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Recent Advances in Diagnosing Chronic Pulmonary Aspergillosis

Purpose: The diagnosis of chronic pulmonary aspergillosis (CPA) is occasionally complicated due to poor sensitivity of mycological culture and colonization of Aspergillus species in the airway. Several diagnostic methods have been developed for the diagnosis of invasive pulmonary aspergillosis; howe...

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Autores principales: Takazono, Takahiro, Izumikawa, Koichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6107790/
https://www.ncbi.nlm.nih.gov/pubmed/30174658
http://dx.doi.org/10.3389/fmicb.2018.01810
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author Takazono, Takahiro
Izumikawa, Koichi
author_facet Takazono, Takahiro
Izumikawa, Koichi
author_sort Takazono, Takahiro
collection PubMed
description Purpose: The diagnosis of chronic pulmonary aspergillosis (CPA) is occasionally complicated due to poor sensitivity of mycological culture and colonization of Aspergillus species in the airway. Several diagnostic methods have been developed for the diagnosis of invasive pulmonary aspergillosis; however, their interpretation and significance are different in CPA. This study aimed to review the recent advances in diagnostic methods and their characteristics in the diagnosis of CPA. Recent findings: Radiological findings of lung, histopathology, and culture are the gold standard of CPA diagnosis. Serodiagnosis methods involving the use of galactomannan and β-D-glucan have low sensitivity and specificity. An Aspergillus-specific IgG antibody assay showed good performance and had better sensitivity and reproducibility than conventional precipitant antibody assays. Currently, it is the most reliable method for diagnosing CPA caused by Aspergillus fumigatus, but evidence on its effectiveness in diagnosing CPA caused by non-fumigatus Aspergillus is lacking. Newly developed lateral flow device Aspergillus and detection of volatile organic compounds in breath have potential, but evidence on its effectiveness in diagnosing CPA is lacking. The increasing prevalence of azole-resistant A. fumigatus strains has become a threat to public health. Some of the azole-resistant-related genes can be detected directly from clinical samples using a commercially available kit. However, its clinical efficacy for routine use remains unclear, since resistance-related genes greatly differ among regions and countries. Conclusion: Several issues surrounding the diagnosis of CPA remain unclear. Hence, further investigations and clinical studies are needed to improve the accuracy and efficiency of CPA diagnosis.
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spelling pubmed-61077902018-08-31 Recent Advances in Diagnosing Chronic Pulmonary Aspergillosis Takazono, Takahiro Izumikawa, Koichi Front Microbiol Microbiology Purpose: The diagnosis of chronic pulmonary aspergillosis (CPA) is occasionally complicated due to poor sensitivity of mycological culture and colonization of Aspergillus species in the airway. Several diagnostic methods have been developed for the diagnosis of invasive pulmonary aspergillosis; however, their interpretation and significance are different in CPA. This study aimed to review the recent advances in diagnostic methods and their characteristics in the diagnosis of CPA. Recent findings: Radiological findings of lung, histopathology, and culture are the gold standard of CPA diagnosis. Serodiagnosis methods involving the use of galactomannan and β-D-glucan have low sensitivity and specificity. An Aspergillus-specific IgG antibody assay showed good performance and had better sensitivity and reproducibility than conventional precipitant antibody assays. Currently, it is the most reliable method for diagnosing CPA caused by Aspergillus fumigatus, but evidence on its effectiveness in diagnosing CPA caused by non-fumigatus Aspergillus is lacking. Newly developed lateral flow device Aspergillus and detection of volatile organic compounds in breath have potential, but evidence on its effectiveness in diagnosing CPA is lacking. The increasing prevalence of azole-resistant A. fumigatus strains has become a threat to public health. Some of the azole-resistant-related genes can be detected directly from clinical samples using a commercially available kit. However, its clinical efficacy for routine use remains unclear, since resistance-related genes greatly differ among regions and countries. Conclusion: Several issues surrounding the diagnosis of CPA remain unclear. Hence, further investigations and clinical studies are needed to improve the accuracy and efficiency of CPA diagnosis. Frontiers Media S.A. 2018-08-17 /pmc/articles/PMC6107790/ /pubmed/30174658 http://dx.doi.org/10.3389/fmicb.2018.01810 Text en Copyright © 2018 Takazono and Izumikawa. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Microbiology
Takazono, Takahiro
Izumikawa, Koichi
Recent Advances in Diagnosing Chronic Pulmonary Aspergillosis
title Recent Advances in Diagnosing Chronic Pulmonary Aspergillosis
title_full Recent Advances in Diagnosing Chronic Pulmonary Aspergillosis
title_fullStr Recent Advances in Diagnosing Chronic Pulmonary Aspergillosis
title_full_unstemmed Recent Advances in Diagnosing Chronic Pulmonary Aspergillosis
title_short Recent Advances in Diagnosing Chronic Pulmonary Aspergillosis
title_sort recent advances in diagnosing chronic pulmonary aspergillosis
topic Microbiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6107790/
https://www.ncbi.nlm.nih.gov/pubmed/30174658
http://dx.doi.org/10.3389/fmicb.2018.01810
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