TY  - JOUR
A1  - White, P. Lewis
A1  - Wiederhold, Nathan P.
A1  - Loeffler, Juergen
A1  - Najvar, Laura K.
A1  - Melchers, Willem
A1  - Herrera, Monica
A1  - Bretagne, Stephane
A1  - Wickes, Brian
A1  - Kirkpatrick, William R.
A1  - Barnes, Rosemary A.
A1  - Donnelly, J. Peter
A1  - Patterson, Thomas F.
T1  - Comparison of nonculture blood-based tests for diagnosing invasive aspergillosis in an animal model
JF  - Journal of Clinical Microbiology
N2  - The European Aspergillus PCR Initiative (EAPCRI) has provided recommendations for the PCR testing of whole blood (WB) and serum/plasma. It is important to test these recommended protocols on nonsimulated "in vivo" specimens before full clinical evaluation. The testing of an animal model of invasive aspergillosis (IA) overcomes the low incidence of disease and provides experimental design and control that is not possible in the clinical setting. Inadequate performance of the recommended protocols at this stage would require reassessment of methods before clinical trials are performed and utility assessed. The manuscript describes the performance of EAPCRI protocols in an animal model of invasive aspergillosis. Blood samples taken from a guinea pig model of IA were used for WB and serum PCR. Galactomannan and beta-D-glucan detection were evaluated, with particular focus on the timing of positivity and on the interpretation of combination testing. The overall sensitivities for WB PCR, serum PCR, galactomannan, and beta-D-glucan were 73%, 65%, 68%, and 46%, respectively. The corresponding specificities were 92%, 79%, 80%, and 100%, respectively. PCR provided the earliest indicator of IA, and increasing galactomannan and beta-D-glucan values were indicators of disease progression. The combination of WB PCR with galactomannan and beta-D-glucan proved optimal (area under the curve AUC], 0.95), and IA was confidently diagnosed or excluded. The EAPRCI-recommended PCR protocols provide performance comparable to commercial antigen tests, and clinical trials are warranted. By combining multiple tests, IA can be excluded or confirmed, highlighting the need for a combined diagnostic strategy. However, this approach must be balanced against the practicality and cost of using multiple tests.
KW  - high-risk hematology
KW  - Guinea pig model
KW  - real-time PCR
KW  - fungal disease
KW  - galactomannan
KW  - pulmonary aspergillosis
KW  - amphotericin B
KW  - Aspergillus fumigatus
KW  - beta-D-glucan
Y1  - 2016
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-189674
VL  - 54
IS  - 4
ER  - 
TY  - JOUR
A1  - Czakai, Kristin
A1  - Leonhardt, Ines
A1  - Dix, Andreas
A1  - Bonin, Michael
A1  - Linde, Joerg
A1  - Einsele, Hermann
A1  - Kurzai, Oliver
A1  - Loeffler, Jürgen
T1  - Krüppel-like Factor 4 modulates interleukin-6 release in human dendritic cells after in vitro stimulation with Aspergillus fumigatus and Candida albicans
JF  - Scientific Reports
N2  - Invasive fungal infections are associated with high mortality rates and are mostly caused by the opportunistic fungi Aspergillus fumigatus and Candida albicans. Immune responses against these fungi are still not fully understood. Dendritic cells (DCs) are crucial players in initiating innate and adaptive immune responses against fungal infections. The immunomodulatory effects of fungi were compared to the bacterial stimulus LPS to determine key players in the immune response to fungal infections. A genome wide study of the gene regulation of human monocyte-derived dendritic cells (DCs) confronted with A. fumigatus, C. albicans or LPS was performed and Krüppel-like factor 4 (KLF4) was identified as the only transcription factor that was down-regulated in DCs by both fungi but induced by stimulation with LPS. Downstream analysis demonstrated the influence of KLF4 on the interleukine-6 expression in human DCs. Furthermore, KLF4 regulation was shown to be dependent on pattern recognition receptor ligation. Therefore KLF4 was identified as a controlling element in the IL-6 immune response with a unique expression pattern comparing fungal and LPS stimulation.
KW  - gene regulation in immune cells
KW  - fungal host response
KW  - Aspergillus fumigatus
KW  - Candida albicans
Y1  - 2016
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-181185
VL  - 6
ER  -