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首页> 外文期刊>Journal of Clinical Microbiology >Antigenemia in Patients with Paracoccidioidomycosis: Detection of the 87-Kilodalton Determinant during and after Antifungal Therapy
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Antigenemia in Patients with Paracoccidioidomycosis: Detection of the 87-Kilodalton Determinant during and after Antifungal Therapy

机译：副球菌病患者的抗原血症：抗真菌治疗期间和之后检测87-Kilodalton决定簇

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Serological diagnosis and follow-up of paracoccidioidomycosis (PCM) patients have relied mainly on the detection of antibody responses by using techniques such as complement fixation (CF) and immunodiffusion. We recently described a novel inhibition enzyme-linked immunosorbent assay (inh-ELISA) which proved to be useful in the diagnosis of PCM via the detection of an 87-kDa determinant in patient sera (B. L. Gomez, J. I. Figueroa, A. J. Hamilton, B. Ortiz, M. A. Robledo, R. J. Hay, and A. Restrepo, J. Clin. Microbiol. 35:3278–3283, 1997). This test has now been assessed as a means of following up PCM patients. A total of 24 PCM patients, classified according to their clinical presentation (6 with the acute form of the disease, of whom two had AIDS, 12 with the multifocal form of the disease, and 6 with the unifocal form of the disease), were studied. The four human immunodeficiency virus-negative patients with acute PCM showed a statistically significant decrease in circulating antigen levels after the start of antifungal therapy. Antigen levels in this group became negative by our criteria (≤2.3 μg/ml) before week 20 and remained so in three of four of these patients. In contrast, the two AIDS patients who also presented with the acute form of PCM showed no statistically significant decrease in circulating antigen levels even after 68 weeks of therapy. Taken together as a group, the patients with the multifocal form showed a statistically significant decrease in antigenemia after 28 weeks of therapy. In addition, five of six patients with the unifocal form became antigen negative by week 40. Antigen level decrease mirrored clinical cure in the majority of patients in all clinical groups; in contrast, measurement of anti-PCM antibodies via the CF test showed wide fluctuations in titers during the follow-up period. The inh-ELISA for the detection of the 87-kDaParacoccidioides brasiliensis determinant would appear to be a valuable additional tool in the follow-up of PCM patients.
机译：副球孢子菌病（PCM）患者的血清学诊断和随访主要依靠通过使用补体固定（CF）和免疫扩散等技术来检测抗体反应。我们最近描述了一种新型的抑制酶联免疫吸附试验（inh-ELISA），通过检测患者血清中的87 kDa决定簇被证明可用于PCM的诊断（BL Gomez，JI Figueroa，AJ Hamilton，B. Ortiz，MA Robledo，RJ Hay和A. Restrepo，J. Clin。Microbiol。35：3278–3283，1997年）。该评估现已被评估为随访PCM患者的一种手段。共有24例PCM患者，根据其临床表现进行了分类（6例为急性疾病，其中2例为AIDS，12例为疾病多灶性，6例为疾病单灶）。研究。在开始抗真菌治疗后，四名患有急性PCM的人类免疫缺陷病毒阴性患者显示出循环抗原水平的统计学显着降低。根据我们的标准，该组的抗原水平在第20周之前变为阴性（≤2.3μg/ ml），并且在这些患者中的四分之三仍然如此。相反，即使是经过68周的治疗，也出现急性形式PCM的两名AIDS患者的循环抗原水平也没有统计学上的显着降低。综合来看，多焦点形式的患者在治疗28周后显示出抗原血症的统计学显着降低。此外，单焦点形式的6名患者中有5名在第40周时变成抗原阴性。相比之下，通过CF测试测量的抗PCM抗体在随访期间显示滴度变化很大。 inh-ELISA检测87-kDa巴西对虾的决定因素似乎是PCM患者随访中有价值的附加工具。

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