Prevalence of Sensitivity to Coccidioidin, With Special Reference to Specific and Nonspecific Reactions to Coccidioidin and to Histoplasmin

Edwards, Phyllis Q.; Palmer, Carroll E.

doi:10.1378/chest.31.1.35

Cited by 106 publications

(67 citation statements)

References 18 publications

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“…Assessment of cellular immunity in coccidioidomycosis serves several purposes. First, it may be used to establish the prevalence of coccidioidal infection in a population within a geographic region (14,20). Second, it may be used to determine new infection, if prior assessment of immunity has been performed and has been found to be lacking.…”

Section: Discussionmentioning

confidence: 99%

In Vitro Whole-Blood Analysis of Cellular Immunity in Patients with Active Coccidioidomycosis by Using the Antigen Preparation T27K

Ampel

Kramer

et al. 2002

Clin Vaccine Immunol

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Measurement of cellular immunity in human coccidioidomycosis has important diagnostic and prognostic implications. The coccidioidin skin test has been the standard for the measurement of this, but it is not available in the United States. We examined the utility of measuring surface expression of CD69 on T lymphocytes in whole blood incubated with the coccidioidal antigen preparation T27K as an alternative to the skin test. Seventy donors with active coccidioidomycosis were studied. The mean fluorescent intensity (MFI) of CD69 expression on CD3 lymphocytes in response to T27K was 28.61 ؎ 1.77, significantly greater than the control response of 11.45 ؎ 0.78 (P < 0.001). The MFI CD69 response to T27K above that for the control (MFI CD69 above control) was 6.35 ؎ 2.18 for seven subjects with disseminated coccidioidomycosis who were studied within 5 months of diagnosis. This was significantly below the value of 20.17 ؎ 3.17 for 18 subjects with pulmonary coccidioidomycosis studied within 5 months of diagnosis and the value of 19.58 ؎ 2.91 for 27 subjects with disseminated coccidioidomycosis studied after 5 months of diagnosis (for both, P < 0.05). There was an inverse correlation between coccidioidal clinical score and MFI CD69 above control for all 34 subjects with disseminated coccidioidomycosis (r ‫؍‬ 0.362; P ‫؍‬ 0.036) but not for the 36 subjects with pulmonary disease (r < 0.001; P ‫؍‬ 0.993). Among 30 subjects for whom data were available, there was a highly significant association between the MFI CD69 above control and the supernatant concentrations of gamma interferon, interleukin-2 (IL-2), and tumor necrosis factor alpha (for all, P < 0.001), but not for IL-4, IL-5, or IL-10. These data indicate that in vitro assessment of CD69 expression on T lymphocytes by using T27K may be a useful measure of cellular immune response among subjects with active coccidioidomycosis.

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Section: Discussionmentioning

confidence: 99%

In Vitro Whole-Blood Analysis of Cellular Immunity in Patients with Active Coccidioidomycosis by Using the Antigen Preparation T27K

Ampel

Kramer

et al. 2002

Clin Vaccine Immunol

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“…These surveys thus provided estimates of the distribution of Coccidioides in the southwestern portion of the United States (31,32). Additionally, some counties in the Southwest had much higher proportions of skin reactivity: skin testing of long-term residents of single counties showed that in Arizona, Maricopa County (Phoenix), Pima County (Tucson), and Pinal County had over 70% positive skin test rates, compared to 10 to 40% in surrounding counties (33,34). In California, 50 to 70% of skin tests were positive in Kern (Bakersfield), Tulare, and Kings Counties, whereas the rate of positive skin tests dropped to 10% in areas a few hundred miles away (33).…”

Section: Coccidioides In the Environmentmentioning

confidence: 99%

“…Additionally, some counties in the Southwest had much higher proportions of skin reactivity: skin testing of long-term residents of single counties showed that in Arizona, Maricopa County (Phoenix), Pima County (Tucson), and Pinal County had over 70% positive skin test rates, compared to 10 to 40% in surrounding counties (33,34). In California, 50 to 70% of skin tests were positive in Kern (Bakersfield), Tulare, and Kings Counties, whereas the rate of positive skin tests dropped to 10% in areas a few hundred miles away (33). However, these data were not analyzed at a local level and were unable to provide the level of mapping detail (township or neighborhood) that would be more applicable to precise mapping of exposure.…”

Section: Coccidioides In the Environmentmentioning

confidence: 99%

Recent Advances in Our Understanding of the Environmental, Epidemiological, Immunological, and Clinical Dimensions of Coccidioidomycosis

et al. 2013

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SUMMARY Coccidioidomycosis is the endemic mycosis caused by the fungal pathogens Coccidioides immitis and C. posadasii . This review is a summary of the recent advances that have been made in the understanding of this pathogen, including its mycology, genetics, and niche in the environment. Updates on the epidemiology of the organism emphasize that it is a continuing, significant problem in areas of endemicity. For a variety of reasons, the number of reported coccidioidal infections has increased dramatically over the past decade. While continual improvements in the fields of organ transplantation and management of autoimmune disorders and patients with HIV have led to dilemmas with concurrent infection with coccidioidomycosis, they have also led to advances in the understanding of the human immune response to infection. There have been some advances in therapeutics with the increased use of newer azoles. Lastly, there is an overview of the ongoing search for a preventative vaccine.

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“…The San Joaquin Valley region is the primary endemic region for C. immitis, which is found in Central and Southern California and Washington [11]. Skin testing from Kern, Tulare, and Kings counties note positive skin tests ranging from 50 to 70 % [12]. Although referred to as the Bnon-California Coccidioides,^C.…”

Section: Geographic Distributionmentioning

confidence: 99%

Update on the Epidemiology of Coccidioidomycosis

Stewart

Thompson

2016

Curr Fungal Infect Rep

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Coccidioidomycosis is an illness caused by the soildwelling, dimorphic fungi, Coccidioides immitis and Coccidioides posadasii, which are found primarily in niche ecological zones of the Western Hemisphere. The bulk of infections due to Coccidioides are found within the endemic areas of Arizona, California, Mexico, and Central America. Outcomes run the gamut from asymptomatic to a self-limited or even chronic pulmonary process, up to severe disseminated, and life-threatening disease. Patients at particular risk include the elderly, pregnant women, and members of certain ethnicities. Recent changes in the epidemiology and our overall understanding of coccidioidomycosis that pose a particular challenge to healthcare professionals include the rising incidence of disease, identification of infections thought to be acquired outside the previously described zones of endemicity, and the risks posed to the immunosuppressed population due to the increasing use of immunomodulatory pharmaceutical agents.

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Prevalence of Sensitivity to Coccidioidin, With Special Reference to Specific and Nonspecific Reactions to Coccidioidin and to Histoplasmin

Cited by 106 publications

References 18 publications

In Vitro Whole-Blood Analysis of Cellular Immunity in Patients with Active Coccidioidomycosis by Using the Antigen Preparation T27K

In Vitro Whole-Blood Analysis of Cellular Immunity in Patients with Active Coccidioidomycosis by Using the Antigen Preparation T27K

Recent Advances in Our Understanding of the Environmental, Epidemiological, Immunological, and Clinical Dimensions of Coccidioidomycosis

Update on the Epidemiology of Coccidioidomycosis

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