Precipitin Antibody Research Articles

Retrospective Comparison of Two Aspergillus IgG Enzyme Immunoassays for Diagnosing Pulmonary Aspergillosis.

Aspergillus-specific antibodies are diagnostic indicators of allergic bronchopulmonary aspergillosis (ABPA) and chronic pulmonary aspergillosis (CPA). Tests for detecting Aspergillus-specific antibodies were not used clinically in Japan, and the production of the Aspergillus precipitin test was discontinued. Thus, alternative tests for diagnosing aspergillosis are urgently needed. We retrospectively evaluated 64 patients with suspected ABPA and CPA who underwent precipitin antibody testing. Serum Aspergillus IgG levels were measured and compared using the Bordier Aspergillus fumigatus ELISA and the Platelia Aspergillus IgG (Bio-Rad) kits. Of the participants, 18 were diagnosed with CPA, and 8 were diagnosed with ABPA. Both the Bordier and Bio-Rad kits showed high sensitivity and specificity for CPA and ABPA. The area under the receiver operating characteristic curves for the Bordier and Bio-Rad kits were 0.97 and 0.95, respectively, for CPA, and 0.89 and 0.91, respectively, for ABPA. In contrast to the Bordier kit, the Bio-Rad kit showed relatively low anti-Aspergillus IgG levels and lower sensitivity to non-fumigatus Aspergillus infections. The Aspergillus-specific IgG ELISA tests showed sufficient diagnostic accuracy. Therefore, these assays are recommended as alternatives to the precipitin kit for diagnosing aspergillosis in clinical settings in Japan.

Evaluation of candidate monovalent Bitis arietans antivenom using eggs from hyperimmunized layer chickens in Zaria Kaduna State, Nigeria

Aim: This research sought to experiment on a cheaper alternative to snake antivenom production using hyperimmunized chicken eggs. Methods: Twenty-two Swiss albino mice were used to determine the median lethal dose (LD50) and lethality neutralization assay. Twenty-layer chickens, aged 17-weeks-old were divided into two groups of 10 chickens each. Based on body weight, group A were hyperimmunized with 1/5th LD50 of crude Bitis arietans venom in adjuvant (Montanide™ ISA 201) at two-weeks interval over eight-weeks period; while group B were administered normal saline. Using polyethylene glycol 6000, immunoglobulin Y was extracted from 15 pooled egg yolks. Twelve Wistar rats were used for the haemorrhagic and anti-haemorrhagic assays. The haemolytic activity of the venom and anti-haemolytic effect of the candidate antivenom was determined in vitro using caprine erythrocytes. Results: The LD50 of the pooled Bitis arietans venom was 0.9 mg/kg. Agar gel immunodiffusion test confirmed the presence of precipitin antibodies in the candidate antivenom. EchiTab plus-ICP® neutralized lethal effect of all dilutions and the stock (10 mg/ml) venom of Bitis arietans while the candidate antivenom was limited to 3log2 dilution of the stock venom (1.25 mg/ml). In the haemorrhagic assay the venom exhibited haemorrhagic activity at 2.5, 5 and 10 mg/ml and the highest anti-haemorrhagic activity of the candidate antivenom at 10mg/ml. The candidate antivenom exhibited significantly higher (p < 0.05) anti-haemolytic activity against the venom of Bitis arietans at 10 mg/ml. Conclusion: The antibodies have inhibitory properties against the lethal, haemorrhagic and haemolytic properties of Bitis arietans venom.

High-resolution computerized tomography changes in diffuse parenchymal lung disease from chronic hypersensitivity pneumonitis related to bird antigen.

Background:Chronic hypersensitivity pneumonitis (HP) is the most common cause of diffuse parenchymal lung disease (DPLD) in India. There is no data regarding the avian antigen exposure-associated DPLD from the country.Methods:Chronic HP from exposure to avian antigen was diagnosed when the high resolution computerized tomography (HRCT) showed features for HP and was supported by the history of exposure to pigeons, the presence of precipitin antibodies (IgG) to avian antigen in high titre with negative rheumatoid factor, antinuclear antibody, and no clinical clue for a collagen vascular disease. The HRCT changes were noted on Likert scale (0–5) in terms of affection of peripheral and/or axial involvement, reticulation, honeycombing, haze, mosaic, traction bronchiectasis, pleural reactions, features of pulmonary hypertension, and air cysts. Cardiomegaly and independent cardiac chamber enlargement were also recorded.Results:The lower lobes were predominantly (65.6%) affected with similar frequency (78.1) of peripheral and axial parenchymal affection. The parenchymal changes in HRCT were haze or ground-glass opacity (100%), mosaic appearance (93.75%), reticulations (68.75%), traction bronchiectasis (34.3%), air cysts (21.8%), and honeycombing (9.37%). Pleural reactions, though not described so far, were found in 50% of cases. Features of pulmonary hypertension (87.5%), cardiomegaly (50%), left and right atrial enlargement (81.2% and 78.1%), and right ventricular enlargement (31.2%) were the common echocardiography findings.Conclusion:Chronic HP from avian exposure shows predominantly lower lobe involvement with haze, reticulation, features of pulmonary hypertension, and pleural reactions as common HRCT findings. The likelihood of pulmonary hypertension appears high and although honeycombing is often present, the classical UIP pattern has not been found.

Detection of Newcastle Diseases antibodies in birds in Jos, Bukuru and Environs using Agar-Gel Precipitation test

Newcastle Disease Virus (NDV lasota) antibodies were surveyed. A serological study of 500 sera from local chicken, turkey, ducks and guinea fowl was carried out to determine the prevalence of Newcastle disease using Agar-gel precipitation technique. Samples were obtained from chickens slaughtered in Jos, Bukuru and environs. The samples were made up of 40 ducks, 50 turkeys, 20 guinea fowl and 390 local chickens. The precipitin antibodies were detected in ducks 7 (17.5%), turkey 12 (24.0%), guinea fowl 3 (15.0%), and local chickens 54 (13.9%). Of the 500 samples screened, a total of 76 (15.2%) were positive for NDV antibodies. Quantitative analysis of sero-positive samples in the four avian species tested yielded a range of antibody titres of 2-16. The importance of using cost effective technique for the detection of NDV carrier state in local birds has been highlighted.DOI: http://dx.doi.org/10.3329/bjvm.v11i2.19121 Bangl. J. Vet. Med. (2013). 11 (2): 87-91

Characteristics and outcomes of chronic pulmonary aspergillosis: a retrospective analysis of a tertiary hospital registry

Our objective was to investigate characteristics risk factors and outcomes of patients with chronic pulmonary aspergillosis (CPA). The Aspergillosis Committee prospectively collected Aspergillus notifications from January 2000 to December 2011. A retrospective analysis of data was performed. Among 1614 notifications registered, 44 cases of CPA in non-immunocompromised patients were identified. The median age was 65 years (Q1-Q3: 54-75), the median body mass index (BMI) was 20 kg/m(2) (Q1-Q3: 16-22) and 15 had chronic obstructive pulmonary disease. All patients had a positive specific serum precipitin antibody titer. Radiological presentations were: cavitations [single n = 31 (70%); multiple n = 12 (27%)] containing mycetomas [n = 18 (41%)], consolidations [n = 19 (43%)], emphysema [n = 15 (34%)] and sequelae of mycobacterial infection [n = 10 (23%)]. The median duration of follow-up was 30 months (Q1-Q3: 14-55). The median duration of antifungal treatment was 6 months (Q1-Q3: 3-12). Outcomes were unfavorable in 14 patients, and 12 (27%) died. Analysis by multivariate Cox regression model with bootstrapping showed that a higher BMI and a lower Charlson index score were predictive of favorable evolution, hazard ratio (95% confidence interval): BMI (+1) = 0.83 (0.71-0.97), Charlson (+1) = 1.37 (1.01-1.85). When analyses were restricted to chronic CPA and chronic necrotizing pulmonary aspergillosis, the multivariate Cox regression model showed that both BMI and Charlson index score were not statistically significant. Our results provide data on clinical characteristics and outcomes of CPA emphasizing the role of preexisting chronic respiratory conditions and protective effect of preserved BMI and lower Charlson index score.

Fungal colonization in patients with chronic respiratory diseases from Himalayan region of India

BackgroundWe screened patients with chronic respiratory diseases for microbiological and serological evidences of fungal colonisation; in order to determine its prevalence in this group of patients, examine potential clinical and radiological predictors of fungal colonisation and characterise fungal agents associated with individual diseases.MethodsBAL samples from 60 consecutive patients were subjected to microscopy and culture for fungal agents. Serum samples were analysed for precipitin antibodies to Aspergillus antigen and Candida cytoplasmic antigen. Statistical significance in the difference of fungal recovery between patient groups was determined using the Chi-square test.ResultsThe major diagnostic groups included patients with bronchogenic carcinoma (n = 31) and tubercular sequelae (n = 16). In all, 28 patients (46.7%) were culture-positive, with Candida and Aspergillus being recovered from 14 and 13 patients respectively. Twenty-one patients (35%) showed presence of precipitin antibodies. Patients with bronchogenic carcinoma showed increased predilection for colonisation with Aspergillus, while Candida was recovered more commonly in tubercular sequelae (p = 0.02). There was no statistically significant association between culture-positivity and specific risk factors/radiological findings.ConclusionThe point-prevalence of fungal colonization was almost 50%. The combination of fungal culture and serology helped improve diagnostic sensitivity. An interesting predilection was observed for Aspergillus and Candida, to preferentially infect patients with Bronchogenic carcinoma and Tubercular sequelae respectively. In absence of specific predictors, the possibility of fungal colonization needs to be explored actively in these patients.

Endemic Fungal Infections in Solid Organ Transplant Recipients

Endemic Fungal Infections in Solid Organ Transplant Recipients

Early targets of nuclear RNP humoral autoimmunity in human systemic lupus erythematosus

The U1 small nuclear RNPs are common targets of autoantibodies in lupus and other autoimmune diseases. However, the etiology and progression of autoimmune responses directed against these antigens are not well understood. The aim of this study was to use a unique collection of serial samples obtained from patients before and after the development of nuclear RNP (nRNP) antibodies to investigate early humoral events in the development of anti-nRNP autoimmunity. Lupus patients with sera available from both before and after the development of nRNP antibody precipitin were identified from the Oklahoma Clinical Immunology Serum Repository. Antibodies in the serial samples were analyzed by enzyme-linked immunosorbent assay, Western blotting, solid-phase epitope mapping, and competition assays. The first-detected nRNP antibodies targeted 6 common initial epitopes in nRNP A, 2 in nRNP C, and 9 in nRNP 70K. The initial epitopes of nRNP A and nRNP C were significantly enriched for proline and shared up to 95% sequence homology. The initial nRNP 70K humoral epitopes differed from those of nRNP A and nRNP C. The initial antibodies to nRNP A and nRNP C were cross-reactive with the SmB'-derived peptide PPPGMRPP. Antibody binding against all 3 nRNP subunits diversified significantly over time. Autoantibodies to nRNP A and nRNP C initially targeted restricted, proline-rich motifs. Antibody binding subsequently spread to other epitopes. The similarity and cross-reactivity between the initial targets of nRNP and Sm autoantibodies identifies a likely commonality in cause and a focal point for intermolecular epitope spreading.

Comparison of protective effects among H5 subtype avian influenza DNA vaccines with optimized HA gene and expressive vectors

AbstractTo evaluate the effects of H5 subtype avian influenza DNA vaccine with HA gene and expressive vector optimization, groups of 3-week-old specific pathogen free (SPF) chickens were inoculated intramuscularly with a single dose of 100 μg or 10 μg of pCIHA5, pCAGGHA5, pCIoptiHA5 or pCAGGoptiHA5 in 200 μl volume. Another group of chickens was injected with 200 μl phosphate-buffered saline (PBS) as controls. Sera were collected every week after vaccination to detect the HI and agar-gel precipitin (AGP) antibodies. Four weeks after the single vaccination, all chickens were challenged with 100LD50 of the highly pathogenic A/Goose/GuangDong/1/96(H5N1) [Gs/GD/1/96(H5N1)]. Oropharyngeal and cloacal swab specimens were collected from all chickens 3, 5 and 7 days after inoculation for titration of virus in eggs. Chickens were observed daily for 2 weeks for signs of disease and death. Results showed that in the groups vaccinated with 100 μg pCAGGoptiHA5 and pCAGGHA5 chickens were completely protected from virus challenge (no disease signs, no virus shedding and no deaths), while only partial protection occurred in chickens vaccinated with 100 μg pCIoptiHA5 (75%) and pCIHA5 (50%). In groups vaccinated with 10 μg pCAGGoptiHA5 and pCAGGHA5 chickens were protected from virus challenge (no disease signs and no deaths). In the group vaccinated with 10 μg pCIoptiHA5 the protection ratio was 75%, while chickens vaccinated with 10 μg pCIHA5 all died after challenge. Results indicated that codon usage optimization of the HA gene and β-actin promoter enhanced the protection efficiency of H5 subtype avian influenza DNA vaccine and the construction pCAGGoptiHA5 could protect chickens from lethal H5N1 virus challenge even at the low dose of 10 μg, implying the possibility for the commercialization of an avian influenza DNA vaccine in the near future.

Avian circoviruses of the genus Circovirus: A potential trigger in Pigeon breeder’s lung (PBL)/Bird fancier’s lung (BFL)

Pigeon breeder's lung (PBL) or Bird fancier's lung (BFL) is one of the most common extrinsic allergic alveolitis or hypersensitivity pneumonitis. It is caused after prolonged inhalation of avian antigens and provokes a hypersensitivity reaction in the lungs of sensitised people. Although the pathogenic mechanism is unclear, the epidemiology of BFL shows that it occurs worldwide, and has been described in adults keeping birds and also in their children. Laboratory findings associated with the disease classified as a type III immunologic reaction that produces blood precipitin antibodies against birds' serum, feathers, intestinal mucin and/or faeces. In particular, the fine dust from pigeon feathers has strong antigenic properties. There is an interaction between host and antigen that seems to be influenced by both genetic and environmental factors. Avian circoviruses (ACV) of the genus Circovirus, has been detected in free-ranging and captive birds worldwide, such as pigeons, canaries, psittacines, Senegal doves, finches, gulls, Australian ravens and geese. T lymphocytes are the main target cells of the ACV and in the above avian species circovirus-like particles were detected in blood, macrophages, feathers, crop secretions, intestinal contents and/or faeces. Most of the ACV was demonstrated that are pantropic and viral antigen in pigeon tissues was most commonly detected in respiratory organs, including the trachea, pharynx and lung. The transmission of the circovirus between the birds usually occurs through inhalation of feathers dust. There is evidence that animal circoviruses may originate when vertebrates become "infected" with DNA from a plant nanovirus. So, it seems that further investigation for the avian circoviruses is needed to determine if they are host specific or not. This study attempts to demonstrate ACV or ACV-like particles as potential triggers in the BFL aetiology, and the possible involvement in BFL's pathogenic mechanism.

An outbreak of infectious bursal disease in eight weeks old IBD vaccinated commercial poultry flock in Maiduguri, Nigeria

An outbreak of infectious bursal disease (IBD) on an IBD vaccinated commercial poultry farm was investigated using clinical and pathological findings as well as antigen and antibody detection by agar gel immunodiffusion test (AGDT). Mortality was observed 3 days after the onset of clinical signs and peaked on day 5 but declined significantly on day 6 after the onset of the clinical signs. The clinical and pathological lesions observed were those of hurdling anorexia, diarrhoea, hemorrhages on the thigh and breast muscles and on the gizzard-proventriculus junction as well as inflamed bursa. A morbidity rate of 90%, mortality rate of 53.3% and a case fatality rate of 59.3% were recorded. The sera collected on day 3 post infection were negative for IBD virus precipitin antibodies, while the sera obtained 15 days post-infection had IBD virus precipitin antibodies with titres ranging from 1:16 to 1:128. In addition, the tissue from infected bursae were all positive for IBD virus precipitin antigens with titres ranging from 1:2 to 1:32. The outbreak could have arisen from IBD vaccination failure. Keywords : infectious bursal disease outbreak, vaccination failure, agar gel immuno-diffusion test, Nigeria Tropical Veterinarian Vol. 22(3&4) 2004: 93-98

Clinical manifestations and treatment outcomes of pulmonary aspergilloma.

Background :Pulmonary aspergilloma usually results from the ingrowth of colonized Aspergillus from a damaged bronchial tree, a pulmonary cyst, or from the cavities of patients with underlying lung diseases. In the present study, we analyzed the clinical features, diagnostic methods, and managements of 36 patients with pulmonary aspergilloma.Methods :Thirty-six patients were diagnosed as having pulmonary aspergilloma at Chung-Ang University Hospital between February 1988 and February 2000. Their medical records were reviewed retrospectively.Results :The age of patients (median±SD) was 53.3±11.8 years, the male to female ratio was 2.36:1, and the most frequent symptom was hemoptysis, which occurred in 24 patients (65%). The most common underlying disease was pulmonary tuberculosis (81%), and the upper lobes of both lungs were the most frequently involved sites. Nine patients received a chest CT in the prone position and seven of these showed a movable fungus ball. Eleven patients were positive for the precipitin antibody to A. fumigatus. Twenty patients underwent surgical resection, and post-operative complications were reported in seven cases. The post-operative mortality was 5.6% (2/36).Conclusion :Pulmonary aspergilloma usually develops in the patients with underlying lung diseases. Resectional lung surgery is considered the mainstay of therapy for pulmonary aspergilloma. However, this operation is associated with significant complications and death in some cases. Therefore, it is necessary to develop reasonable criteria for selection of candidates for such surgery.

Cloning and expression of the gene which encodes a tube precipitin antigen and wall-associated beta-glucosidase of Coccidioides immitis.

We report the structure and expression of the Coccidioides immitis BGL2 gene which encodes a previously characterized 120-kDa glycoprotein of this fungal respiratory pathogen. The glycoprotein is recognized by immunoglobulin M tube precipitin (TP) antibody present in sera of patients with coccidioidomycosis, a reaction which has been used for serodiagnosis of early coccidioidal infection. The deduced amino acid sequence of BGL2 shows 12 potential N glycosylation sites and numerous serine-threonine-rich regions which could function as sites for O glycosylation. In addition, the protein sequence includes a domain which is characteristic of family 3 glycosyl hydrolases. Earlier biochemical studies of the purified 120-kDa TP antigen revealed that it functions as a beta-glucosidase (EC 3.2.1.21). Its amino acid sequence shows high homology to several other reported fungal beta-glucosidases which are members of the family 3 glycosyl hydrolases. Results of previous studies have also suggested that the 120-kDa beta-glucosidase participates in wall modification during differentiation of the parasitic cells (spherules) of C. immitis. In this study we showed that expression of the BGL2 gene is elevated during isotropic growth of spherules and the peak of wall-associated BGL2 enzyme activity correlates with this same phase of parasitic cell differentiation. These data support our hypothesis that the 120-kDa beta-glucosidase plays a morphogenetic role in the parasitic cycle of C. immitis.

Detection of Antibodies toCoccidioides immitisby Enzyme Immunoassay

Two hundred twenty-six specimens (160 serum samples, 66 cerebrospinal fluid samples) were tested with the Meridian Premier Coccidioides enzyme immunoassay (MPC-EIA), and the results were compared with those of conventional serologic tests detecting complement-fixing (CF) and tube precipitin (TP) antibodies. Of the 73 positive specimens by CF, 72 were positive by MPC-EIA (72 IgG positive, 48 IgM positive) and 1 was indeterminate. Of the 132 specimens negative by CF, 126 were negative by MPC-EIA, 3 were IgM positive only, and 3 were indeterminate. Of the three patients with specimens positive for IgM only, CF demonstrated seroconversion within a month in one. All 21 specimens that displayed anticomplementary activity by CF were confirmed negative by agar gel immunodiffusion for CF antibodies (IDCF) and TP antibodies (IDTP); 20 of these serum samples were also negative by MPC-EIA, and 1 was indeterminate. After exclusion of the 25 specimens with anticomplementary or indeterminate activity, results of MPC-EIA were in agreement with those of CF in 99% of specimens. With CF as reference, MPC-EIA had a specificity of 98%, sensitivity of 100%, and positive and negative predictive values of 96% and 100%, respectively. Correlation coefficient values from linear regressions of log-2 CF titer vs MPC-EIA IgG index values were calculated at .290 for serum samples and .931 for cerebrospinal fluid.

Diagnosis of pulmonary aspergillosis in cases with cavity as sequela of tuberculosis

Non-invasive pulmonary aspergillosis is frequently seen in cases with cavity as sequela of tuberculosis. Diagnosis of non-invasive pulmonary aspergillosis is not easy except for cases whose chest X-ray findings show a typical fungus ball. How to diagnose pulmonary aspergillosis was studied in 21 patients who showed changes in the radiological findings of cavity as sequela of tuberculosis. We made sputum culture of Aspergillus, measurement of precipitin antibody titer to Aspergillus fumigatus and measurement of PASTOREX ASPERGILLUS in serum and sputum on the 21 patients (group A). PASTOREX ASPERGILLUS in sputum was evaluated in three grades: 1+ approximately 3+. We diagnosed 14 patients as pulmonary aspergillosis (PA group) among the 21 patients taking into account the chest X-ray findings and the results of the above-stated investigations. The types of chest X-ray findings of these 14 patients were fungus ball type (FB) in 2 patients, productive aspergilloma on the inner wall of a cavity (PAIC) in 8, mixed type with FB and PAIC in 2 and non-specific change in 2. However, there were 3 patients with the chest X-ray findings suggestive of PAIC in 7 patients (non-PA group) who were not diagnosed as pulmonary aspergillosis. Sputum culture were positive in 11 patients of PA group (79%) and negative in all patients of non-PA group. Precipitin antibody were positive in 8 patients of PA group (67%) and negative in all patients of non-PA group. PASTOREX ASPERGILLUS in serum were negative in all 21 patients. PASTOREX ASPERGILLUS in sputum were 3+ (+3) in all 14 patients of PA group and in 2 patients of non-PA group and 2+ (+2) in 2 patients of non-PA group. 12 patients of PA group were treated by antifungal agents and 11 patients responded well to the treatment. We also made sputum culture of Aspergillus and measurement of PASTOREX ASPERGILLUS in sputum on 14 patients (group B) who had respiratory diseases with stable cavities and 17 patients (group C) who had respiratory diseases without a cavity. In group B, sputum culture were positive in 1 patient and PASTOREX ASPERGILLUS in sputum were 3+ (+3) in 2 patients, 2+ (+2) in 1 and 1+ (+) in 2. In group C, sputum culture were negative in all patients and PASTOREX ASPERGILLUS in sputum were 3+ (+3) in 1 patient, 2+ (+2) in 3 and 1+ (+) in 2. Measurement of PASTOREX in sputum was a useful tool to diagnose non-invasive aspergillosis in addition to sputum culture and measurement of precipitin antibody titer. The sensitivity of PASTOREX in sputum was high but its specificity was low, however, its specificity could be raised by applying semi-quantitative analysis of PASTOREX in sputum.

加湿器肺の１例

A 61-year-old female was admitted to our hospital complaining of fever and dyspnea. She had been using a humidifier in her home before admission.A chest X-ray film on admission showed diffuse micronodular shadows in the bilateral lung fields. A transbronchial lung biopsy revealed specific findings of hypersensitivity pneumonitis.A provocation test using the humidifier was positive, and a diagnosis of humidifier lung was made. The precipitin antibody reaction of the patient's serum to various antigens was negative, but Acremonium and Cladosporium were cultured from water in the humidifier. We therefore speculated that these fungi could be the pathogenic antigens.However, an inhalative provocation test using these fungi was not performed due to her refusal.

Immunological Neutralization of Cobrotoxin by Its Homologous Precipitin and Non-Precipitin Antibodie1

Anti-cobrotoxin antibodies can be separated into precipitin and non-precipitin antibodies. The precipitin antibody possesses the same binding affinity to cobrotoxin as non-precipitin antibody, but the neutralizing capability of the latter is superior to that of the former in blocking cobrotoxin binding to nicotinic acetylcholine receptor (nAChR). After preincubation with antibodies, cobrotoxin completely lost its binding activity to nAChR. The dissociation of cobrotoxin-nAChR complex by the antibodies was low, and 60% of the complex formation appeared to be irreversible. These results indicate that the neutralization of cobrotoxin by the antibody may predominantly involve unbound, receptor-free cobrotoxin. The relationships of neutralization capacity and binding affinity as well as bond strength between cobrotoxin and its antibodies are incongruous. Different local conformational changes of a unique Trp in cobrotoxin on binding with the precipitin and non-precipitin antibodies seem to lead to different accessibility for fluorescence quenchers. Characterization of the binding domains by immunoprecipitation with the antibodies correlated with the quenching results. Thus, the binding topography of cobrotoxin may play an important role over the binding affinity and bond strength in neutralization by cobrotoxin antibody.

Allergic Aspergillus Sinusitis

Allergic Aspergillus sinusitis seems to be diagnosed more frequently. This entity has definite similarities to allergic bronchopulmonary aspergillosis (ABPA) serologically and histopathologically. Rosenberg et al 1 have suggested clinical and immunologic criteria for ABPA that includes: (1) bronchoconstriction, (2) eosinophilia, (3) immediate skin reactivity to Aspergillus antigen, (4) precipitin antibodies against Aspergillus antigen, (5) elevated IgE, (6) history of pulmonary infiltrates, and (7) central bronchiectasis. If all seven criteria are fulfilled, the diagnosis of ABPA is considered definite. A probable diagnosis is made if six of seven criteria exist. The clinical picture of allergic Aspergillus sinusitis and ABPA, however, is not strictly limited to Aspergillus species. Bipolaris , 2 Curvularia , 3 and Exserohilum 4 species have been cultured from individuals with sinusitis that is clinically and histopathologically indistinguishable from allergic Aspergillus sinusitis. Serologic evaluation is also similar in that total IgE is elevated, with demonstrable fungus-specific IgE and precipitin IgG antibod

A seroreactive 120-kilodalton beta-1,3-glucanase of Coccidioides immitis which may participate in spherule morphogenesis.

A beta-glucosidase of Coccidioides immitis was identified in electrophoresis gel separations of the concanavalin A-bound mycelial culture-filtrate-plus-lysate preparation. p-Nitrophenol-beta-D-glucopyranoside was used as the substrate to visualize the enzymatically active fraction in nonreducing gels. The gel-isolated, chromatographically purified enzyme has an optimal pH of 8.0 and cleaves beta-1,3-glycosyl linkages. The alkaline beta-glucosidase was further characterized by a pI of 3.8 to 4.0, optimal activity at 37 to 40 degrees C, and molecular size of 120 kDa as identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The purified beta-glucosidase is identical to a previously reported 120-kDa antigen (Ag) which reacts with immunoglobulin M (IgM) tube precipitin (TP) antibody in sera from patients with coccidioidomycosis. The TP-Ag was described as a valuable serodiagnostic reagent for detection of specific IgM in patients with early coccidioidal infections. The beta-glucosidase, like the TP-Ag, was localized in the cell wall and cytoplasmic vesicles of parasitic cells (spherules) by immunofluorescence and immunoelectron microscopy with specific antiserum raised against the purified enzyme. The boiled cell wall fraction isolated from these same young (presegmented) spherules was partially digested by the beta-glucosidase. Addition of a potent beta-glucosidase inhibitor, 1-deoxynojirimycin, to the parasitic-phase culture medium at a concentration of 200 microM blocked or retarded conversion of arthroconidia to spherules. Antibody was raised in guinea pigs against chromatographically purified 1-deoxynojirimycin which was conjugated with bovine serum albumin. The inhibitor was localized by immunofluorescence in the wall of the 1-deoxynojirimycin-treated cells. We suggest that the spherule wall-associated, alkaline hydrolase functions as a beta-1,3-glucanase to provide for wall plasticity as well as intussusception of newly synthesized wall polymers during the period of rapid diametric growth of parasitic cells of C. immitis.

Nail dust aerosols from onychomycotic toenails. Part II. Clinical and serologic aspects. 1984.

The podiatric procedure of burring hyperkeratotic fungal infected toenails results in large quantities of nail dust aerosols. An extremely large percentage (31%) of podiatrists who were analyzed for immunoglobulin E (IgE) by antibody radioimmunoassay were found to have abnormally high levels. Incidence of precipitin antibodies to Trichophyton rubrum in sera of those in practice from 0 to 15 years was 23%, and those in practice 16 years or more was 29%. In this study, podiatrists who were chronically exposed to nail dust aerosols after years of practice presented with symptoms of conjunctivitis, rhinitis, asthma, coughing, hypersensitivity, and impaired lung function.