Diagnosis of histoplasmosis by antigen detection based upon experience at the histoplasmosis reference laboratory

Wheat, L. Joseph; Garringer, Todd; Brizendine, E. J.; Connolly, Patricia

doi:10.1016/s0732-8893(02)00367-x

Cited by 96 publications

(53 citation statements)

References 27 publications

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“…Polysaccharide antigen detection by radioimmune assay has also proved useful in the diagnosis of histoplasmosis, particularly in disseminated cases (Wheat et al, 1991(Wheat et al, , 1997(Wheat et al, , 2002Wheat, 2001;Wheat & Kauffman, 2003), although cross-reactivity may be a problem (Wheat et al, 1997). In addition, the polysaccharide detection test has historically only been available at one centre in the United States, making it somewhat inaccessible to workers in developing countries.…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…An alternative approach to immunoAbbreviations: CF, complement fixation; HMIN, histoplasmin; ID, immunodiffusion; pHMIN, purified histoplasmin; ptHMIN, purified, treated histoplasmin. diagnosis is to detect Histoplasma antigens in urine or serum, and this has proved particularly useful in cases of disseminated disease (Gomez et al, 1997;Wheat et al, 1991Wheat et al, , 1997Wheat et al, , 2002Wheat, 2001;Wheat & Kauffman, 2003).…”

Section: Introductionmentioning

confidence: 99%

“…However, it was appreciated at an early stage that HMIN in its native form was not an ideal serodiagnostic reagent, because of problems associated with the presence of cross-reactive carbohydrate components within it. This had a detrimental effect on the specificity of the CF test (Kaufman et al, 1997) diagnosis is to detect Histoplasma antigens in urine or serum, and this has proved particularly useful in cases of disseminated disease (Gomez et al, 1997;Wheat et al, 1991Wheat et al, , 1997Wheat et al, , 2002Wheat, 2001;Wheat & Kauffman, 2003).Since the 1980s, immunoassays with varying degrees of sensitivity and specificity have been developed for the detection of anti-H. capsulatum antibodies in clinical specimens (Brock et al, 1983;Kumar et al, 1985;Maiga & Marjolet, 1985;Raman et al, 1990;Torres et al, 1993;Zimmerman et al, 1990). These variations have been attributed to the cross-reactive carbohydrate epitopes present on HMIN.…”

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ELISA for early diagnosis of histoplasmosis

Guimarães

Pizzini

Guedes

et al. 2004

Journal of Medical Microbiology

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An ELISA was developed and evaluated as a method for detecting antibodies against glycosylated and deglycosylated histoplasmin (HMIN). Sera from patients with histoplasmosis, paracoccidioidomycosis, sporotrichosis, coccidioidomycosis, aspergillosis, cryptococcosis and healthy donors were tested by ELISA against purified, deglycosylated histoplasmin (ptHMIN) and compared with purified, native (i.e. glycosylated) histoplasmin (pHMIN). Although cross-reactivity was not abolished when ptHMIN was used in the test, it was reduced (pHMIN ELISA 93 % versus ptHMIN ELISA 96 %). However, there were statistically significant differences between the sensitivities of these two methods for the detection of antibodies (pHMIN ELISA 57 % versus ptHMIN ELISA 92 %; P , 0 . 001) and between the efficiency of the methods (pHMIN ELISA 83 % versus ptHMIN ELISA 95 %; P , 0 . 001). These parameters compare better than previously published data relating to the use of treated HMIN in diagnostic ELISAs. Some of the reactivities of serum samples were compared by immunoblotting using deglycosylated HMIN and by immunodiffusion using the crude antigen. The results demonstrated that cross-reactions with heterologous sera in both ELISAs could also be observed in immunoblotting and arose from shared protein epitopes. These data suggest that ELISA using deglycosylated HMIN is a very sensitive diagnostic method and, by using commercially available antigen, it can be easily standardized and performed faster than previous Western blot-based tests using the same antigen. It provides a useful adjunct to existing methods of diagnosis that could be applied even in situations where laboratory facilities were relatively limited. INTRODUCTIONHistoplasmosis is a systemic fungal disease caused by Histoplasma capsulatum. The significance of histoplasmosis results from its worldwide distribution (Rios-Fabra et al., 1994;Wheat, 2001), its ability to mimic other serious disease entities (Goodwin et al., 1980;McKinsey et al., 1997) and its propensity to cause serious disseminated infection in immunocompromised patients (Bradsher, 1996;Goodwin et al., 1980;Wheat, 1996;Wheat & Kauffman, 2003).Definitive diagnosis has typically relied either on direct visualization of the organism in tissue and/or the isolation of the causative organism, which is time-consuming and lacking in sensitivity (Bullock, 1995;Kwon-Chung & Bennet, 1992;Wheat, 2001). The detection of patients' antibody responses offers a more rapid alternative to microbiological means of diagnosis, and the detection of host anti-H. capsulatum antibodies by immunodiffusion (ID) and complement fixation (CF) tests is often used (Bullock, 1995;Kaufman et al., 1997). Both the yeast and mycelial phases of the fungus produce a number of exoantigens in culture, the most important and characteristic being the H and M antigens. These two antigens are the primary immunoreactive constituents of histoplasmin (HMIN), the standard diagnostic reagent used in ID and CF for many years (Standard & Kaufman, 1976). However, it was...

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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ELISA for early diagnosis of histoplasmosis

Guimarães

Pizzini

Guedes

et al. 2004

Journal of Medical Microbiology

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“…Blood cultures, especially those using the lysiscentrifugation system (isolator tube), are more sensitive for patients who have disseminated infection than for those who have pulmonary disease only. Measuring the cell wall polysaccharide antigen of H. capsulatum in urine is a sensitive diagnostic tool for patients who have disseminated infection (394). Antigen is rarely detected in patients who have chronic pulmonary histoplasmosis or granulomatous mediastinitis, but it is positive in approximately 80% of those who have acute pulmonary histoplasmosis.…”

Section: Infections Caused By Histoplasma Capsulatummentioning

confidence: 99%

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

et al. 2008

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SUMMARY In recent years, the increasing number of donors from different regions of the world is providing a new challenge for the management and selection of suitable donors. This is a worldwide problem in most countries with transplantation programs, especially due to the increase in immigration and international travel. This paper elaborates recommendations regarding the selection criteria for donors from foreign countries who could potentially transmit tropical or geographically restricted infections to solid-organ transplant recipients. For this purpose, an extensive review of the medical literature focusing on viral, fungal, and parasitic infections that could be transmitted during transplantation from donors who have lived or traveled in countries where these infections are endemic has been performed, with special emphasis on tropical and imported infections. The review also includes cases described in the literature as well as risks of transmission during transplantation, microbiological tests available, and recommendations for each infection. A table listing different infectious agents with their geographic distributions and specific recommendations is included.

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Carbohydrates as Unique Structures for Disease Diagnosis

Rittenhouse-Olson

2008

Carbohydrate‐Based Vaccines and Immunotherapies

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Diagnosis of histoplasmosis by antigen detection based upon experience at the histoplasmosis reference laboratory

Cited by 96 publications

References 27 publications

ELISA for early diagnosis of histoplasmosis

ELISA for early diagnosis of histoplasmosis

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

Carbohydrates as Unique Structures for Disease Diagnosis

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