Antigens In Body Fluids Research Articles

The secretor status of blood group antigens in the saliva in people with oral cancers: a systematic review

BackgroundHuman ABO blood group type and the antigenic secretor status are hypothesized to associate with oral diseases including oral cancer. Secretor status is the ability of individuals to secrete blood group antigens into body fluids. This study aimed to evaluate the secretor status of ABO antigens of saliva in patients with oral cancers or oral potentially malignant disorders (OPMDs) relative to healthy adults.MethodsA systematic and comprehensive online search from inception to April 28, 2022, was carried out in MEDLINE, Embase, PsycInfo, and Emcare. The language was limited to English. Yielded records were screened by two independent reviewers at the title and abstract phase and at full-text screening. Studies investigating adults (≥ 18 years) with oral cancers or oral potentially malignant disorders compared to adults free of oral cancer were included in this study. Data were extracted according to the planned objectives. Methodological quality was assessed, and the findings were analyzed narratively. Meta-analyses were conducted to pool the odds of the non-secretor status of oral cancers and OPMDs compared to healthy adults.ResultsThe search included a total of 34 studies from three databases. Nine duplicates were removed. During the title and abstract screening, 11 irrelevant studies were excluded. Twelve studies were screened during the full-text screening, and eight articles were eligible to be included in the final analysis. A pooled odds ratio (OR) of 3.80 (95%CI, 1.53–9.44) was estimated when pooled 1254 oral cancers and oral potentially malignant disorders patients compared to 666 healthy adults.Discussion and conclusionThe odds of being a non-secretor appear to be approximately 3.8 times higher in patients with oral cancers and oral potentially malignant disorders compared to healthy adults. The lack of ABO blood group antigens in body fluids of non-secretors is more exposed to exogenous antigens than secretors. The host-parasite interactions of secretors and non-secretors underlying oral cancer and other diseases may be evidence to support or refuse them. Clinicians may use the secretor status as a detection test during their regular oral check-ups for high-risk populations for oral cancers. Non-secretors can be given more attention considering them as high-risk groups, and in terms of prognosis, differences between these two groups may be expected.

P485 Hiv-positive, solid organ transplant (SOT), and non-Hiv-positive/non-transplant (NHNT) associated with cryptococcosis in Brazil: First national multicenter cohort study

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM ObjectivesTo describe the characteristics, mortality, and therapeutic response among hospitalized patients with cryptococcosis in Brazil.MethodsThis is a multicenter retrospective cohort study of seven Brazilian public tertiary hospitals (Figure 1). Medical records of patients admitted from January 2014 to December 2019 were evaluated. Confirmed cases of the first episode of cryptococcosis were included. Hosts were classified as HIV-positive, solid organ transplant (SOT), and non-HIV-positive/non-transplant (NHNT). Mortality was defined as the time of patient admission to in-hospital death from any cause. Statistical analysis was performed using the software R and JAMOVI.ResultsA total of 384 patients were included; the median (25th-75th) age was 39 (31-48) years and 283 (73.7%) were men. Hosts were 304 (79.2%) HIV-positive, 16 (4.2%) SOT, and 64 (16.7%) NHNT. More frequent diagnosis tools were culture, direct microscopic examination of infected body fluids using India ink, histological examination of tissue samples, and detection of cryptococcal polysaccharide antigen in body fluids (CrAg) using latex. Central nervous system (CNS) cryptococcosis had a significantly higher counting level across disease categories, with 313 cases or 81.5%. NHNT were more likely to have CNS cryptococcosis than people HIV-positive (84.4% vs. 81.9%, respectively). SOT patients had more pulmonary form infections (31.2%) as compared with HIV-positive (3.3%) and NHNT (1.6%). Other extrapulmonary sites category had HIV-positive and NHNT basically the same percentage of disease involvement (14%) compared with SOT (6.2%) (P < .001, Figure 2). Among cases with identification of specie, 56% were Cryptococcus neoformans and 4.4% were C. gattii. A total of 271 (70.6%) patients were discharged home with total or partial improvement and 113 (29.4%) patients died during hospitalization. In-hospital mortality among HIV-positive, SOT, and NHNT patients was 30.3% (92/304), 12.5% (2/16), and 29.7% (19/64), respectively. Induction therapy with AMB had the conventional deoxycholate mainly in combination with fluconazole (234, 84.2%). Only 80 (22.3%) patients received an AMB lipid formulation (liposomal AMB, n = 35 and AMB lipid complex, n = 45). The median (25th-75th) length of AMB therapy was 20 (14–32) days. Death patients had more age when compared with discharged-to-home cases (43 vs. 38 years, P < .002). Patients with CNS cryptococcosis had lower mortality (83/313, 26.5%) when compared with the other categories [pulmonary, 5/16 (31.2%) and other extrapulmonary sites, 25/55 (45.4%)] (P = .017). Survival benefits were seen for patients who received monotherapy or combination therapy. However, D-AMB alone showed a higher mortality rate, although not statistically significant (P = .537).ConclusionHIV infection is the most important condition among patients with cryptococcosis in Brazil and CNS involvement is the commonest manifestation in all hosts, mainly HIV-positive and NHNT. The proportion of pulmonary cryptococcosis is relevant in SOT patients. Mortality was high in all categories of hosts. Understanding the epidemiology and characteristic of patients admitted to our hospitals will help to understand the burden and causes of mortality and identify strategies to improve this scenario. Optimized diagnosis (i.e., lateral flow assay) and treatment (i.e., AMB lipid formulation plus flucytosine) are urgently necessary for our setting.

Secretor status prevents individuals from Helicobacter pylori infection

ABO antigens are not only present on the surface of red blood cells but are also secreted in body fluids. Individuals who can secrete these antigens in body fluids are called secretors while those who cannot are known as non-secretors. As compared to secretor non-secretors are at high risk to different bacterial, heart and autoimmune diseases but it is not clear that secretor status has an association with Helicobacter pylori. Therefore, this study was conducted to determine the secretor and non-secretor status in Helicobacter pylori infected patients. This cross-sectional study was carried out at Institute of Paramedical Sciences, Khyber Medical University Peshawar. A total of 192 samples were included in this study, 96 from Helicobacter pylori infected patients and 96 as a control group. Saliva samples were taken for the determination of secretor and non-secretor status by using Absorption inhibition method. Blood samples were obtained for ABO blood grouping and Helicobacter pylori determination. Out of 96 Helicobacter pylori infected patients, 36 (37.5%) were found as secretors and 60 (62.5%) were found as non-secretors while in normal individuals, secretors were 67 (69.8%) and non-secretors were 29 (30.2%). In H. pylori infected patients, classification of various ABH blood groups like A, B, AB and O were 24 (25%), 33 (34.3%), 18 (18.8%) and 21 (21.9%) respectively. In normal individuals’ the frequency of ABO was 28 (29.2%) of A, 28 (29.2%) of B, 8 (8.3%) of AB and 32 (33.3%) of O blood groups respectively. It is concluded that Helicobacter pylori infected patients have lowest secretor and highest non-secretors, because ABH antigens present in the body fluids of secretor show resistance to Helicobacter pylori infection. Moreover, non-secretors are more susceptible to bacterial infections. And it is known that Helicobacter pylori is a bacterium which can cause bacterial infections like gastric ulcer and duodenal ulcer. While normal individuals have highest secretor and lowest non-secretor status. Keywords: ABO blood groups; Body fluids; Helicobacter pylori; Non-secretor http://dx.doi.org/10.19045/bspab.2021.100053

Evaluation of lipoarabinomannan in the diagnosis of tuberculosis

The detection of lipoarabinomannan (LAM) antigens in body fluids has several potential advantages compared with the diagnostic methods used currently. The aim of this study was to evaluate the possible role of the detection of LAM in the serum and the urine as a diagnostic aid in the diagnosis of different forms of tuberculosis (TB). This study included 62 newly confirmed tuberculosis cases classified into two groups: group A included patients with pulmonary TB (n=36), and was further divided into two groups: group A1 [the smear-positive pulmonary TB group (n=24)] and group A2 [the smearnegative pulmonary TB group (n=12)]; group B included the extrapulmonary TB group (n=26); and 10 apparently healthy individuals served as the control group. The LAM level was measured in the serum and the urine by an enzyme-linked immunosorbant assay. The mean level of quantitative serum LAM was higher in group A1 (0.55±0.20?ng/ml) compared with group A2 (0.44±0.30?ng/ml) or group B (0.41±0.27?ng/ml). The mean level of quantitative urine LAM was higher in group A1 (0.81±0.24?ng/ml) compared with group B (0.72±0.35?ng/ml) and group A2 (0.65±0.37?ng/ml; P<0.001). The quantitative urine LAM test correlated positively with the degree of bacillary burden (P<0.05). Quantitative serum LAM had a sensitivity of 88.7%, specificity 90%, accuracy 88.9%, positive predictive value 98.2%, and negative predictive value 56.3%. Quantitative urine LAM had a sensitivity of 85.5%, specificity 90%, accuracy 86.1%, positive predictive value 98.1%, and negative predictive value 50%. A combination of serum and urine LAM tests identified that 98.4% of the cases with a positive TB culture correlated with higher serum LAM levels. Advanced chest radiography involvement and TB culture correlated with higher urine LAM levels (P<0.05). The LAM test is a valuable addition in the diagnosis of TB and its different forms. A combination of quantitative serum and urine LAM increased the sensitivity of the test. The quantitative urine LAM test offers additional clinical insight into the degree of TB disease severity and has more applicability.

Anti-Taenia solium monoclonal antibodies for the detection of parasite antigens in body fluids from patients with neurocysticercosis

Neurocysticercosis (NCC), an infection of the brain by Taenia solium (Ts) cysts, is the most common cause of adult-onset epilepsy in developing countries. Serological testing consists primarily of varying methods to detect antibodies in body fluids and more recently antigen (Ag) detection assays to identify individuals or animals with viable parasites. Antigen assays currently in use employ monoclonal antibodies (mAbs) raised against T. saginata, which have known cross reactivity to animal cestodes but are highly specific in human samples. We produced, characterized and tested 21 mAbs raised against T. solium whole cyst antigens, vesicular fluid or excretory secretory products. Reactivity of the TsmAbs against specific cyst structures was determined using immunofluorescence and immunohistochemistry on histological sections of Ts muscle cysts. Four TsmAbs reacted to vesicular space alone, 9 to the neck and cyst wall, one to the neck and vesicular space and 7 to the neck, cyst wall and vesicular space. An in-house ELISA assay to detect circulating Ts antigen, using the TsmAbs as capture antibodies and a rabbit polyclonal anti-Ts whole cyst antibody as a detector antibody demonstrated that eight of the 21 TsmAbs detected antigens in known NCC-positive human sera and three of these also in urine samples. Reactivity was expressed as normalized ratios of optical densities (OD positive control/OD negative control). Three TsmAbs had ratios >10 and five between 2 and 10. The TsmAbs have potential utility for the diagnosis and post-treatment monitoring of patients with viable NCC infections.

A Genetic Modifier of the Gut Microbiome Influences the Risk of Graft-versus-Host Disease and Bacteremia After Hematopoietic Stem Cell Transplantation

The human gut microbiome is involved in vital biological functions, such as maintenance of immune homeostasis and modulation of intestinal development and enhanced metabolic capabilities. Disturbances of the intestinal microbiota have been associated with development and progression of inflammatory conditions, including graft-versus-host disease (GVHD). The fucosyltransferase 2 (FUT2) gene produces an enzyme that is responsible for the synthesis of the H antigen in body fluids and on the intestinal mucosa. FUT2 genotype has been shown to modify the gut microbiome. We hypothesized that FUT2 genotype influences risk of GVHD and bacterial translocation after allogeneic hematopoietic stem cell transplantation (HSCT). FUT2 genotype was determined in 150 consecutive patients receiving allogeneic HSCT at our center. We abstracted clinical characteristics and outcomes from the transplantation database. Cumulative risk of any acute GVHD varied by FUT2 genotype, with decreased risk in those with A/A genotype and increased risk in those with G/G genotype. In contrast, the cumulative incidence of bacteremia was increased in those with A/A genotype. We conclude that the FUT2 genotype influences risk of acute GVHD and bacteremia after HSCT. We hypothesize that the mechanisms involve altered intestinal surface glycosylation and microbial composition but this requires additional study.

Reprograming of gut microbiome energy metabolism by the FUT2 Crohn's disease risk polymorphism.

Fucosyltransferase 2 (FUT2) is an enzyme that is responsible for the synthesis of the H antigen in body fluids and on the intestinal mucosa. The H antigen is an oligosaccharide moiety that acts as both an attachment site and carbon source for intestinal bacteria. Non-secretors, who are homozygous for the loss-of-function alleles of FUT2 gene (sese), have increased susceptibility to Crohn's disease (CD). To characterize the effect of FUT2 polymorphism on the mucosal ecosystem, we profiled the microbiome, meta-proteome and meta-metabolome of 75 endoscopic lavage samples from the cecum and sigmoid of 39 healthy subjects (12 SeSe, 18 Sese and 9 sese). Imputed metagenomic analysis revealed perturbations of energy metabolism in the microbiome of non-secretor and heterozygote individuals, notably the enrichment of carbohydrate and lipid metabolism, cofactor and vitamin metabolism and glycan biosynthesis and metabolism-related pathways, and the depletion of amino-acid biosynthesis and metabolism. Similar changes were observed in mice bearing the FUT2−/− genotype. Metabolomic analysis of human specimens revealed concordant as well as novel changes in the levels of several metabolites. Human metaproteomic analysis indicated that these functional changes were accompanied by sub-clinical levels of inflammation in the local intestinal mucosa. Therefore, the colonic microbiota of non-secretors is altered at both the compositional and functional levels, affecting the host mucosal state and potentially explaining the association of FUT2 genotype and CD susceptibility.

Point-Counterpoint: β- d -Glucan Testing Is Important for Diagnosis of Invasive Fungal Infections

ABSTRACT Invasive fungal infections are a significant cause of morbidity and mortality in patients who receive immunosuppressive therapy, such as solid organ and hematopoietic stem cell transplant (HSCT) recipients. Many of the fungi associated with these infections are angioinvasive and are best diagnosed by visualizing the organism in or culturing the organism from deep tissue. However, obtaining such tissue often requires an invasive procedure. Many HSCT recipients are thrombocytopenic, making such procedure too risky because of potential bleeding complications. Additionally, positive blood cultures are rare for patients with angioinvasive fungal infections, making this diagnostic strategy of little value. Undiagnosed fungal infections in these patient populations are a significant cause of mortality. Prophylactic use of antifungal agents, such as the echinocandins, during periods of neutropenia or graft-versus-host disease may prevent some fungal infections but increase the risk for others. Detection of fungal antigens in body fluids, including cryptococcus capsular polysaccharide, histoplasma antigen, galactomannan, and β- d -glucan, is viewed as being clinically useful for at least the presumptive diagnosis of invasive fungal infections. β- d -Glucan is an attractive antigen in that it is found in a broad range of fungal agents, including the commonly encountered agents Candida spp., Aspergillus spp., and Pneumocystis jirovecii. Cross-reactions with certain hemodialysis filters, beta-lactam antimicrobials, and immunoglobulins, which raise concerns about false-positive tests, have also been described. As a result, the use of this testing must be closely monitored. In this point-counterpoint, we have asked Elitza Theel, who directs the Infectious Disease Serology Laboratory at the Mayo Clinic, to address why she believes that this test has value in the diagnosis of invasive fungal infections. We have asked Christopher Doern, Director of Clinical Microbiology at Children's Medical Center of Dallas, why he questions the clinical value of β- d -glucan testing.

Robert Royston Amos (Robin) Coombs. 9 January 1921 — 25 January 2006

Robin Coombs, one of the pioneers of British immunology, was responsible for the development of innovative approaches to identify the presence of diagnostic antibodies and antigens in body fluids, and for the use of red-cell-linked assays to identify important functional molecules on diverse cell types. He was responsible for the development of immunology as a discipline in its own right, and his mechanistic dissection of hypersensitivity reactions brought clarity to a hitherto confusing area of disease. Although best known for the development of the Coombs test for detection of Rhesus antibodies, the Cambridge ‘school’ that he established has spawned and disseminated a diverse array of talented immunologists worldwide, embracing virtually all areas of molecular and cellular immunology.

Antigen and Antibody Testing for the Diagnosis of Blastomycosis in Dogs

Early diagnosis and treatment are associated with an improved prognosis in blastomycosis. The diagnosis of blastomycosis may be missed by cytology, histopathology, culture, or serology. An enzyme immunoassay (EIA) for detection of Blastomyces dermatitidis galactomannan antigen in body fluids has been used for rapid diagnosis of blastomycosis in humans. Measurement of Blastomyces antigen in urine or serum by the MVista Blastomyces antigen EIA is more sensitive than measurement of anti-Blastomyces antibodies for diagnosis of blastomycosis in dogs. Serum and urine samples from 46 dogs with confirmed blastomycosis were tested for Blastomyces antigen and serum was tested for anti-Blastomyces antibodies. The sensitivity for the detection of antigen in urine was 93.5% and it was 87.0% in serum. The sensitivity of antibody detection by agar gel immunodiffusion (AGID) was 17.4% and it was 76.1% by EIA. Antigen and antibody decreased during itraconazole treatment. Antigen detection is a more sensitive test for diagnosis of blastomycosis than antibody testing by AGID, the only commercially available method. Antigen concentrations decreased with treatment.

Evaluation of integral membrane antigens of Mycobacterium habana for serodiagnosis of extrapulmonary tuberculosis: association between levels of antibodies and Mycobacterium tuberculosis antigens

The performance of integral membrane antigens (IMAs) of Mycobacterium habana TMC 5135 in detecting antimycobacterial antibodies in serum and body fluids of patients mainly of extrapulmonary tuberculosis was evaluated. The IMAs were recovered from the detergent phase during Triton X-114 treatment of the plasma membrane of M. habana. Antimycobacterial antibodies were detected by ELISA using IMAs in serum and body fluids of 42 patients and 62 control subjects. As authentic adjunct Mycobacterium tuberculosis antigens were also detected (by ELISA) in body fluids and circulating immune complexes using anti- M. tuberculosis H 37Ra antibodies. Anti- M. habana IMA antibody detection increased the positivity rate from 26.% (11/42) and 10% (4/42) obtained by culture and smear microscopy, respectively, to 86% (36/42). M. tuberculosis antigens were also found in 29 out of 36 anti- M. habana IMA antibody-positive cases. Interestingly, all 11 culture-positive cases were also positive for anti- M. habana IMA antibodies. The mean antigen titres in 23 cases, positive for antigens in body fluids, were 2.34 times higher in those who were also positive for anti-IMA antibodies in serum than in those negative for these antibodies. M. habana IMAs may be promising non-tubercular candidate antigens in ELISA-based serodiagnosis of extrapulmonary tuberculosis with substantial sensitivity, specificity and safety.

An immunosensor with potential for the detection of viral antigens in body fluids, based on surface second harmonic generation

Field methods of assessing the immune status of animals are required to optimise vaccination programmes to control bovine viral diarrhoea (BVD) virus. An optoelectronic immunosensor was evaluated for the detection of viral antigens in a crude cell lysate in a pilot study. Binding of (BVD) virus antigen by two monoclonal antibodies immobilised on two different media (ELISA plate wells, and glass coverslips) was detected and quantified using the laser induced surface second harmonic generation (SSHG) technique. The results for both assays were correlated with an enzyme-linked immunoassay (ELISA) used for the diagnosis of BVD virus infection in cattle (ELISA plate; R 2=0.86, coverslips; Exp. 1; R 2=0.75, Exp. 2; R 2=0.67). The method will allow rapid detection of antigens in the body fluids of farm animals.

Development and application of HHV-6 antigen capture assay for the detection of HHV-6 infections.

An HHV-6 antigen capture assay measuring gp116/64/54 antigen was developed. This ELISA is specific for HHV-6 Variants A and B, does not cross react with other human herpesviruses, is sensitive, stable, quantitative, and can detect antigen in body fluids and cell cultures. Relative to virus isolation or techniques for measuring HHV-6 nucleic acids, the assay is much simpler and less expensive to perform. Plasmas/sera (413) obtained from healthy donors, children with Exanthem subitum, febrile illnesses, patients with Chronic Fatigue Syndrome, and AIDS patients tested by antigen capture assay demonstrated that the assay is useful in clinical laboratory settings. The capture assay can also be used to monitor cell cultures for virus isolation, production, quantitation, and antiviral agent screening.

Experimental infection of swine with a sandfly (Lutzomyia shannoni) isolate of vesicular stomatitis virus, New Jersey serotype.

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Detection of HIV-p24 antigen in body fluids by immunotrapping on Staphylococcus aureus (cowan 1) bacteria, gold immunolabelling and backscattered electron analysis in a scanning electron microscope

An immunosorbent electron microscopical (ISEM) method, the Protein A-coated bacteria technique/gold, (PA-CBT/G), was developed for the detection of non-particulate soluble antigens. The method is based on immunotrapping of antigens on antibody coated, glutaraldehyde cross-linked, Protein A-rich, Staphylococcus aureus bacteria. The ‘trapped’ antigen is then identified by colloidal-gold immunolabelling. Gold particles are observed in a scanning/transmission electron microscope by analysis of backscattered electrons. With this method it was possible to detect the presence of p24 HIV antigens in blood, semen, saliva, crevicular and cerebrospinal fluids from HIV seropositive cases. Although the PA-CBT/G identified correctly the p24 antigen in only 80% of the ELISA HIV-antigen positive sera, it detected, more frequently than ELISA, HIV-antigen in seminal and oral fluids. The PA-CBT/ G method could thus be useful to fully characterise individual HIV excretion patterns in body fluids other than sera even from patients negative for HIV-antigen by ELISA.

Letters to the Editor

Journal of Paediatrics and Child HealthVolume 29, Issue 6 p. 481-484 Free Access Letters to the Editor First published: December 1993 https://doi.org/10.1111/j.1440-1754.1993.tb03027.xCitations: 1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat REFERENCES 1 Beauchamp G., Kosmorsky G. Learning disabilities: Update comment on the visual system. Pediatr. Clin. North Am. 1987; 34: 1439– 45. 2 Helveston E. M., Ellis F. D., Estes R. et al. Visual function and academic performance. Am. J. Ophthalmol. 1985; 99: 346– 55. 3 American Academy of Pediatrics, Committee on Children with Disabilities, American Association for Pediatric Ophthalmology and Strabismus and American Academy of Ophthalmology. Policy statement on learning disabilities, dyslexia and vision. Pediatrics 1992; 90: 124– 6. 4 Health Care Committee, NH&MRC. Learning Difficulties in Children and Adolescents. NH&MRC, May 1990. 5 The Royal Australian College of Ophthalmologists and The Australian College of Paediatrics. Joint Policy Statement on Learning Disabilities, Dyslexia and Vision. October 1990. 1 Spinola S. M., Sheaffer C. I., Philbrick K. B., Gilligan P. H. Antigenuria after Haemophilus influenzae type b polysaccharide immunization: A prospective study. J. Pediatr. 1986; 109: 835– 7. 2 Sood S. K., Ballanco G. A., Mather F. J., Pramberg J. C., Daum R. S. Distribution and excretion of capsular antigen after immunization with Haemophilus influenzae type b polysaccharide-Ne/sser/a meningitidis outer membrane protein conjugate vaccine. J. Infect. Dis. 1990; 161: 574– 7. 3 Rothstein E. P., Madore D. V., Girone J. A. C. et al. Comparison of antigenuria after immunization with three Haemophilus influenzae type b conjugate vaccines. Pediatr. Infect. Dis. J. 1991; 10: 311– 14. 4 Ingram D. L., Paerson A. W., Occhiuti A. R. Detection of bacterial antigens in body fluids with the Wellcogen Haemophilus influenzae b, Streptococcus pneumoniae and Neisseria meningitidis (ACYW135) latex agglutination tests. J. Clin. Microbiol. 1983; 18: 1119– 21. 5 Lampe R. M., Chottipitayasunondh T., Sunakorn P. Detection of bacterial antigen in pleural fluid by counterimmuno-electrophoresis. J. Pediatr. 1976; 88: 557– 60. 6 Murphy T. V., Clements J. F., Granoff D. M. Concentration of Haemophilus influenzae type b (HIB) polysaccharide (PRP) in urine of healthy HIB carriers and patients with diseases as measured by ELISA. Pediatr. Res. 1989; 25 (Part 2): 185A. 1 Butler K. M., Baker C. J. Candida: An increasingly important pathogen in the nursery. Pediatr. Clin. North Am. 1988; 35: 543– 63. 2 Ho N. K. Systemic candidiasis in premature infants. Aust. Paediatr. J. 1984; 20: 127– 30. 3 Stuck K. J., Silver T. M., Jaffe M. H., Bowerman R. A. Sonographic demonstration of renal fungal balls. Radiology 1981; 142: 473– 4. 4 Hufnagle K. G., Khan S. N., Penn D., Cacciarelli A., Williams P. Renal calcifications: A complication of long term frusemide therapy. Pediatrics 1982; 70: 360– 3. 5 Cramer B. C., Ozere R., Andrews W. Renal stone following medical treatment of renal candidiasis. Pediatr. Radiol. 1990; 21: 43– 4. 6 Short A., Cooke R. W. I. The incidence of renal calcification in preterm infants. Arch. Dis. Child. 1991; 66: 412– 17. Citing Literature Volume29, Issue6December 1993Pages 481-484 ReferencesRelatedInformation

Infections with Aspergillus Species

Invasive aspergillosis is a common infection in patients who are immunocompromised. The diagnosis of invasive aspergillosis is difficult in the absence of confirmation by tissue biopsy and histological studies. Therefore, recent advances that may be important for the development of highly sensitive and specific serodiagnostic tests for the early diagnosis of invasive aspergillosis are reviewed. The inability of the detection of antibody to Aspergillus to lead to early diagnosis of invasive aspergillosis also is emphasized. However, sensitive methods that reliably detect significant amounts of aspergillus antigen in body fluids of high-risk patients are currently being evaluated and may provide a noninvasive early diagnostic test that is both sensitive and specific. Also, current antifungal agents with anti-aspergillus activity that have potential as therapeutic or prophylactic agents are reviewed briefly.

Serodiagnosis of candidiasis, aspergillosis, and cryptococcosis.

During the past decade, substantial progress has been made in the development of new approaches and methods for the serological diagnosis of the mycoses. Clinically relevant antigens have been adapted for use in immunoassays for the detection of specific antibodies, and methods that detect fungal antigens in body fluids have been progressively refined. Nevertheless, few of the novel serological techniques have as yet found widespread clinical use. Reasons for this apparent discrepancy include the paucity of clinical data that substantiate improved predictive value for disease of antibody tests that use specific immunodominant antigens. The usefulness of detection of antigenemia in invasive candidiasis and invasive aspergillosis has been limited by the rapid clearance of Candida mannan and Aspergillus galactomannan from serum, which results in only moderate sensitivity for disease. False-negative results are especially frequent when single serum samples are tested in cases where fungal infection is clinically suspected. The detection of antigen in samples of urine collected serially may circumvent this problem in the future. The limited dissemination of methods for the detection of fungal antigens is also due to the slow development of simple and reliable commercial kits.

Search for cytomegalovirus in the postmortem brains of schizophrenic patients using the polymerase chain reaction.

Cytomegalovirus infection has a number of features that suggest a possible association between congenital infection and schizophrenia. Previous studies have investigated anticytomegalovirus antibody titers or attempted directly to identify viral antigens in body fluids or brain tissue from schizophrenic subjects but have been limited by the sensitivity of the available methods. The highly sensitive polymerase chain reaction, a newly developed technique for gene amplification, was used to search for cytomegalovirus in the DNA extracted from postmortem temporal cortex samples of eight schizophrenic subjects, eight nonschizophrenic suicide victims, and eight normal controls. Cytomegalovirus-specific DNA amplification was not detected in any of the samples. The implications of this finding for the viral hypothesis of schizophrenia are discussed.

Identification, Characterization, and Quantitation of Soluble HLA Antigens in the Circulation and Peritoneal Dialysate of Renal Patients

Human lymphocyte antigen (HLA) class I and class II antigens and beta 2 microglobulin (B2M) were identified in peritoneal dialysate (PD) and serum from patients with end-stage renal disease (ESRD) using monoclonal antibodies in an enzyme-linked immunoassay. The HLA class I and class II antigens each exhibited approximate molecular weights of 50,000 to 60,000 daltons by chromatography on Sepharose CL 6B. Class I antigens in serum and PD fluid were associated with B2M. Free B2M (Mr 11,500) also was detected in both sera and PD fluids. Unlike class I antigens, class II antigens were not found to have attached B2M. Class I and class II antigens eluted from 2-diethylaminoethanol ion exchange gradient columns at 0.07 mol/L (molar) phosphate buffer pH 7.2 and migrated with alpha 2-beta 1 mobility in agarose electrophoresis. Class I antigens were purified from ESRD patients' PD fluid by solid-phase immunoaffinity chromatography. Enzyme-linked immunoassay demonstrated that this purified protein was composed of a class I heavy chain and B2M. Class I allospecificity was confirmed by neutralization on known HLA typing antisera in a microcytotoxicity assay. Soluble HLA class I antigen preparations specifically inhibited blast transformation of responder lymphocytes in mixed lymphocyte culture reactions. Inhibition was dose dependent and ranged from 0% to 95%. The presence of soluble HLA antigens in body fluids may play an important part in the immunologic tolerance to self. This study demonstrates a ready source of large quantities of soluble HLA for detailed analysis.