Sendid B, Dotan N, Nseir S, Savaux C, Vandewalle P, Standaert A, Zerimech F, Guery B P, Dukler A, Colombel J F, Poulain D
INSERM U799, Université Lille 2, Lille, France.
Clin Vaccine Immunol. 2008 Dec;15(12):1868-77. doi: 10.1128/CVI.00200-08. Epub 2008 Oct 29.
Antibodies against Saccharomyces cerevisiae mannan (ASCA) and antibodies against synthetic disaccharide fragments of glucans (ALCA) and chitin (ACCA) are biomarkers of Crohn's disease (CD). We previously showed that Candida albicans infection generates ASCA. Here, we explored ALCA and ACCA as possible biomarkers of invasive C. albicans infection (ICI). ASCA, ALCA, ACCA, and Candida mannan antigen and antibody detection tests were performed on 69 sera obtained sequentially from 18 patients with ICIs proven by blood culture, 59 sera from CD patients, 47 sera from hospitalized subjects colonized by Candida species (CZ), and 131 sera from healthy controls (HC). ASCA, ALCA, and ACCA levels in CD and ICI patients were significantly different from those in CZ and HC subjects (P<0.0001). In ICI patients, these levels increased as infection developed. Using ASCA, ALCA, ACCA, and Platelia Candida tests, 100% of ICIs were detected, with the kinetics of the antibody response depending on the patient during the time course of infection. A large number of sera presented with more than three positive tests. This is the first evidence that the detection of antibodies against chitin and glucans has diagnostic value in fungal infections and that these tests can complement more specific tests. Future trials are necessary to assess the value of these tests in multiparametric analysis, as well as their pathophysiological relevance.
抗酿酒酵母甘露聚糖抗体（ASCA）、抗葡聚糖和几丁质合成二糖片段抗体（ALCA）以及抗几丁质抗体（ACCA）是克罗恩病（CD）的生物标志物。我们之前发现白色念珠菌感染可产生ASCA。在此，我们探究了ALCA和ACCA作为侵袭性白色念珠菌感染（ICI）潜在生物标志物的可能性。对从18例经血培养证实患有ICI的患者中依次采集的69份血清、59份CD患者血清、47份念珠菌属定植的住院患者（CZ）血清以及131份健康对照（HC）血清进行了ASCA、ALCA、ACCA以及念珠菌甘露聚糖抗原和抗体检测试验。CD和ICI患者的ASCA、ALCA和ACCA水平与CZ和HC受试者的水平存在显著差异（P<0.0001）。在ICI患者中，随着感染进展，这些水平会升高。使用ASCA、ALCA、ACCA和Platelia念珠菌检测，可检测出100%的ICI，抗体反应动力学在感染过程中因患者而异。大量血清呈现三项以上阳性检测结果。这是首个证据表明，检测抗几丁质和葡聚糖抗体在真菌感染中具有诊断价值，且这些检测可补充更具特异性的检测。未来有必要进行试验，以评估这些检测在多参数分析中的价值及其病理生理学相关性。
