Evaluation of Aspergillus and Mucorales specific T-cells and peripheral blood mononuclear cell cytokine signatures as biomarkers of environmental mold exposure
INTERNATIONAL JOURNAL OF MEDICAL MICROBIOLOGY
Authors: Page, Lukas; Weis, Philipp; Mueller, Tobias; Dittrich, Marcus; Lazariotou, Maria; Dragon, Mariola; Waaga-Gasser, Ana Maria; Helm, Johanna; Dandekar, Thomas; Einsele, Hermann; Loeffler, Juergen; Ullmann, Andrew J.; Wurster, Sebastian
Abstract
Mold specific T-cells have been described as a supportive biomarker to monitor invasive mycoses and mold exposure. This study comparatively evaluated frequencies and cytokine profiles of Aspergillus fumigatus and Mucorales reactive T-cells depending on environmental mold exposure. Peripheral blood mononuclear cells (PBMCs) obtained from 35 healthy donors were stimulated with mycelial lysates of A. fumigatus and three human pathogenic Mucorales species. CD154(+) specific T-cells were quantified by flow cytometry. In a second cohort of 20 additional donors, flow cytometry was complemented by 13-plex cytokine assays. Mold exposure of the subjects was determined using a previously established questionnaire. Highly exposed subjects exhibited significantly greater CD154(+) A. fumigatus and Mucorales specific na ve and memory T-helper cell frequencies. Significant correlation (r = 0.48-0.79) was found between A. fumigatus and Mucorales specific T-cell numbers. Logistic regression analyses revealed that combined analysis of mold specific T-cell frequencies and selected cytokine markers (A. fumigatus: IL-5 and TNF-alpha, R. arrhizus: IL-17A and IL-13) significantly improves classification performance, resulting in 75-90 % predictive power using 10-fold cross-validation. In conclusion, mold specific T-cell frequencies and their cytokine signatures offer promising potential in the assessment of environmental mold exposure. The cytokines identified in this pilot study should be validated in the clinical setting, e. g. in patients with hypersensitivity pneumonitis.
Candida-reactive T cells for the diagnosis of invasive Candida infection of the lumbar vertebral spine
MYCOSES
Authors: Koehler, Felix C.; Cornely, Oliver A.; Wisplinghoff, Hilmar; Chang, De-Hua; Richter, Anne; Koehler, Philipp
Abstract
Invasive Candida infection is the fourth most common bloodstream infection. Blood cultures are the current gold standard diagnostic method, however, false negatives remain a clinical challenge. We developed a new technique measuring Candida-reactive T cells as diagnostic read-out for invasive Candida infection. In a pilot study, we followed the treatment course of a patient with an invasive Candida infection of the lumbar vertebral spine. We present the case of a 56-year-old patient with HIV-associated Burkitt lymphoma who developed septic shock during chemotherapy-induced neutropenia. For the first time, we provide flow cytometry-based diagnostics with Candida-reactive Tcells for invasive candidiasis with comprehensive MRI imaging. The Candida-reactive Tcell assay has potential to complement current diagnostic assays for invasive Candida infection and thus to support targeted treatment.