Comparison of two commercial tests (Immy vs. Dynamiker) for cryptococcal capsular antigen

Abstract INTRODUCTION Lateral flow assay is an advanced method useful in the early diagnosis of cryptococcal meningitis. We aimed to compare two commercial tests for cryptococcal capsular antigen in the sera of asymptomatic patients with human immunodeficiency virus in Barranquilla, Colombia. METHODS Thawed (n=162) previously collected serums (2016-2019) were processed using IMMY and Dynamiker cryptococcal antigen lateral flow assay. RESULTS Compared to IMMY's results, Dynamiker's sensitivity, specificity, positive predictive value, negative predictive value, and kappa index were 100%, 89.9%, 48.3%, 100.0%, and 0.61, respectively. CONCLUSIONS The Dynamiker test had excellent sensitivity, acceptable specificity, and a low detection threshold for cryptococcal antigen in the tested samples.

Serological diagnosis of paracoccidioidomycosis using a Paracoccidioides spp. comercial antigen and the counterimmunoelectrophoresis method

ABSTRACT Purpose: In-house Paracoccidioides spp. antigens are commonly used in the serological diagnosis of paracoccidioidomycosis (PCM). The sensitivity and specificity of a commercial Paracoccidioides spp. antigen was assessed for PCM serological testing. Method: Counterimmunoelectrophoresis and double immunodiffusion were used to evaluate the Paracoccidioides ID Antigen reagent in sera from PCM cases and patients with other diseases. Results: All active PCM sera (n=24) were reactive using counterimmunoelectrophoresis (sensitivity = 100%), including 11 cases of infection by P. brasiliensis sensu stricto and one by P. americana. Fifteen (88%) out of 17 sera from patients on treatment or cured were reactive, including one case of P. lutzii infection. One to three bands of antigen-antibody precipitate were observed on the agarose gel, with a predominance of two to three bands in the test with untreated PCM sera or at the beginning of antifungal therapy. All sera from patients with histoplasmosis (n=7), aspergillosis (n=5), and other diseases (n=27) tested negative (specificity = 100%). The overall sensitivity and specificity using the commercial antigen and double diffusion test were 75% and 100%, respectively. Conclusion: The commercial antigen performed satisfactorily and may contribute to the dissemination of the use of serological tests for the PCM diagnosis.

Fungos isolados em travesseiros de crianças e adolescentes com rinite e/ou asma / Isolated fungi on pillows of children and teenagers with rhinitis and/or asthma

Introdução: Pouco se sabe sobre a distribuição de fungos dentro das casas e nos materiais onde ficam concentrados, como os travesseiros, objeto que passa maior tempo em contato próximo com o paciente, podendo ser um reservatório importante e facilitar a sensibilização e o desencadeamento de crises alérgicas. O conhecimento da ocorrência de fungos em locais pouco pesquisados, bem como sua taxonomia, torna-se fundamental. Objetivos: Avaliar ocorrência de fungos em travesseiros de crianças alérgicas, o ambiente e os aspectos relacionados. Métodos: Pacientes com rinite e/ou asma, e teste cutâneo positivo para fungos foram selecionados. Realizado questionário ambiental no domicílio e coletado travesseiros em uso, os quais foram aspirados na área interna e externa para obtenção de amostras de fungos. Travesseiros novos, comprados em comércio local, serviram de controle. Resultados: A prevalência de sensibilização dos pacientes a fungos foi de 5,46% (13 dos 238 avaliados). Nenhum ambiente revelou-se adequado para pacientes alérgicos. Todos os travesseiros, inclusive os controles, estavam contaminados, tanto na sua área externa como na interna; o número médio de unidades formadoras de colônias (UFC/m2) apresentou diferença significativa na parte externa, sendo maior naqueles com mais de 7 anos de uso. A diversidade e a quantidade de fungos encontrados nos travesseiros dos pacientes foi maior que nos controles. Das 39 espécies e/ou outro nível taxonômico identificados, 32 (82,0%) podem causar alergia do Tipo I - IgE mediada, e os mais frequentes foram Candida, Penicillium sp., Cladosporium sp., Mycelia sterilia, Fusarim sp., Aureobasidium pullulans e Aspergillus. Nenhum tipo de enchimento foi considerado ideal, e o que apresentou menor nível de contaminação foi o de viscoelástico. Conclusão: Travesseiros são fontes de fungos e seus alérgenos. A maioria dos fungos isolados pode causar sensibilização com resposta IgE mediada. O painel utilizado mostrou-se insuficiente para identificar sensibilização aos fungos isolados.

Introduction: Little is known about fungi distribution in houses and materials where they are concentrated. Pillows are objects that remain much time in close contact with people and can be an important fungal reservoir, thus facilitating sensitization and triggering allergic crises. The knowledge of occurrence of fungi in unfrequently reported places, as well as their taxonomy, has become fundamental. Objectives: To evaluate the occurrence of fungi in pillows of allergic children, including the environment and related aspects. Methods: Patients with rhinitis and/or asthma and positive skin test for fungi were selected. An environmental questionnaire was completed at home and pillows in use were collected and aspirated inside and outside to obtain fungal samples. New pillows, bought in local stores, served as controls. Results: The prevalence of sensitization of patients to fungi was 5.46% (13 of 238 patients evaluated). No environment proved to be suitable for allergic patients. All the pillows, including the controls, were contaminated, both inside and outside; the mean number of colony forming units (CFU/m2) showed a significant difference in the outside and was greater in pillows with more than 7 years of use. The diversity and amount of fungi found on patients' pillows was greater than in controls. Of the 39 species and/or other taxonomic level identified, 32 (82.0%) may cause type I IgE-mediated allergy, and the most frequent fungi were Candida, Penicillium sp., Cladosporium sp., Mycelia sterilia, Fusarim sp., Aureobasidium pullulans and Aspergillus. No type of filling material was considered ideal, and the one with lowest level of contamination was viscoelastic. Conclusion: Pillows are sources of fungi and their allergens. Most isolated fungi can cause sensitization with IgE-mediated response. The panel used was insufficient to identify sensitization to isolated fungi.

Recombinant 60-kDa heat shock protein from Paracoccidioides brasiliensis: is it a good antigen for serological diagnosis of paracoccidioidomycosis?

Paracoccidioides brasiliensis and P. lutzii are fungi that cause paracoccidioidomycosis (PCM), the most prevalent systemic mycosis in South America. For serological diagnosis, although 43-kDa glycoprotein (gp43) is regarded as highly specific for PCM, the occurrence of false negative reactions in sera from patients infected with P. lutzii suggests that preparation with only one antigen is not recommended. Heat shock proteins are feasible alternatives as a second antigen because they are often highly immunogenic. In this study, we evaluated the usefulness of recombinant 60-kDa heat shock protein from P. brasiliensis (rPbHsp60) for the serological diagnosis of PCM. Using western blotting assay, we observed that 77.3% of the sera from PCM patients were positive to rPbHsp60, with 90.9% positivity to recombinant gp43 (rgp43). More importantly, sera from healthy subjects had 27% positivity to rPbHsp60 and none to rgp43. When rPbHsp60 was used in ELISA, we did not observe significant differences between the reactions with sera from PCM patients and healthy subjects, while the difference was clearly evident when the antigen was rgp43. Furthermore, rPbHsp60 was recognized by sera from patients with histoplasmosis, aspergillosis, sporotrichosis or tuberculosis in an ELISA test. These results show that rPbHsp60 is not a good antigen for PCM diagnosis.

Lateral flow asaay for cryptococcal antigen: animportant advance to improve thhe continuum of hiv care and reduce cryptococcal meningitis-related mottality / Ensaio de Fluxo Lateral para antígeno criptocócico: um importante avanço para melhorar o continuum de cuidados com HIV e reduzir a mortalidade relacionada à meningite criptocóccica

SUMMARYAIDS-related cryptococcal meningitis continues to cause a substantial burden of death in low and middle income countries. The diagnostic use for detection of cryptococcal capsular polysaccharide antigen (CrAg) in serum and cerebrospinal fluid by latex agglutination test (CrAg-latex) or enzyme-linked immunoassay (EIA) has been available for over decades. Better diagnostics in asymptomatic and symptomatic phases of cryptococcosis are key components to reduce mortality. Recently, the cryptococcal antigen lateral flow assay (CrAg LFA) was included in the armamentarium for diagnosis. Unlike the other tests, the CrAg LFA is a dipstick immunochromatographic assay, in a format similar to the home pregnancy test, and requires little or no lab infrastructure. This test meets all of the World Health Organization ASSURED criteria (Affordable, Sensitive, Specific, User friendly, Rapid/robust, Equipment-free, and Delivered). CrAg LFA in serum, plasma, whole blood, or cerebrospinal fluid is useful for the diagnosis of disease caused by Cryptococcusspecies. The CrAg LFA has better analytical sensitivity for C. gattii than CrAg-latex or EIA. Prevention of cryptococcal disease is new application of CrAg LFA via screening of blood for subclinical infection in asymptomatic HIV-infected persons with CD4 counts < 100 cells/mL who are not receiving effective antiretroviral therapy. CrAg screening of leftover plasma specimens after CD4 testing can identify persons with asymptomatic infection who urgently require pre-emptive fluconazole, who will otherwise progress to symptomatic infection and/or die.

RESUMOA meningite criptocócica continua causando um substancial índice de óbitos em pacientes infectados por HIV em países de baixa e média renda. Ferramentas diagnósticas para detecção do antígeno capsular polissacarídico criptocócico (CrAg) em soro e líquor tais como o teste de aglutinação de látex (latex-CrAg) ou o imunoensaio (EIE) têm sido utilizadas por muitos anos. Técnicas diagnósticas mais aprimoradas seriam cruciais nas fases assintomática e sintomática da criptococose para reduzir a mortalidade. Recentemente, o ensaio de fluxo lateral para detecção do antígeno criptocócico (LFA CrAg) foi incluído no arsenal diagnóstico. Contrariamente aos outros testes, LFA CrAg é um ensaio imunocromatográfico em formato similar ao teste de gravidez, e requer pouca ou nenhuma infraestrutura laboratorial. Este teste preenche os critérios ASSURED (Affordable, Sensitive,Specific, User friendly,Rapid/ robust,Equipment-free,Delivered) da Organização Mundial da Saúde e pode ser utilizado em soro, plasma, sangue total ou líquor para o diagnóstico da criptococose. LFA CrAg tem melhor sensibilidade analítica para o C. gattii que o teste de látex-CrAg ou EIE. A prevenção da doença criptocócica constituiria uma nova aplicação do LFA CrAg, mediante a triagem de amostras de sangue para a identificação de infecção sub-clínica em pacientes infectados pelo HIV que não apresentam sintomas, possuem contagem de CD4 < 100 células/mL e não recebem terapia antirretroviral eficaz. A triagem de CrgA em amostras de plasma remanescente da contagem de CD4 pode identificar pacientes com infecção assintomática que precisam urgentemente de tratamento preemptivo com fluconazol, evitando assim a progressão para doença sintomática e/ou óbito.

Paracoccidioidoyycosis: challenges in the develpment of a vaccine against an eendemic mycosis in the americas / Paracoccidioidomicose: desafios no desenvolvimento de uma vacina contra micose endêmica nas Américas

SUMMARYParacoccidioidomycosis (PCM), caused by Paracoccidioides spp, is an important endemic mycosis in Latin America. There are two recognized Paracoccidioides species, P. brasiliensis and P. lutzii, based on phylogenetic differences; however, the pathogenesis and disease manifestations of both are indistinguishable at present. Approximately 1,853 (~51,2%) of 3,583 confirmed deaths in Brazil due to systemic mycoses from 1996-2006 were caused by PCM. Antifungal treatment is required for patients with PCM. The initial treatment lasts from two to six months and sulfa derivatives, amphotericin B, azoles and terbinafine are used in clinical practice; however, despite prolonged therapy, relapses are still a problem. An effective Th1-biased cellular immune response is essential to control the disease, which can be induced by exogenous antigens or modulated by prophylactic or therapeutic vaccines. Stimulation of B cells or passive transference of monoclonal antibodies are also important means that may be used to improve the efficacy of paracoccidioidomycosis treatment in the future. This review critically details major challenges facing the development of a vaccine to combat PCM.

RESUMOA paracoccidioidomicose (PCM), causada por Paracoccidioides spp, é importante micose endêmica na América Latina. Com base em diferenças filogenéticas, existem duas espécies reconhecidas de Paracoccidioides, P. brasiliensis e P. lutzii, no entanto, a patogênese e as manifestações clínicas de ambas são indistinguíveis atualmente. Aproximadamente 1853 (~51,2%) de 3583 mortes confirmadas, atribuídas a micoses sistêmicas de 1996-2006, no Brasil foram causadas por PCM. Tratamento antifúngico é necessário para pacientes com PCM. O tratamento inicial dura de dois a seis meses e derivados de sulfa, anfotericina B, azóis e terbinafina são utilizados na prática clínica; no entanto, apesar da terapêutica prolongada, as recaídas ainda são um problema. Uma resposta imune celular eficaz, tendendo a Th1, é essencial para controlar a doença que pode ser induzida por antígenos exógenos, ou moduladas por vacinas profiláticas ou terapêuticas. A estimulação de células B ou a transferência passiva de anticorpos monoclonais também são meios importantes que podem ser utilizados para melhorar a eficácia do tratamento da paracoccidioidomicose no futuro. Esta revisão detalha criticamente os principais desafios que o desenvolvimento de uma vacina para combater a PCM enfrenta.

Diagnóstico serológico de la esporotricosis mediante el empleo del antígeno de micelio de Sporothrix schenckii sensu stricto / Serological diagnosis of sporotrichosis using an antigen of Sporothrix schenckii sensu stricto mycelium

En este estudio se desarrolló y se evaluó el ensayo por inmunoabsorción ligado a enzimas (ELISA), para la detección de anticuerpos en sueros de pacientes con esporotricosis, para lo cual se empleó un antígeno crudo de Sporothrix schenckii sensu stricto obtenido a partir de la forma micelial. Los sueros positivos para esporotricosis fueron ensayados por otras técnicas serológicas: inmunodifusión doble (IDD) y contrainmunoelectroforesis (CIE). El ensayo fue validado utilizando sueros de otras patologías como histoplasmosis, paracoccidioidomicosis, tuberculosis, leishmaniasis, lupus y sueros de individuos sanos como controles negativos. Se encontró una especificidad de 100 % con las técnicas utilizadas y una sensibilidad del antígeno de S.schenckii sensu stricto, por encima del 98% para IDD, CIE y ELISA. Estos resultados demuestran la alta sensibilidad y especificidad del antígeno de S. schenckii sensu stricto, para el diagnóstico de la esporotricosis, empleando las técnicas de IDD, CIE y ELISA. Los resultados sugieren, que este antígeno podría ser usado en conjunto con otras pruebas convencionales para el diagnóstico diferencial y puede ser útil para monitorizar la evolución de la enfermedad y respuesta al tratamiento.

We developed and analyzed an Enzyme-Linked Immunosorbent Assay (ELISA) in order to detect antibodies in sera from sporotrichosis patients. We used a crude antigen of Sporothrix schenckii sensu stricto, obtained from the mycelial phase of the fungi. Positive sera were analyzed by other serological techniques such as double immunodiffusion (IGG) and counterimmunoelectrophoresis (CIE). The assay was validated by using sera from patients with other pathologies such as: histoplasmosis, paracoccidioidomycosis, tuberculosis, leishmaniasis, lupus and healthy individuals as negative controls. For the Sporothrix schenckii sensu stricto antigen, we found a 100% of specificity by every technique and sensitivity higher than 98% with IDD, CIE and ELISA. Our results show a high sensitivity and specificity for the Sporothrix schenckii sensu stricto antigen, so it can be used for IDD, CIE and ELISA. The results suggest that this antigen could be used in conjunction with other conventional tests for differential diagnosis and may be useful for monitoring the disease progression and response to treatment.

Influence of the Paracoccidioides brasiliensis 14-3-3 and gp43 proteins on the induction of apoptosis in A549 epithelial cells

The fungal strain Paracoccidioides brasiliensis remains viable inside of epithelial cells and can induce apoptosis in this population. However, until now, the molecules that participate in this process remained unknown. Thus, this study evaluated the contribution of two P. brasiliensis molecules, the 14-3-3 and glycoprotein of 43 kDa proteins, which had been previously described as extracellular matrix adhesins and apoptosis inductors in human pneumocytes. Accordingly, epithelial cells were treated with these molecules for different periods of time and the expression of the apoptosis regulating-proteins Bak, Bax, Bcl-2, p53 and caspases were evaluated by terminal deoxynucleotidyl transferase dUTP nick end labelling, flow cytometry and real-time polymerase chain reaction analysis. Our results demonstrated that treatment with these molecules induces apoptosis signalling in pulmonary epithelial cells, showing the same pattern of programmed cell-death as that observed during infection with P. brasiliensis. Thus, we could conclude that P. brasiliensis uses these molecules as virulence factors that participate not only in the fungal adhesion process to host cells, but also in other important cellular mechanisms such as apoptosis.

A Case of Allergic Fungal Rhinosinusitis with Concurrently Occuring Fungus Ball

Allergic fungal rhinosinusitis (AFRS) is a noninvasive fungal infection of the paranasal sinuses that are usually seen in young immunocompetent patients with atopy and/or asthma. Fungus balls can grow in moist cavities of the paranasal sinuses of a host with normal immunologic status. Cases of AFRS with concurrent fungus balls is very rare. We present a case of a patient who had AFRS on one side of the paranasal sinus and allergic fungal sinusitis on the other side. A 51-year-old female with atopy presented with a few-year history of nasal obstruction and rhinorrhea, as well as a history of high-dose systemic steroid therapy. The patient had nasal polyps and showed an elevated level of total IgE and positive MAST to fungal antigens. Endoscopic sinus surgery was performed. Allergic mucin from the right maxillary sinus contained sheets of eosinophils and Charcot-Leyden crystals. Also, a clay-like dark brown material from the left maxillary sinus was revealed to be a fungus ball.

Avaliação dos efeitos de antígenos de Paracoccidioides brasiliensis em células dendríticas derivadas de monócitos de pacientes com paracoccidioidomicose: expressão de moléculas de superfície, linfoproliferação e secreção de citocinas / Evaluation of Paracoccidioides brasiliensis antigens effects on monocyte-derived dendritic cells from patients with paracoccidioidomycosis: expression of surface molecules, lymphoproliferation and secretion of cytokines

INTRODUÇÃO: A paracoccidioidomicose (PCM) induz uma resposta imune tipo Th1 relacionada à proteção, com imunodepressão antígeno-específica transitória. As células dendríticas (DCs) são as mais potentes apresentadoras de antígeno, porém, pouco se sabe sobre seu papel na PCM humana e sobre os efeitos do fungo em suas funções. OBJETIVO: Investigar os efeitos in vitro de antígenos de Paracoccidioides brasiliensis (P. brasiliensis) sobre as DCs derivadas de monócitos de pacientes com PCM. MÉTODOS: Foram incluídos 27 pacientes com PCM ativa (PA; com diagnóstico micológico, histopatológico ou títulos de anticorpos anti-P. brasiliensis >= 32) e 31 pacientes com PCM tratada (PT; anticorpos anti-P. brasiliensis com títulos <= 4, em duas coletas num período de 6 meses, e doença comprovada no passado pelos mesmos critérios de pacientes com PCM ativa), e de 39 indivíduos sadios (CO; não sensibilizados a antígenos de P. brasiliensis e sem anticorpos a tais antígenos fúngicos) foram geradas a partir de monócitos do sangue periférico, tratados com IL-4 e GM-CSF. As DC diferenciadas não-tratadas (nDC) ou tratadas com TNF-alfa (DC+TNF) foram estimuladas com os antígenos de P. brasiliensis: glicoproteína de 43 kDa (gp43) a 2 e 5 ug/mL (Gp2 e Gp5), e antígeno solúvel a 15 ug/mL (CFA). As moléculas de superfície CD11c, CD1a, HLA-DR, CD86, CD80 e DC-SIGN das DCs foram analisadas por citometria de fluxo e as citocinas IL-10, IL-12p40, IL-1beta e CCL18 foram dosadas nos sobrenadantes das culturas por ELISA. As DCs foram então co-cultivadas com linfócitos autólogos, medindo-se a linfoproliferação por incorporação de timidina triciada e dosando-se por ELISA os níveis de citocinas IL-10, IL-4, IFN-y e TNF-alfa foram dosadas nos sobrenadantes dessas culturas. RESULTADOS: As DCs de PA e PT apresentaram expressão de CD11c e CD1a similar à observada nas DCs de CO. No grupo PT, Gp5 induziu maior expressão de HLA-DR em comparação ao grupo PA, e o CFA aumentou o percentual de DCs CD86+. As...

INTRODUCTION: Paracoccidioidomycosis (PCM) induces a Th1 immune response associated with protection, with a transitory antigen-specific immunodepression. Dendritic cells (DCs) are the most potent antigen presenting cells, but little is known about their role on human PCM and the effects of fungal antigens on their functions. OBJECTIVE: To investigate the in vitro effects of Paracoccidioides brasiliensis (P. brasiliensis) antigens on monocyte-derived DCs from patients with PCM. METHODS: Twenty-seven patients with active PCM (PA; with mycological or histopathological diagnosis or antibody titles anti-P. brasiliensis >= 32) and 31 treated PCM (PT; antibody titles <= 4 on two samples within six months, and proved disease in the past by the same criteria of active PCM) and from 39 non-PCM subjects (CO; non-sensitized to P. brasiliensis antigens and without anti-fungal antigens antibodies) were included in this study and DCs were generated from peripheral blood monocytes with IL-4 and GM-CSF. Differentiated DCs were treated with TNF-alfa (DC+TNF) or left untreated (nDC) and then stimulated with P. brasiliensis antigens: 43 kDa glycoprotein (gp43) at 2 and 5 ug/mL (Gp2 and Gp5), and the cell-free antigen at 15 ug/mL (CFA). Surface molecules CD11c, CD1a, HLA-DR, CD85, CD80 and DC-SIGN were analyzed by flow cytometry and the cytokines IL-10, IL-12p40, IL-1beta and CCL18 were assayed by ELISA. DCs were cocultured with autologous lymphocytes: lymphoproliferation was measured by the incorporation of tritiated thymidine and the cytokines IL-10, IL-4, IFN-y and TNF-alfa were also assayed by ELISA. RESULTS: DCs from PA and PT groups showed similar expression of CD11c and CD1a to those of CO group. On the PT group, Gp5 induced higher expression of HLA-DR when compared to PA and CFA increased the percentage of CD86+ DCs. When stimulated with CFA, TNF-alfa -treated DCs from the PT group secreted large amounts of IL-12p40. This antigen also induced strong proliferation of...

Evaluación de la actividad antifúngica de extractos liquénicos e identificación de sus metabolitos / Evaluation of the fungicide activity from lichens extracts and identification their metabolites

Los líquenes son los hongos que establecen una relación simbiótica con un alga o cianobacteria. En esta simbiosis se producen por parte del hongo, una serie de metabolitos secundarios conocidos como sustancias liquénicas; las cuales presentan una marcada actividad antibiótica. En Cuba no se tienen antecedentes sobre estudios de metabolitos liquénicos por lo que se propone; evaluar el efecto fungicida de extractos liquénicos producidos por especies cubanas así como identificar sus metabolitos. Se emplearon líquenes de diferentes zonas del país (Parmotrema dilatatum, P. tinctorum, P. praesorediosum P. cristiferum, Ramalina americana, Cladonia ceratophylla y Cladonia portentosa spp. pacífica), a los cuales se les extrajo con acetona, las sustancias liquénicas almacenadas en el talo. Los extractos fueron probados contra los hongos fitopatógenos Rhizoctonia solani y Phythophtora nicotianae; por el método de envenenamiento del medio de cultivo agar papa dextrosa a concentraciones de: 0,01 por ciento; 0,03 por ciento y 0,07 por ciento. Se utilizó un control negativo de dimetilsufóxido al 0,07 por ciento y se determinaron los porcentajes de inhibición, cuyos resultados fueron analizados estadísticamente. Los metabolitos secundarios presentes en los extractos se identificaron por cromatografía de capa fina (TLC). Exceptuando el extracto liquénico de P. cristiferum, todos los demás mostraron más de un 50 por ciento de inhibición del crecimiento de ambos hongos a la concentración de 0,07 por ciento, mientras que a las restantes concentraciones los valores fueron variados con diferencias significativas con respecto al control. Se lograron identificar tres metabolitos liquénicos: metil 2‘-O- metilmicrofilinato, 4-O-Demetilmicrofilinico y el ácido ramaniloico.

Lichens are fungi that establish a symbiotic relationship with an alga or cyanobacterium. This symbiosis produced by the fungus, a series of secondary metabolites known as lichen substances; which show a strong antibiotic activity. In Cuba there is no background on the studies above lichen metabolites so it is proposed; evaluate the fungicidal activity of lichen extracts produced by Cuban species and to identify metabolites. Lichens from different areas of the country (Parmotrema dilatatum, P. tinctorum, P.praesorediosum, P. cristiferum, Ramalina americana, Cladonia ceratophylla and Cladonia portentosa spp. pacífica), to which it extracted with acetone, the lichen substances stored in tallus. The extracts were tested against the fungal pathogens Rhizoctonia solani and Phythophtora nicotianae; poisoning by the method of culture medium potato dextrose agar at concentrations of 0.01 percent; 0.03 percent and 0.07 percent. A negative control to 0.07 percent dimethylsulfoxide was used and the percentage of inhibition, the results were analyzed statistically determined. Secondary metabolites present in the extracts were identified by thin layer chromatography (TLC). Except P. cristiferum lichen extract, all others showed more than 50 percent growth inhibition of both fungi at concentration of 0.07 percent, while the remaining concentrations were varied values with significant differences from the control. Was made to identify three lichen metabolites metilmicrofilinato 2‘ methyl-O, 4-ODemetilmicrofilinico and ramaniloico acid.

Prevalence of prracoccidioidomycosis infection y intradermal reaction in rurall areas in alfenas, minas gerais, Braill / Prevalência da paracoccidioidomicose por intradermorreação em áreas rurais de Alfenas, Minas Gerais, Brasil

This study aimed to estimate the prevalence of paracoccidioidal infection by intradermal reaction (Delayed-Type Hypersensitivity, DTH) to Paracoccidioides brasiliensis in rural areas in Alfenas, Southern Minas Gerais (MG) State, Brazil, and to assess risk factors (gender, occupation, age, alcohol intake and smoking) associated with infection. We conducted a population-based cross-sectional study using intradermal tests with gp 43 paracoccidioidin in 542 participants, who were previously contacted by local health agents and so spontaneously attended the test. Participants underwent an interview by filling out a registration form with epidemiological data and were tested with an intradermal administration of 0.1 mL of paracoccidioidin in the left forearm. The test was read 48 hours after injection and was considered positive if induration was greater than or equal to 5 mm. Out of 542 participants, 46.67% were positive to the skin test. Prevalence increased in accordance with an increase of age. There was statistical significance only for males. Occupation, alcohol intake and smoking habits were not significantly associated with the risk of paracoccidioidomycosis infection. There is relevance of paracoccidioidomycosis infection in such rural areas, which suggests that further epidemiological and clinical studies on this mycosis should be done in the southern part of Minas Gerais State.

Este estudo teve como objetivo estimar a prevalência de sensibilização da pele pelo Paracoccidioides brasiliensis em áreas rurais em Alfenas, MG, Brasil, e avaliar os fatores de risco associados à infecção. Foi realizado um estudo transversal de base populacional utilizando testes intradérmicos com paracoccidioidina em 542 indivíduos selecionados por demanda espontânea. Os participantes foram submetidos a uma entrevista através do preenchimento de um formulário de inscrição com os dados epidemiológicos e os testes com a administração intradérmica de 0,1 mL de paracoccidioidina no antebraço esquerdo. O teste foi lido 48 h após a injeção e foi considerado positivo se enduramento era maior ou igual a 5 mm. De 542, 46,67% participantes foram positivos ao teste de pele. Prevalência aumentou de acordo com o aumento da idade. Houve significância estatística apenas para o sexo masculino. Profissão, alcoolismo e tabagismo não foram significativamente associados com o risco de infecção paracoccidioidomicose. Há relevância da infecção paracoccidioidomicose em áreas rurais, o que sugere mais estudos epidemiológicos e clínicos sobre esta micose no sul do estado de Minas Gerais.

Double-antigen sandwich ELISA for detecting Aspergillus fumigatus anti-Afmp1cr and Afmp2cr antibodies / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish two double-antigen sandwich ELISA systems to detect anti-Afmp1cr and Afmp2cr antibodies of Aspergillus fumigatus.</p><p><b>METHODS</b>Recombinant Afmp1cr and Afmp2cr proteins of A.fumigatus expressed in Pichia pastoris were obtained. Double-antigen sandwich ELISA systems for detecting specific anti-Afmp1cr and anti-Afmp2cr antibodies were developed after chessboard titrating to determine the appropriate concentrations of the recombinant proteins and HRP-labeled proteins. The sensitivity of the assay was evaluated using serum samples of rabbits immunized with Afmp1cr and Afmp2cr. The specificity of the assay was evaluated by detecting serum samples from healthy donors and patients with other pathogenic fungal and baterial infections. The performance of the two ELISA kits was furthered evaluated using serum samples from patients with suspected Aspergillus infection.</p><p><b>RESULTS</b>The established ELISA kits were capable of detecting anti-Afmp1cr and anti-Afmp2cr antibodies in immunized rabbit serum at the maximum dilutions of 800 and 3200, respectively. No cross-reactivity was observed in detecting serum from patients with other pathogenic fungal or bactetial infections. Both of the two kits yielded positive results in sera from two established Aspergillus-infected cases and a suspected case.</p><p><b>CONCLUSIONS</b>Two antibody-capture ELISA kits were developed for the laboratory diagnosis of A.fumigatus infection and can be potentially useful in the clinical diagnosis of Aspergillosis infections.</p>

Variability in Galactomannan detection by platelia Aspergillus EIA™ according to the Aspergillus species / Variabilidade na detecção de galactomanana pelo Platelia Aspergillus EIA® de acordo com a espécie de Aspergillus

Here we investigate the extent to which different Aspergillus species release galactomannan (GM) in vitro. Marked variability was observed in GM reactivity between and within Aspergillus species, with A. terreus strains showing the highest GM indexes. The in vivo significance of these findings remains to be determined.

O estudo objetivou investigar a liberação in vitro de galactomanana (GM) em distintas espécies patogênicas de fungos do gênero Aspergillus. Grande variabilidade foi detectada tanto intra quanto inter espécies, sendo as cepas da espécie A. terreus relacionadas aos maiores índices de GM detectados. O significado in vivo destes achados permanece em aberto, porém merece investigação.

The retrospective study of serum aspergillus galactomannan (GM) antigen assay in invasive aspergillosis on hematological diseases / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the relationship between the optical density index of serum aspergillus galactomannan (GM) assay and invasive aspergillosis (IA).</p><p><b>METHODS</b>From Jan 2008 to Dec 2011, 825 hematological diseases patients with neutrophil count <0.5×10⁹/L⁹ by continuous blood count tests were admitted into our hospital. The optical density index of GM assay was ≥0.5 at least once. Of 825 patients, 247 cases were manifested as fever during hospitalization. The optical density index of GM antigen was detected by enzyme-linked immunosorbent assay, and the sensitivity and specificity of optical density ranged in 0.5-1.5.</p><p><b>RESULTS</b>In this study, the sensitivity and specificity of GM assay with continuous twice samples (73% and 93%, respectively) were higher than single sample (66% and 80%, respectively) when optical density index ≥1.0. 69 cases were diagnosed as proven IA with the incidence rate of 8.36%.</p><p><b>CONCLUSION</b>The cut-off level for serum GM antigen assay should be decided as optical density index in two continuous samples of ≥1.0.</p>

A double-antigen sandwich ELISA for detecting Penicillium marneffei Mp1p-specific antibody / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish an immunological method for detecting antibodies of Penicillium marneffei.</p><p><b>METHODS</b>The recombinant Mp1p protein of Penicillium marneffei was expressed in Pichia pastoris and labeled with HRP (Mp1p-HRP) with a modified sodium periodate method. A double-antigen sandwich enzyme-linked immunosorbant assay (ELISA) was established by determining the optimal coating concentration of Mp1p protein and the concentration of the detecting protein Mp1p-HRP. The sensitivity and specificity of the assay was evaluated by detecting Mp1p antibodies in 100 serum samples from healthy donors, 15 samples from culture-confirmed penicilliosis patients, and 21 samples from patients with culture-confirmed other fungal infections.</p><p><b>RESULTS</b>A double-antigen sandwich ELISA was successfully established for detecting Mp1p-specific antibody. The specificity of the assay was 100% (121/121) for detecting Mp1p-specific antibody in the sera from healthy donors and patients with other fungal infection. The detection results of the 15 serum samples from patients with culture-confirmed penicilliosis showed positivity for Mp1p antibody in 2 samples and Mp1p antigen positivity in 12 samples; combining the detection results of Mp1p antigen and antibody obviously increased the diagnostic sensitivity to 93.3% (14/15).</p><p><b>CONCLUSION</b>The double-antigen sandwich ELISA shows a high specificity in detecting Mp1p-specific antibody, and simultaneous detection of Mp1p antigen and antibody can increase the diagnostic sensitivity for penicilliosis.</p>

Generation and Immunity Testing of a Recombinant Adenovirus Expressing NcSRS2-NcGRA7 Fusion Protein of Bovine Neospora caninum

Neospora caninum is the etiologic agent of bovine neosporosis, which affects the reproductive performance of cattle worldwide. The transmembrane protein, NcSRS2, and dense-granule protein, NcGRA7, were identified as protective antigens based on their ability to induce significant protective immune responses in murine neosporosis models. In the current study, NcSRS2 and NcGRA7 genes were spliced by overlap-extension PCR in a recombinant adenovirus termed Ad5-NcSRS2-NcGRA 7, expressing the NcSRS2-NcGRA7 gene, and the efficacy was evaluated in mice. The results showed that the titer of the recombinant adenovirus was 10(9)TCID50/ml. Three weeks post-boost immunization (w.p.b.i.), the IgG antibody titer in sera was as high as 1:4,096. IFN-gamma and IL-4 levels were significantly different from the control group (P<0.01). This research established a solid foundation for the development of a recombinant adenovirus vaccine against bovine N. caninum.

Cryptococcosis in Colombia: Results of the national surveillance program for the years 2006-2010 / Criptococosis en Colombia: resultados de la encuesta nacional, 2006-2010

Introduction: A survey on cryptococcosis is being conducted regularly in Colombia since 1997. We present hereby the results corresponding to patients diagnosed from 2006 to 2010. Objective: To analyze the data obtained during this period. Materials and methods: Retrospective analysis of the corresponding surveys. Results: A total of 526 surveys originating from 72% of the Colombian political divisions were received during the 5-year period. Most patients (76.6%) were males and 74.9% were 21-50 years old. The most prevalent risk factor was HIV infection (83.5%) with cryptococcosis defining AIDS in 23% of the cases. In the general population the estimated mean annual incidence rate for cryptococcosis was 2.4 x 106 inhabitants while in AIDS patients this rate rose to 3.3 x 103. In 474 surveys stating clinical features, most frequent complaints were headache 84.5%, fever 63.4%, nausea and vomiting 57.5%, mental alterations 46.3%, meningeal signs 33.0%, cough 26.4% and visual alterations 24.5%. Neurocryptococcosis was recorded in 81.8% of the cases. Laboratory diagnosis was based on direct examination, culture and latex in 29.3% cases. From 413 Cryptococcus isolates analyzed, 95.6% were identified as C. neoformans var. grubii, 1% C. neoformans var. neoformans, and 3.4% C. gattii. Treatment was reported for 71.6% of the cases with amphotericin B alone or in combination with fluconazole prescribed in 28%. Conclusions: Surveys done through passive surveillance continue to be sentinel markers for HIV infection and represent a systematic approach to the study of opportunistic problems regularly afflicting AIDS patients since cryptococcosis requires no compulsory notification in Colombia.

Introducción. Desde 1997 se viene realizando un programa nacional de vigilancia sobre la criptococosis en Colombia. Se presentan los resultados correspondientes a los pacientes diagnosticados entre el 2006 y el 2010. Objetivo. Analizar los datos obtenidos durante este periodo. Materiales y métodos. Análisis retrospectivo de las encuestas. Resultados. Durante los cinco años mencionados se recibieron 526 encuestas representativas del 72 % de la división política colombiana. La mayoría de pacientes (76,6 %) eran hombres y 74,9 % estaban entre los 21 y los 50 años. El factor de riesgo prevalente fue la infección por VIH (83,5 %), y la criptococosis definió el sida en 23 % de los casos. La incidencia anual promedio en la población general fue de 2,4 por un millón de habitantes mientras que, en pacientes con sida, aumentó a 3,3 por 1.000. En 474 encuestas se informaron manifestaciones clínicas; las más frecuentes fueron: cefalea (84,5 %), fiebre (63,4 %), náuseas y vómito (57,5 %), alteraciones mentales (46,3 %), signos meníngeos (33 %), tos (26,4 %) y alteraciones visuales (24,5 %). La neurocriptococosis se reportó en 81,8 % de los casos. El diagnóstico se hizo por examen directo, cultivo y antigenemia en 29,3 % de los casos. De 413 aislamientos recuperados, 95,6 % fueron C. neoformans var. grubii, 1 % C. neoformans var. neoformans, y 3,4 % C. gattii. En 71,6 % de los casos para el tratamiento se administró anfotericina B y en 28 % se combinó con fluconazol. Conclusiones. La vigilancia pasiva continúa siendo un marcador centinela para la infección por VIH, y constituye una aproximación sistemática al estudio de infecciones oportunistas en pacientes con sida, debido a que la criptococosis no es de notificación obligatoria en Colombia.

Carbohydrate-rich high-molecular-mass antigens are strongly recognized during experimental Histoplasma capsulatum infection / Antígenos de alta massa molecular ricos em carboidratos são fortemente reconhecidos durante infecção experimental por Histoplasma capsulatum

INTRODUCTION: During histoplasmosis, Histoplasma capsulatum soluble antigens (CFAg) can be naturally released by yeast cells. Because CFAg can be specifically targeted during infection, in the present study we investigated CFAg release in experimental murine histoplasmosis, and evaluated the host humoral immune response against high-molecular-mass antigens (hMMAg. >150 kDa), the more immunogenic CFAg fraction. METHODS: Mice were infected with 2.2x10(4) H. capsulatum IMT/HC128 yeast cells. The soluble CFAg, IgG anti-CFAg, IgG anti-hMMAg, and IgG-hMMAg circulating immune complexes (CIC) levels were determined by enzymelinked immunosorbent assay, at days 0, 7, 14, and 28 post-infection. RESULTS: We observed a progressive increase in circulating levels of CFAg, IgG anti-CFAg, IgG anti-hMMAg, and IgG-hMMAg CIC after H. capsulatum infection. The hMMAg showed a high percentage of carbohydrates and at least two main immunogenic components. CONCLUSIONS: We verified for the first time that hMMAg from H. capsulatum IMT/HC128 strain induce humoral immune response and lead to CIC formation during experimental histoplasmosis.

INTRODUÇÃO: Durante a histoplasmose, os antígenos solúveis de Histoplasma capsulatum (CFAg) podem ser liberados naturalmente pelas células leveduriformes. Considerando que os CFAg constituem um alvo específico durante a infecção, no presente estudo nós investigamos a liberação de CFAg durante a histoplasmose murina experimental, e avaliamos a resposta imune humoral do hospedeiro contra antígenos de alta MM (hMMAg; >150 kDa), altamente imunogênicos. MÉTODOS: Camundongos foram infectados com 2.2x10(4) leveduras de H. capsulatum, cepa IMT/HC128. Os níveis de CFAg solúveis, IgG anti-CFAg, IgG anti-hMMAg, e também de imunocomplexos circulantes (CIC) IgG-hMMAgs foram determinados por ELISA nos dias 0, 7, 14 e 28 após a infecção. RESULTADOS: Após a infecção por H. capsulatum, observamos um aumento progessivo de CFAg circulantes, IgG anti-CFAg, IgG anti-hMMAg, e também de CIC IgG-hMMAgs. Os hMMAg apresentaram alta porcentagem de carboidratos e, pelo menos, dois componentes imunogênicos. CONCLUSÕES: Mostramos pela primeira vez que os hMMAg de H. capsulatum cepa IMT/HC128 induzem resposta imune humoral e levam à formação de CIC durante a histoplasmose experimental.

Profile of total IgG, IgG1, IgG2, IgG3 and IgG4 levels in sera of patients with paracoccidioidomycosis: treatment follow-up using Mexo and rPb27 as antigens in an ELISA

The levels of total of IgG, IgG1, IgG2, IgG3 and IgG4 were evaluated in 54 patients with chronic paracoccidioidomycosis (PCM) before, during and after treatment using an enzyme-linked immunosorbent assay with Mexo and recombinant Pb27 (rPb27) as the antigens. Mexo was effective in distinguishing PCM patients from individuals in the negative control group (NC) based on total IgG and rPb27 performed worse than Mexo when these two groups were compared. IgG1, IgG2, IgG3 and IgG4 could not be used to clearly distinguish PCM patients from those in the NC group using either antigen. There was no clear relationship between antibody levels and the period of treatment. The majority of patients presented with decreased antibody levels during treatment, with no statistically significant differences among the different periods of treatment. Only IgG4 presented a negative correlation between its levels and clinical improvement during treatment. In total, 65 percent of untreated PCM patients showed reactivity against IgG4 when the Mexo antigen was used and this reactivity decreased over the course of treatment. There was a tendency towards decreasing antibody levels during treatment, but these antibody levels did not necessarily clear after the treatment was stopped. Mexo was useful for PCM diagnosis using total IgG; however, more studies are necessary before this antigen can be used in measuring the levels of total IgG and its subclasses for monitoring patients during treatment.