic response over time, resulting in a false negative test or a weak DTH [37].…”

Section: Discussionmentioning

confidence: 99%

IgG reactivity profile to Paracoccidioides spp. antigens in people with asymptomatic Paracoccidioidomycosis

Lenhard-Vidal

Bender

Assolini

et al. 2021

Journal of Medical Microbiology

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Introduction. Paracoccidioidomycosis (PCM) is a systemic mycosis caused by Paracoccidioides spp. As the disease is known to affect mostly men over 40 years old who previously worked handling soil, some cities of agricultural economy in endemic regions may have more cases of paracoccidioidal infection. Gap statement. The true frequency of PCM cannot be established in Brazil because it is not a disease of mandatory reporting. The detection of paracoccidioidal infection may assist in the planning of health services, in order to provide early detection of the disease and to prevent its worsening or even progression to death. In addition, little is described about sera reactivity with antigens from different species of Paracoccidiodes, especially P. lutzii. Aim. Current research was conducted in an inland municipality of southern Brazil, in order to assess infection rate within this endemic region of PCM disease. Methodology. ELISA was employed to evaluate 359 sera from random volunteers from Guarapuava, Paraná, Brazil, to detect IgG against cell-free antigens (CFA) from P. restrepiensis B339, P. americana LDR3 and P. lutzii LDR2. Confirmatory ELISA employed gp43 from B339. Reduction of cross-reactions was sought by treatment with sodium metaperiodate (SMP-CFA, SMP-gp43). Immunoblot was performed with 37 selected sera among those reactive in ELISA. Epidemiological profile was assessed by questionnaire. Results. ELISA reactivity was: CFA/SMP-CFA in general 37.3/17.8 %, B339 25.3/14.5 %, LDR3 24.5/1.4 %, LDR2 8.3/5.8 %; gp43/SMP-gp43 7.2/4.7 %. There were sera reactive with multiple CFAs. In immunoblot, five sera showed the same reaction profile with P. lutzii’s antigens as PCM disease sera. Rural residence and soil-related professions were risk factors for paracoccidioidal infection. Conclusion. The low prevalence is in accordance with previous reports of lower PCM disease endemicity in Guarapuava than in other areas of Paraná. Although P. brasiliensis seems to be the prevalent strain of the region, 21 sera from people who only lived in Guarapuava reacted with P. lutzii LDR2. CFA-ELISA with whole antigens seems a good option for serological screening in epidemiological surveys.

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Standardization and Prevalence of the Booster Phenomenon: Evaluation Using a Two-Step Skin Test with 43 kDa Glycoprotein in Individuals from an Endemic Region of Paracoccidioidomycosis

Abstract: The results indicate that the prevalence of paracoccidioidal infection in endemic areas is underestimated, as the booster phenomenon has not been considered in epidemiological surveys for this infection.

Cited by 2 publications

References 41 publications

A Case-Control Study of Paracoccidioidomycosis in Women: The Hormonal Protection Revisited

A Case-Control Study of Paracoccidioidomycosis in Women: The Hormonal Protection Revisited

IgG reactivity profile to Paracoccidioides spp. antigens in people with asymptomatic Paracoccidioidomycosis

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