TY  - JOUR
A1  - Sánchez-Maldonado, Jose Manuel
A1  - Moñiz-Díez, Ana
A1  - ter Horst, Rob
A1  - Campa, Daniele
A1  - Cabrera-Serrano, Antonio José
A1  - Martínez-Bueno, Manuel
A1  - Garrido-Collado, María del Pilar
A1  - Hernández-Mohedo, Francisca
A1  - Fernández-Puerta, Laura
A1  - López-Nevot, Miguel Ángel
A1  - Cunha, Cristina
A1  - González-Sierra, Pedro Antonio
A1  - Springer, Jan
A1  - Lackner, Michaela
A1  - Alcazar-Fuoli, Laura
A1  - Fianchi, Luana
A1  - Aguado, José María
A1  - Pagano, Livio
A1  - López-Fernández, Elisa
A1  - Clavero, Esther
A1  - Potenza, Leonardo
A1  - Luppi, Mario
A1  - Moratalla, Lucia
A1  - Solano, Carlos
A1  - Sampedro, Antonio
A1  - Cuenca-Estrella, Manuel
A1  - Lass-Flörl, Cornelia
A1  - Canzian, Federico
A1  - Loeffler, Juergen
A1  - Li, Yang
A1  - Einsele, Hermann
A1  - Netea, Mihai G.
A1  - Vázquez, Lourdes
A1  - Carvalho, Agostinho
A1  - Jurado, Manuel
A1  - Sainz, Juan
T1  - Polymorphisms within the TNFSF4 and MAPKAPK2 loci influence the risk of developing invasive aspergillosis: a two-stage case control study in the context of the aspBIOmics consortium
JF  - Journal of Fungi
N2  - Here, we assessed whether 36 single nucleotide polymorphisms (SNPs) within the TNFSF4 and MAPKAPK2 loci influence the risk of developing invasive aspergillosis (IA). We conducted a two-stage case control study including 911 high-risk patients diagnosed with hematological malignancies that were ascertained through the aspBIOmics consortium. The meta-analysis of the discovery and replication populations revealed that carriers of the TNFSF4\(_{rs7526628T/T}\) genotype had a significantly increased risk of developing IA (p = 0.00022). We also found that carriers of the TNFSF4\(_{rs7526628T}\) allele showed decreased serum levels of TNFSF14 protein (p = 0.0027), and that their macrophages had a decreased fungicidal activity (p = 0.048). In addition, we observed that each copy of the MAPKAPK2\(_{rs12137965G}\) allele increased the risk of IA by 60% (p = 0.0017), whereas each copy of the MAPKAPK2\(_{rs17013271T}\) allele was estimated to decrease the risk of developing the disease (p = 0.0029). Mechanistically, we found that carriers of the risk MAPKAPK2\(_{rs12137965G}\) allele showed increased numbers of CD38+IgM-IgD- plasmablasts in blood (p = 0.00086), whereas those harboring two copies of the allele had decreased serum concentrations of thymic stromal lymphopoietin (p = 0.00097). Finally, we also found that carriers of the protective MAPKAPK2\(_{rs17013271T}\) allele had decreased numbers of CD27-IgM-IgD- B cells (p = 0.00087) and significantly lower numbers of CD14+ and CD14+CD16- cells (p = 0.00018 and 0.00023). Altogether, these results suggest a role of the TNFSF4 and MAPKAPK2 genes in determining IA risk.
KW  - invasive aspergillosis
KW  - TNFSF4
KW  - MAPKAPK2
KW  - genetic susceptibility
KW  - B cells
KW  - monocytes
KW  - serum biomarkers
KW  - TSLP
KW  - TNFSF14
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-220107
SN  - 2309-608X
VL  - 7
IS  - 1
ER  - 
TY  - JOUR
A1  - Carvalho-Pereira, Joana
A1  - Fernandes, Filipa
A1  - Araújo, Ricardo
A1  - Springer, Jan
A1  - Loeffler, Juergen
A1  - Buitrago, María José
A1  - Pais, Célia
A1  - Sampaio, Paula
T1  - Multiplex PCR based strategy for detection of fungal pathogen DNA in patients with suspected invasive fungal infections
JF  - Journal of Fungi
N2  - A new and easy polymerase chain reaction (PCR) multiplex strategy, for the identification of the most common fungal species involved in invasive fungal infections (IFI) was developed in this work. Two panels with species-specific markers were designed, the Candida Panel for the identification of Candida species, and the Filamentous Fungi Panel for the identification of Aspergillus species and Rhizopusarrhizus. The method allowed the correct identification of all targeted pathogens using extracted DNA or by colony PCR, showed no cross-reactivity with nontargeted species and allowed identification of different species in mixed infections. Sensitivity reached 10 to 1 pg of DNA and was suitable for clinical samples from sterile sites, with a sensitivity of 89% and specificity of 100%. Overall, the study showed that the new method is suitable for the identification of the ten most important fungal species involved in IFI, not only from positive blood cultures but also from clinical samples from sterile sites. The method provides a unique characteristic, of seeing the peak in the specific region of the panel with the correct fluorescence dye, that aids the ruling out of unspecific amplifications. Furthermore, the panels can be further customized, selecting markers for different species and/or resistance genes.
KW  - molecular diagnosis
KW  - fungal infections
KW  - multiplex PCR
KW  - Candida sp.
KW  - Aspergillus sp.
KW  - Rhizopus arrhizus
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-219392
SN  - 2309-608X
VL  - 6
IS  - 4
ER  - 
TY  - JOUR
A1  - Springer, Jan
A1  - Held, Jürgen
A1  - Mengoli, Carlo
A1  - Schlegel, Paul Gerhardt
A1  - Gamon, Florian
A1  - Träger, Johannes
A1  - Kurzai, Oliver
A1  - Einsele, Hermann
A1  - Loeffler, Juergen
A1  - Eyrich, Matthias
T1  - Diagnostic performance of (1→3)-β-D-glucan alone and in combination with aspergillus PCR and galactomannan in serum of pediatric patients after allogeneic hematopoietic stem cell transplantation
JF  - Journal of Fungi
N2  - Data on biomarker-assisted diagnosis of invasive aspergillosis (IA) in pediatric patients is scarce. Therefore, we conducted a cohort study over two years including 404 serum specimens of 26 pediatric patients after allogeneic hematopoietic stem cell transplantation (alloSCT). Sera were tested prospectively twice weekly for Aspergillus-specific DNA, galactomannan (GM), and retrospectively for (1→3)-β-D-glucan (BDG). Three probable IA and two possible invasive fungal disease (IFD) cases were identified using the European Organization for Research and Treatment of Cancer and the Mycoses Study Group (EORTC/MSGERC) 2019 consensus definitions. Sensitivity and specificity for diagnosis of probable IA and possible IFD was 80% (95% confidential interval (CI): 28–99%) and 55% (95% CI: 32–77%) for BDG, 40% (95% CI: 5–85%) and 100% (95% CI: 83–100%) for GM, and 60% (95% CI: 15–95%) and 95% (95% CI: 75–100%) for Aspergillus-specific real-time PCR. However, sensitivities have to be interpreted with great caution due to the limited number of IA cases. Interestingly, the low specificity of BDG was largely caused by false-positive BDG results that clustered around the date of alloSCT. The following strategies were able to increase BDG specificity: two consecutive positive BDG tests for diagnosis (specificity 80% (95% CI: 56–94%)); using an optimized cutoff value of 306 pg/mL (specificity 90% (95% CI: 68–99%)) and testing BDG only after the acute posttransplant phase. In summary, BDG can help to diagnose IA in pediatric alloSCT recipients. However, due to the poor specificity either an increased cutoff value should be utilized or BDG results should be confirmed by an alternative Aspergillus assay.
KW  - beta-D-glucan
KW  - galactomannan
KW  - real-time PCR
KW  - Aspergillus
KW  - pediatric
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-234179
SN  - 2309-608X
VL  - 7
IS  - 3
ER  - 
TY  - JOUR
A1  - Springer, Jan
A1  - Walther, Grit
A1  - Rickerts, Volker
A1  - Hamprecht, Axel
A1  - Willinger, Birgit
A1  - Teschner, Daniel
A1  - Einsele, Hermann
A1  - Kurzai, Oliver
A1  - Loeffler, Juergen
T1  - Detection of Fusarium Species in Clinical Specimens by Probe-Based Real-Time PCR
JF  - Journal of Fungi
N2  - The mold Fusarium is a ubiquitous fungus causing plant, animal and human infections. In humans, Fusarium spp. are the major cause of eye infections in patients wearing contact lenses or after local trauma. Systemic infections by Fusarium spp. mainly occur in immunosuppressed patients and can disseminate throughout the human body. Due to high levels of resistance to antifungals a fast identification of the causative agent is an urgent need. By using a probe-based real-time PCR assay specific for the genus Fusarium we analysed several different clinical specimens detecting Fusarium spp. commonly found in clinical samples in Germany. Also, a large collection of lung fluid samples of haematological patients was analysed (n = 243). In these, two samples (0.8%) were reproducibly positive, but only one could be confirmed by sequencing. For this case of probable invasive fungal disease (IFD) culture was positive for Fusarium species. Here we describe a rapid, probe-based real-time PCR assay to specifically detect DNA from a broad range of Fusarium species and its application to clinically relevant specimens.
KW  - probe-based real-time PCR
KW  - Fusarium
KW  - bronchoalveolar lavage fluid
KW  - fungal molecular diagnostics
Y1  - 2019
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-193111
SN  - 2309-608X
VL  - 5
IS  - 4
ER  - 
TY  - JOUR
A1  - Belic, Stanislav
A1  - Page, Lukas
A1  - Lazariotou, Maria
A1  - Waaga-Gasser, Ana Maria
A1  - Dragan, Mariola
A1  - Springer, Jan
A1  - Loeffler, Juergen
A1  - Morton, Charles Oliver
A1  - Einsele, Hermann
A1  - Ullmann, Andrew J.
A1  - Wurster, Sebastian
T1  - Comparative Analysis of Inflammatory Cytokine Release and Alveolar Epithelial Barrier Invasion in a Transwell® Bilayer Model of Mucormycosis
JF  - Frontiers in Microbiology
N2  - Understanding the mechanisms of early invasion and epithelial defense in opportunistic mold infections is crucial for the evaluation of diagnostic biomarkers and novel treatment strategies. Recent studies revealed unique characteristics of the immunopathology of mucormycoses. We therefore adapted an alveolar Transwell® A549/HPAEC bilayer model for the assessment of epithelial barrier integrity and cytokine response to Rhizopus arrhizus, Rhizomucor pusillus, and Cunninghamella bertholletiae. Hyphal penetration of the alveolar barrier was validated by 18S ribosomal DNA detection in the endothelial compartment. Addition of dendritic cells (moDCs) to the alveolar compartment led to reduced fungal invasion and strongly enhanced pro-inflammatory cytokine response, whereas epithelial CCL2 and CCL5 release was reduced. Despite their phenotypic heterogeneity, the studied Mucorales species elicited the release of similar cytokine patterns by epithelial and dendritic cells. There were significantly elevated lactate dehydrogenase concentrations in the alveolar compartment and epithelial barrier permeability for dextran blue of different molecular weights in Mucorales-infected samples compared to Aspergillus fumigatus infection. Addition of monocyte-derived dendritic cells further aggravated LDH release and epithelial barrier permeability, highlighting the influence of the inflammatory response in mucormycosis-associated tissue damage. An important focus of this study was the evaluation of the reproducibility of readout parameters in independent experimental runs. Our results revealed consistently low coefficients of variation for cytokine concentrations and transcriptional levels of cytokine genes and cell integrity markers. As additional means of model validation, we confirmed that our bilayer model captures key principles of Mucorales biology such as accelerated growth in a hyperglycemic or ketoacidotic environment or reduced epithelial barrier invasion upon epithelial growth factor receptor blockade by gefitinib. Our findings indicate that the Transwell® bilayer model provides a reliable and reproducible tool for assessing host response in mucormycosis.
KW  - mucormycosis
KW  - alveolar epithelium
KW  - in vitro model
KW  - cytokines
KW  - dendritic cells
Y1  - 2019
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-252477
VL  - 9
ER  -