Kappe R, Rimek D
Haema AG, Institut für Medizinische Mikrobiologie und Hygiene am Helios-Klinikum, Nordhäuser Strasse 74, D-99089 Erfurt, Germany.
Mycoses. 2004;47 Suppl 1:55-9. doi: 10.1111/j.1439-0507.2004.01035.x.
The clinical significance of Aspergillus antibody assays for the diagnosis of invasive aspergillosis (IA) is unclear. In two studies, three different antibody assays were evaluated with patients suffering from proven IA: (i) a commercial haemagglutination test (HAT), (ii) a commercial enzyme immunoassay (EIA) for IgG, IgM, and IgA, and (iii) an experimental mitogillin enzyme immunoassay for IgG, IgM, and IgA. In the first study, 99 serum samples from 26 patients with IA and 22 serum samples from 22 control patients were tested with all the three tests. Ten of the 26 patients (38%) reacted positively in at least one antibody assay. The highest sensitivity was generated by the detection of IgG using the EIA formats (22 and 21%, respectively), the HAT had a sensitivity of 8%. IgM type antibodies were detected in only two patients; no IgA type antibodies were detected. The specificities of the IgG EIA and the HAT were 72 and 85%, respectively. Antibody detection was the single positive laboratory test in two patients with proven and probable IA. In the second study, antibody test results of 60 patients with proven IA were retrospectively evaluated. Fourteen patients (23%) tested positive in the EIA and/or in the HAT. Investigations of the antibody levels in individual immunocompromised patients over time revealed that IgG production started after a mean of 10.8 days after diagnosis of IA. To conclude, antibodies against Aspergillus were detected in 23% of patients with IA. The antibody production started in successfully treated immunosuppressed patients after a mean of 10.8 days after the onset of infection. In particular, the detection of IgG-antibodies with an EIA can be useful for the confirmation of the diagnosis of IA and for the monitoring of the treatment of IA.
曲霉抗体检测对于侵袭性曲霉病（IA）诊断的临床意义尚不清楚。在两项研究中，对患有确诊IA的患者评估了三种不同的抗体检测方法：（i）一种商业血凝试验（HAT），（ii）一种用于检测IgG、IgM和IgA的商业酶免疫测定（EIA），以及（iii）一种用于检测IgG、IgM和IgA的实验性丝裂霉素酶免疫测定。在第一项研究中，用这三种检测方法对来自26例IA患者的99份血清样本和来自22例对照患者的22份血清样本进行了检测。26例患者中有10例（38%）在至少一种抗体检测中呈阳性反应。使用EIA检测IgG产生的敏感性最高（分别为22%和21%），HAT的敏感性为8%。仅在两名患者中检测到IgM型抗体；未检测到IgA型抗体。IgG EIA和HAT的特异性分别为72%和85%。在两名确诊和可能患有IA的患者中，抗体检测是唯一呈阳性的实验室检查。在第二项研究中，对60例确诊IA患者的抗体检测结果进行了回顾性评估。14例患者（23%）在EIA和/或HAT中检测呈阳性。对个体免疫功能低下患者随时间的抗体水平调查显示，IgG产生在IA诊断后平均10.8天开始。总之，23%的IA患者检测到抗曲霉抗体。抗体产生在成功治疗的免疫抑制患者中于感染开始后平均10.8天开始。特别是，使用EIA检测IgG抗体对于IA诊断的确认和IA治疗的监测可能有用。
