Usami Makoto, Ohata Atsushi, Horiuchi Takeshi, Nagasawa Koichi, Wakabayashi Toshio, Tanaka Shigenori
Division of Surgical Metabolism, Faculty of Health Sciences, Kobe University School of Medicine, Japan.
Transfusion. 2002 Sep;42(9):1189-95. doi: 10.1046/j.1537-2995.2002.00162.x.
The false-positive elevation of plasma (1-->3)-beta-D-glucan level, a serodiagnostic test for deep-seated mycosis, is suspected in patients administered with blood components.
(1-->3)-beta-D-Glucan and endotoxin levels in blood components consisting of 12 albumins, 8 immunoglobulins, and 3 blood coagulation factors were measured by fungal infection tests (Fungitec G-test, Seikagaku Co.; the Wako WB003 test, Wako Pure Chemical Industries; and the Endospec ES test, Seikagaku Co.). In vitro release of (1-->3)-beta-D-glucan from the depth-type filters made by cellulose membrane to process blood components was analyzed through an in vitro filtration process as a source of (1-->3)-beta-D-glucan in blood components.
The amounts of (1-->3)-beta-D-glucan in blood components ranged from 0 to 7510 pg per mL in the Fungitec G-test, with wide variations among brands. The positive rates over 20 pg per mL were 75 percent in albumin solutions, 40 percent in blood coagulation factors, and 63 percent in immunoglobulin solutions. (1-->3)-beta-D-Glucan levels released from the five depth filters ranged from 5 to 2516 pg per mL. The (1-->3)-beta-D-glucan level in filtration fluid was decreased by rinsing with distilled water, but rebounded again during the albumin filtration process.
Depth filters are considered the source of (1-->3)-beta-D-glucan content in some blood components.
对于接受血液成分治疗的患者,怀疑其血浆(1→3)-β-D-葡聚糖水平(一种深部真菌病的血清学诊断检测指标)会出现假阳性升高。
采用真菌感染检测方法(Fungitec G检测,Seikagaku公司;Wako WB003检测,和光纯药工业株式会社;Endospec ES检测,Seikagaku公司)测定了12种白蛋白、8种免疫球蛋白和3种凝血因子组成的血液成分中的(1→3)-β-D-葡聚糖和内毒素水平。通过体外过滤过程分析了由纤维素膜制成的深度型过滤器向处理血液成分过程中(1→3)-β-D-葡聚糖的体外释放情况,以此作为血液成分中(1→3)-β-D-葡聚糖的来源。
在Fungitec G检测中,血液成分中(1→3)-β-D-葡聚糖的含量范围为每毫升0至7510皮克,不同品牌之间差异很大。每毫升超过20皮克的阳性率在白蛋白溶液中为75%,在凝血因子中为40%,在免疫球蛋白溶液中为63%。从五个深度过滤器释放的(1→3)-β-D-葡聚糖水平范围为每毫升5至2516皮克。用蒸馏水冲洗后,过滤液中的(1→3)-β-D-葡聚糖水平降低,但在白蛋白过滤过程中又再次反弹。
深度过滤器被认为是某些血液成分中(1→3)-β-D-葡聚糖含量的来源。