Department of Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, No. 12, Jiang Wangmiao Street, Nanjing, 210042, People's Republic of China.
Mycopathologia. 2014 Aug;178(1-2):53-61. doi: 10.1007/s11046-014-9777-x. Epub 2014 Jun 29.
Invasive aspergillosis (IA) is a major concern in patients with severe immune deficiency. As antifungal susceptibility varies in different fungal pathogens, accurate and timely identification of species is becoming imperative for guidance of therapy and reducing high mortality rates in patients with IA. But, in fact, the diagnosis is challenging and new validated techniques are required for the detection and identification of clinically relevant isolates. The laser capture microdissection (LCM) system enables analysis of cytologically and/or phenotypically defined cell types from heterogeneous tissue and has been used in diagnosis and fungal species identification in pulmonary aspergillosis of white storks. To establish the experimental foundation for clinical application of the system, we microdissected and collected Blankophor-stained single hyphal strands from tissue cryosections of murine model of invasive pulmonary aspergillosis (IPA) with A. fumigatus by LCM, subsequently processed for DNA extraction, PCR sequencing, and species molecular identification. The sensitivity of LCM-PCR sequencing was 89 % (89/100), and the specificity was 100 %. Moreover, the positive predictive value and negative predictive value were 100 and 78.43 %, respectively. The result approved that the LCM-based methods had the potential for accurately diagnosis and rapidly identification fungal pathogens of IPA.
侵袭性曲霉病(IA)是严重免疫缺陷患者的主要关注点。由于不同真菌病原体的抗真菌敏感性不同,因此准确、及时地鉴定物种对于指导治疗和降低 IA 患者的高死亡率变得至关重要。但实际上,诊断具有挑战性,需要新的经过验证的技术来检测和鉴定临床上相关的分离株。激光捕获显微切割(LCM)系统能够从异质组织中分析细胞学和/或表型定义的细胞类型,并已用于白鹳肺部曲霉病的诊断和真菌物种鉴定。为了为该系统的临床应用建立实验基础,我们通过 LCM 从小鼠侵袭性肺部曲霉病(IPA)模型的组织冷冻切片中微切割和收集经 Blankophor 染色的单个菌丝,随后进行 DNA 提取、PCR 测序和物种分子鉴定。LCM-PCR 测序的灵敏度为 89%(89/100),特异性为 100%。此外,阳性预测值和阴性预测值分别为 100%和 78.43%。结果证实,基于 LCM 的方法具有准确诊断和快速鉴定 IPA 真菌病原体的潜力。