Follow‐up of anti‐Aspergillus IgG and IgA antibodies in bone marrow transplanted patients with invasive aspergillosis

Abstract

A total of 89 patients at risk for, or with invasive aspergillosis (IA) were recruited from bone marrow transplantation (BMT) units in two Lisbon hospitals, and followed for 2(1/2) years to monitor their immune response. Of these patients, six developed probable IA, from which five died. The presence of serum IgG or IgA antibodies against seven Aspergillus recombinant antigens was assessed in patients with IA, using an enzyme-linked immunosorbent assay (ELISA). In parallel, the serum levels of galactomannan (GM) were also monitored, using the Platelia Aspergillus kit (Sanofi Pasteur, Marnes-la-Coquette, France). Superoxide dismutase (Sod) and 94 kDa were the most immunogenic antigens for IgA, while the IgG pattern of recognition changed from patient to patient. From our results we conclude that although follow-up of antibodies against these antigens should not be used as a diagnostic method, patients with IA do produce an immune response that may influence disease outcome.

Strong Correlation between Serum Aspergillus Galactomannan Index and Outcome of Aspergillosis in Patients with Hematological Cancer: Clinical and Research Implications

“…Seventeen of the 20 prospective studies included patients undergoing standard chemotherapy and patients who received myeloablative chemotherapy and underwent autologous or allogeneic BMT or HSCT [12-14, 17-23, 31-36, 38], and the remaining 3 studies enrolled allogeneic BMT and HSCT recipients only [15,16,37]. Various age groups were included in the 20 prospective studies, as follows: adults (11 studies) [17][18][19][20][21][22][34][35][36][37][38], pediatric patients (1 study) [23], and both adult and pediatric patients (8 studies ) [12][13][14][15][16][31][32][33]. Nine studies provided information regarding autopsy ex- Pinel et al [14] c,e Bretagne et al [25] c,e amination [31,[33][34][35][36][37][38][39][40].…”

“…Because many studies did not include autopsy examination and because of decreasing rates of performance of autopsy [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29], we evaluated survival (alive vs. dead) without taking into consideration autopsy finding or causes of death (aspergillosis vs. other), as reported by the original authors.…”

AspergillusInfections in Transplant Recipients

“…Those based on the detection of antifungal antibodies have proven to be unreliable in transplant recipients receiving immunosuppressive agents (51). Instead, tests based on identifying fungal antigens or metabolites released into the circulation are potentially promising.…”

Pulmonary complications following hematopoietic stem cell transplantation: Diagnostic approaches

“…However, IPA specific serologic studies may be useful in determining the prognosis of patients at risk of IPA, as Exposto and co-workers [75] found that an increase in IgG antibodies against the 94-kDa antigen predicts recovery from IPA. To date, Aspergillus serology is not available in North America [76].…”