Indirect enzyme-linked immunosorbent assay for zygomycosis

Kaufman, Leo; Turner, Laura F.; McLaughlin, David W.

doi:10.1128/jcm.27.9.1979-1982.1989

Cited by 30 publications

(19 citation statements)

References 5 publications

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“…The experimental use of serologies to detect invasive zygomycosis has been attempted in several laboratories (154,198,220,230,275,365,417,429,517,522). Although several serologic modalities have been tested, the enzymelinked immunosorbent assays (ELISA) seem to have the best sensitivity and specificity for detecting antibodies produced during invasive zygomycosis (230,365). These serologically based tests have demonstrated that the zygomycetes share several antigenic determinants with one another.…”

Section: Serologic Diagnosis Of Infections With the Zygomycetesmentioning

confidence: 99%

“…These serologically based tests have demonstrated that the zygomycetes share several antigenic determinants with one another. This antigenic sharing makes it impossible for the various species and even genera to be reliably distinguished from one another (198,230,365). In addition to detecting antibody production due to invasive disease, double-diffusion and ELISA techniques have been used to detect antibodies produced as a result of allergic alveolitis (404).…”

Section: Serologic Diagnosis Of Infections With the Zygomycetesmentioning

confidence: 99%

“…Other nonculture techniques have also been developed for the diagnosis of disease caused by Rhizopus. Detection of antibodies produced during an invasive infection (198,230,365,517) or secondary to an allergic response to inhaled fungal elements (404) has been successful. Sandvren and Edwards (404) were able to detect antibodies to Rhizopus in sawmill workers by both double-diffusion and ELISA techniques, although the ELISA method proved to be more sensitive.…”

Section: Rhizopus Speciesmentioning

confidence: 99%

“…Similarly, antibodies stimulated by subcutaneous exposures to R. (oryzae) arrhizus have been detected using crossed immunoelectrophoresis and counterimmunoelectrophoresis (198). ELISA (230) and immunodiffusion assays (230,365) using R. arrhizus antigens detect antibodies produced during an infection with the zygomycetes. Both the sensitivity and specificity of the ELISA are superior to those of immunodiffusion.…”

Section: Rhizopus Speciesmentioning

confidence: 99%

“…Both the sensitivity and specificity of the ELISA are superior to those of immunodiffusion. Neither test is able to determine the species responsible for dis-ease, however (230,365). In the assays developed by Yankey and Abraham (517), antibodies produced during disease with a zygomycete could be detected using either counterimmunoelectrophoresis or indirect immunofluorescence techniques.…”

Section: Rhizopus Speciesmentioning

confidence: 99%

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Zygomycetes in Human Disease

2000

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SUMMARY The Zygomycetes represent relatively uncommon isolates in the clinical laboratory, reflecting either environmental contaminants or, less commonly, a clinical disease called zygomycosis. There are two orders of Zygomycetes containing organisms that cause human disease, the Mucorales and the Entomophthorales. The majority of human illness is caused by the Mucorales. While disease is most commonly linked to Rhizopus spp., other organisms are also associated with human infection, including Mucor, Rhizomucor, Absidia, Apophysomyces, Saksenaea, Cunninghamella, Cokeromyces, and Syncephalastrum spp. Although Mortierella spp. do cause disease in animals, there is no longer sufficient evidence to suggest that they are true human pathogens. The spores from these molds are transmitted by inhalation, via a variety of percutaneous routes, or by ingestion of spores. Human zygomycosis caused by the Mucorales generally occurs in immunocompromised hosts as opportunistic infections. Host risk factors include diabetes mellitus, neutropenia, sustained immunosuppressive therapy, chronic prednisone use, iron chelation therapy, broad-spectrum antibiotic use, severe malnutrition, and primary breakdown in the integrity of the cutaneous barrier such as trauma, surgical wounds, needle sticks, or burns. Zygomycosis occurs only rarely in immunocompetent hosts. The disease manifestations reflect the mode of transmission, with rhinocerebral and pulmonary diseases being the most common manifestations. Cutaneous, gastrointestinal, and allergic diseases are also seen. The Mucorales are associated with angioinvasive disease, often leading to thrombosis, infarction of involved tissues, and tissue destruction mediated by a number of fungal proteases, lipases, and mycotoxins. If the diagnosis is not made early, dissemination often occurs. Therapy, if it is to be effective, must be started early and requires combinations of antifungal drugs, surgical intervention, and reversal of the underlying risk factors. The Entomophthorales are closely related to the Mucorales on the basis of sexual growth by production of zygospores and by the production of coenocytic hyphae. Despite these similarities, the Entomophthorales and Mucorales have dramatically different gross morphologies, asexual reproductive characteristics, and disease manifestations. In comparison to the floccose aerial mycelium of the Mucorales, the Entomophthorales produce a compact, glabrous mycelium. The asexually produced spores of the Entomophthorales may be passively released or actively expelled into the environment. Human disease with these organisms occurs predominantly in tropical regions, with transmission occurring by implantation of spores via minor trauma such as insect bites or by inhalation of spores into the sinuses. Conidiobolus typically infects mucocutaneous sites to produce sinusitis disease, while Basidiobolus infections occur as subcutaneous mycosis of the trunk and extremities. The Entomophthorales are true pathogens, infecting primarily immunocompetent hosts. They generally do not invade blood vessels and rarely disseminate. Occasional cases of disseminated and angioinvasive disease have recently been described, primarily in immunocompromised patients, suggesting a possible emerging role for this organism as an opportunist.

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