Extent of Lung Involvement and Serum Cryptococcal Antigen Test in Non-Human Immunodeficiency Virus Adult Patients with Pulmonary Cryptococcosis / 中华医学杂志(英文版)

<p><b>Background</b>Serum cryptococcal antigen (CrAg) test is the most used noninvasive method to detect cryptococcal infection. However, false-negative CrAg test is not uncommon in clinical practice. Then, the aim of this study was to investigate the factors associated with false-negative CrAg test among non-human immunodeficiency virus (HIV) adult patients with pulmonary cryptococcosis and its clinical features.</p><p><b>Methods</b>One hundred and fourteen non-HIV adult patients with pulmonary cryptococcosis, proven by biopsy, were retrospectively reviewed. Finally, 85 patients were enrolled; 56 were CrAg positive (CrAg+ group) and 29 were negative (CrAg- group). It was a cross-sectional study. Then, baseline characteristics, underlying diseases, clinical symptoms, laboratory findings, and chest radiological findings were reviewed and analyzed. Chi-square test was used to analyze categorical variable. Odds ratio (OR) was used to measure correlation. Student's t- test was obtained to analyze continuous variable.</p><p><b>Results</b>No difference in baseline characteristics, underlying diseases, clinical symptoms, and laboratory findings were found between two groups (P > 0.05 in all). Nevertheless, diffuse extent lesion was 82.1% in CrAg+ group and 10.3% in CrAg- group (χ = 40.34, P < 0.001; OR = 39.87).</p><p><b>Conclusions</b>Among patients with limited pulmonary involvement, a negative serum CrAg does not preclude the diagnosis of pulmonary cryptococcosis. However, among patients with extensive pulmonary involvement, serum CrAg is a useful diagnostic tool for pulmonary cryptococcosis. Furthermore, we also noticed that the untypical and mild presentations with extensive pulmonary lesion might be the features of pulmonary cryptococcosis, which needs further investigation.</p>

Invasive airway aspergillosis in immunocompetent host: a case report

Invasive airway aspergillosis [IAA] is a rarely reported type of invasive pulmonary aspergillosis [IPA]. In most patients, IAA is associated with immune dysfunction or other underlying diseases. It is very rare in patients with normal immune function and without pre-existing diseases. We describe here, a previously healthy 58-year-old male farmer who presented to our department with cough and bloody sputum associated with shortness of breath and who was diagnosed with IAA despite having no apparent immunodeficiency

Expression of interleukin-17A in asthmatic mice and its significance / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the serum level of interleukin-17A (IL-17A) and its expressions in the lung, spleen and thymus in asthmatic mice.</p><p><b>METHODS</b>In 14 normal BALB/c female mice and 14 asthmatic mice, the changes in the airway pathology and the cell proportion in the bronchoalveolar lavage fluid (BALF) were observed. The serum level of IL-17A and IL-17A expressions in the tissue homogenates of the lung, spleen and thymus of the mice were detected by sandwich enzyme-linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>The airway inflammation in the asthmatic mice was characterized mainly by eosinophil and neutrophil infiltration, which was not observed in the normal control group. Serum IL-17A levels and IL-17A expressions in the lung, spleen and thymus of the asthmatic mice were significantly higher than those in the normal control group (P<0.01). In the asthmatic mice, IL-17A expression in the lung tissues was positively correlated with the percentages of neutrophils (r=0.693, P=0.040) and eosinophils (r=0.733, P=0.030) in the BALF.</p><p><b>CONCLUSION</b>IL-17A is highly expressed in the serum, lung, spleen and thymus of asthmatic mice. IL-17A may be one of the major cytokines involved in exacerbation of bronchial asthma, and is probably associated with the recruitment of neutrophils and eosinophils into the airways.</p>