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[PMID]: 26493031 [Au] Autor: Maier P; Heinzelmann S; Böhringer D; Reinhard T [Ad] Endereço: Eye Centre, University Hospital Freibur, Germany. [Ti] Título: Prolonged organ culture reduces the incidence of endothelial immune reactions. [So] Source: Eye (Lond);30(1):127-32, 2016 Jan. [Is] ISSN: 1476-5454 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: PURPOSE The number of antigen-presenting cells decreases during organ culture of corneoscleral discs. This might result in a decrease of immune reactions with increasing duration of organ culture. To investigate this hypothesis, we performed a retrospective analysis of all penetrating keratoplasties that were consecutively performed over the last 5 years.PATIENTS AND METHODS All cases of penetrating keratoplasties (n=1006) were divided into two groups, with the division made at the median of the storage time (21 days). These two groups were compared by a Cox proportional hazards survival model regarding the incidence of endothelial immune reactions, clear graft survival, and chronic endothelial cell loss following penetrating keratoplasty considering patient's age, donor's age, and risk situation as co-variates.RESULTS We observed statistically significantly fewer endothelial immune reactions (20.1% (95% confidence interval 15.5-24.5%) after 2 years) in the group with a storage time of more than 21 days compared with the group with a storage time of <21 days (26.5% (95% confidence interval 21.6-31.2%) after 2 years). However, the duration of organ culture did not have a statistically significant effect on clear graft survival or chronic endothelial cell loss.CONCLUSION Our results demonstrate that an increased duration of organ culture leads to a lower incidence of endothelial immune reactions following penetrating keratoplasty. However, we do not recommend increased storage times in general as overall graft survival did not improve. The reason for this apparent paradox may be that the endothelial cell count decreases during storage time. [Mh] Termos MeSH primário: Células Apresentadoras de Antígenos/imunologia Epitélio Posterior/imunologia Ceratoplastia Penetrante [Mh] Termos MeSH secundário: Adulto Idoso Perda de Células Endoteliais da Córnea/patologia Criopreservação/métodos Sobrevivência de Enxerto/fisiologia Seres Humanos Incidência Meia-Idade Técnicas de Cultura de Órgãos Preservação de Órgãos/métodos Precipitinas/sangue Modelos de Riscos Proporcionais Estudos Retrospectivos Fatores de Tempo Doadores de Tecidos [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Precipitins) [Em] Mês de entrada: 1608 [Cu] Atualização por classe: 170101 [Lr] Data última revisão: 170101 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 151024 [St] Status: MEDLINE [do] DOI: 10.1038/eye.2015.207

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[PMID]: 25474508 [Au] Autor: Pajaro A; Nikoloutsopoulos T; Roberts-Thomson P [Ad] Endereço: 1Department of Allergy and Clinical Immunology, Flinders Medical Centre 2SA Pathology, Flinders Medical Centre, Adelaide, SA, Australia. [Ti] Título: Diagnostic utility of unidentified precipitin lines (UPLs) in immune precipitation assays. [So] Source: Pathology;47(1):62-7, 2015 Jan. [Is] ISSN: 1465-3931 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Unidentified precipitin lines (UPLs) are lines in immune precipitin assays which do not characterise with known extractable nuclear antigen (ENA) antibodies. Currently, the clinical significance of UPLs is uncertain.The aim of this study was to determine the clinical and laboratory correlates of UPLs detected over a 3 year period in a regional immunopathology laboratory.A total of 144 patients with UPLs on ENA testing were retrospectively analysed.ENA by counterimmunoelectrophoresis (CIE) was performed on 11,869 patient samples with further characterisation being performed for 1437 positive results. Ten percent of the positive ENAs demonstrated UPLs. The majority of patients with UPLs were female (71%) with an average age of 60 years. Precipitin lines for both continuously growing myeloid cell line K562 and rabbit thymus extract (RTE) were more frequent (47%), compared to K562 only (41%) or RTE only (12%). The most common antinuclear antibody (ANA) patterns associated with UPLs were speckled (29%), homogenous (16%), mixed patterns (14%), with 30% negative ANA and 5% showing cytoplasmic patterns (Golgi, GWB, mitochondrial). Both ANA positive and ANA negative patients with UPLs were generally associated with connective tissue and autoimmune disease with the majority demonstrating a positive association of UPLs with Ro52 and/or Ro60/SSA detected by Euroimmun line immunoassay. UPLs frequently seen with a negative ANA were also identified in renal disease, pulmonary fibrosis/bronchiectasis and malignancy/lymphoma.UPLs have uncertain diagnostic utility at this stage and further work needs to be done to clarify this question. UPLs were found in systemic and organ specific autoimmune disease, renal, pulmonary and neoplastic disorders. UPLs can occur in both ANA positive and ANA negative sera. The nature of the precipitating antigen in UPLs is still obscure. [Mh] Termos MeSH primário: Anticorpos Antinucleares/análise Antígenos Nucleares/imunologia Doenças do Tecido Conjuntivo/diagnóstico Imunoprecipitação Precipitinas [Mh] Termos MeSH secundário: Doenças Autoimunes/diagnóstico Doenças do Tecido Conjuntivo/imunologia Feminino Seres Humanos Masculino Meia-Idade Estudos Retrospectivos [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Antibodies, Antinuclear); 0 (Antigens, Nuclear); 0 (Precipitins) [Em] Mês de entrada: 1508 [Cu] Atualização por classe: 151119 [Lr] Data última revisão: 151119 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 141205 [St] Status: MEDLINE [do] DOI: 10.1097/PAT.0000000000000189

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[PMID]: 24488131 [Au] Autor: Hos D; Heindl LM; Bucher F; Cursiefen C [Ad] Endereço: Department of Ophthalmology, University of Cologne, Cologne, Germany. [Ti] Título: Evidence of donor corneal endothelial cell migration from immune reactions occurring after descemet membrane endothelial keratoplasty. [So] Source: Cornea;33(4):331-4, 2014 Apr. [Is] ISSN: 1536-4798 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: PURPOSE: The migratory capacity of donor corneal endothelial cells after Descemet membrane endothelial keratoplasty (DMEK) is not fully understood. We report 2 patients who developed immune reactions after DMEK with endothelial precipitates detectable not only on the grafts but also on host corneal areas stripped off the host Descemet membrane during surgery and initially not covered by the donor Descemet membrane and endothelium ("naked stroma"), strongly suggesting that migration of donor-derived endothelial cells had occurred. METHODS: Observational case series of 2 patients. RESULTS: A 71-year-old man (case 1) and an 84-year-old man (case 2) with Fuchs endothelial dystrophy underwent successful DMEK surgery. Postoperatively, the peripheral corneal stroma showed a denuded area that was not covered by the DMEK graft or by the patients' residual Descemet membrane (because of large descemetorhexis and slight graft decentration). After 18 (case 1) and 6 (case 2) months, a diffuse endothelial immune reaction with precipitates on the graft and, surprisingly, also on peripheral corneal areas that were initially denuded of the host Descemet membrane and not covered by the donor Descemet membrane was observed. The outermost corneal parts covered by the patients' own residual Descemet membrane showed no precipitates. Under treatment with topical corticosteroids, the precipitates rapidly disappeared. Visual acuity, central corneal thickness, and endothelial cell counts were not significantly affected. CONCLUSIONS: The immune reaction episodes in our patients with endothelial precipitates detectable on adjacent host areas initially stripped off and not covered by donor Descemet membrane provide direct in vivo evidence of donor corneal endothelial cell migration after DMEK, filling areas of "naked stroma." [Mh] Termos MeSH primário: Movimento Celular/fisiologia Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior Epitélio Posterior/fisiologia Distrofia Endotelial de Fuchs/cirurgia Precipitinas [Mh] Termos MeSH secundário: Idoso Idoso de 80 Anos ou mais Contagem de Células Glucocorticoides/uso terapêutico Seres Humanos Implante de Lente Intraocular Masculino Facoemulsificação Prednisolona/análogos & derivados Prednisolona/uso terapêutico Doadores de Tecidos Acuidade Visual [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nome de substância: 0 (Glucocorticoids); 0 (Precipitins); 8B2807733D (prednisolone acetate); 9PHQ9Y1OLM (Prednisolone) [Em] Mês de entrada: 1408 [Cu] Atualização por classe: 141120 [Lr] Data última revisão: 141120 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 140204 [St] Status: MEDLINE [do] DOI: 10.1097/ICO.0000000000000054

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[PMID]: 22547734 [Au] Autor: Godet C; Meurice JC; Roblot F; Kauffmann-Lacroix C; Verdaguer M; Frat JP; Cadranel J [Ti] Título: Efficacy of nebulised liposomal amphotericin B in the attack and maintenance treatment of ABPA. [So] Source: Eur Respir J;39(5):1261-3, 2012 May. [Is] ISSN: 1399-3003 [Cp] País de publicação: England [La] Idioma: eng [Mh] Termos MeSH primário: Anfotericina B/administração & dosagem Antifúngicos/administração & dosagem Aspergilose Broncopulmonar Alérgica/tratamento farmacológico Nebulizadores e Vaporizadores [Mh] Termos MeSH secundário: Corticosteroides/uso terapêutico Idoso Aspergilose Broncopulmonar Alérgica/diagnóstico Aspergilose Broncopulmonar Alérgica/diagnóstico por imagem Aspergilose Broncopulmonar Alérgica/imunologia Eosinófilos/efeitos dos fármacos Feminino Seres Humanos Imunoglobulina E/sangue Itraconazol/uso terapêutico Lipossomos Precipitinas/sangue Radiografia [Pt] Tipo de publicação: CASE REPORTS; LETTER [Nm] Nome de substância: 0 (Adrenal Cortex Hormones); 0 (Antifungal Agents); 0 (Liposomes); 0 (Precipitins); 304NUG5GF4 (Itraconazole); 37341-29-0 (Immunoglobulin E); 7XU7A7DROE (Amphotericin B) [Em] Mês de entrada: 1208 [Cu] Atualização por classe: 161125 [Lr] Data última revisão: 161125 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 120502 [St] Status: MEDLINE [do] DOI: 10.1183/09031936.00162311

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[PMID]: 22329454 [Au] Autor: Ampere A; Delhaes L; Soots J; Bart F; Wallaert B [Ad] Endereço: Service de Pneumologie, Centre Hospitalier Béthune, Lille, France. [Ti] Título: Hypersensitivity pneumonitis induced by Shiitake mushroom spores. [So] Source: Med Mycol;50(6):654-7, 2012 Aug. [Is] ISSN: 1460-2709 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Hypersensitivity pneumonitis (HP) is a pulmonary granulomatosis involving an immunoallergic mechanism caused by chronic inhalation of antigens, most frequently organic substances, as well as chemicals. We report the first European case of hypersensitivity pneumonitis due to the inhalation of Shiitake mushroom spores. A 37-year-old French Caucasian man with a one-month history of persistent dry cough, shortness of breath and loss of weight was admitted to our hospital on December 2010. Anamnesis showed he was involved in mushroom production beginning in the summer of 2010. His temperature on admission was 36.6°C and he had a normal blood pressure (135/90 mmHg). Bilateral fine crackles were audible in the base of both lungs. Pulmonary function tests showed a mild restrictive pattern with decreased DLco and a PaO(2) of 65 mmHg, Chest CT scan revealed reticulo-nodular shadows, slight ground glass opacities, liner atelectasis, and subpleural opacities in both lung fields. Bronchoscopy was normal but cytological examination of BAL revealed a predominant lymphocytosis (55%). Serum precipitins to the Shiitake mushroom spores were positive (3 precipitins arcs with high intensity) and as a result we advised the patient to cease his mushroom production activities. The diagnosis of hypersensitivity pneumonitis due to inhalation of Shiitake mushroom spores was established as a result of the improvement of all of his clinical symptoms, i.e., cough, weight loss, bilateral fine crackles, mild restrictive pattern of pulmonary function, and reticulo-nodular shadows on chest CT, once exposure was eliminated. Recent interest in exotic mushrooms varieties, e.g., Shiitake, in developed countries because of their possible medicinal properties might increase the potential risk of HP among mushrooms workers. Therefore, healthcare professionals have to take this new potential respiratory disease into account. [Mh] Termos MeSH primário: Alveolite Alérgica Extrínseca/microbiologia Exposição por Inalação/efeitos adversos Cogumelos Shiitake/imunologia Esporos Fúngicos/imunologia [Mh] Termos MeSH secundário: Adulto Alveolite Alérgica Extrínseca/imunologia Antígenos de Fungos/efeitos adversos Antígenos de Fungos/imunologia Líquido da Lavagem Broncoalveolar/imunologia Broncoscopia Seres Humanos Pulmão/microbiologia Pulmão/patologia Linfocitose/imunologia Linfocitose/microbiologia Masculino Doenças Profissionais/imunologia Doenças Profissionais/microbiologia Testes de Precipitina Precipitinas/sangue Testes de Função Respiratória Tórax/diagnóstico por imagem Tomografia Computadorizada por Raios X Ultrassonografia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Antigens, Fungal); 0 (Precipitins) [Em] Mês de entrada: 1211 [Cu] Atualização por classe: 161125 [Lr] Data última revisão: 161125 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 120215 [St] Status: MEDLINE [do] DOI: 10.3109/13693786.2012.658091

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[PMID]: 21676373 [Au] Autor: Chee SP; Jap A [Ad] Endereço: Singapore National Eye Centre, Singapore; National University Health System, Singapore; Singapore Eye Research Institute, Singapore. Electronic address: chee.soon.phaik@snec.com.sg. [Ti] Título: Immune ring formation associated with cytomegalovirus endotheliitis. [So] Source: Am J Ophthalmol;152(3):449-453.e1, 2011 Sep. [Is] ISSN: 1879-1891 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: PURPOSE: To describe immune ring (IR) formation as a manifestation of cytomegalovirus (CMV) endotheliitis. DESIGN: Retrospective observational case series. METHODS: Review of all consecutive CMV anterior uveitis and endotheliitis patients seen at the Singapore National Eye Centre for the occurrence of an IR. CMV infection was diagnosed by polymerase chain reaction analysis of the aqueous. RESULTS: None of the 72 eyes with CMV anterior uveitis had an IR formation. Four episodes of IR formation were seen in 3 eyes (14.3%) of 21 cases of CMV-positive endotheliitis. All were unilateral and all 3 patients were human immunodeficiency virus negative middle-aged Chinese males. The IR developed 2 to 7 months after occurrence of the endotheliitis and the aqueous was positive for CMV during 2 of the episodes of IR formation. In 2 eyes, the IR occurred at the completion of a course of systemic ganciclovir when the aqueous was negative for CMV. The immune rings resolved with combination therapy of topical prednisolone acetate 0.12% and ganciclovir. Patient 1 had a recurrence of the IR 4 months after stopping treatment but again resolved following treatment with ganciclovir and topical corticosteroids. CONCLUSION: Corneal immune rings can occur as a result of CMV infection. Hence CMV infection may have to be considered in such cases. [Mh] Termos MeSH primário: Infecções por Citomegalovirus/diagnóstico Epitélio Posterior/imunologia Infecções Oculares Virais/diagnóstico Uveíte Anterior/diagnóstico [Mh] Termos MeSH secundário: Administração Tópica Adulto Antivirais/administração & dosagem Antivirais/uso terapêutico Humor Aquoso/virologia Citomegalovirus/genética Citomegalovirus/isolamento & purificação Infecções por Citomegalovirus/tratamento farmacológico Infecções por Citomegalovirus/imunologia DNA Viral/análise Quimioterapia Combinada Infecções Oculares Virais/tratamento farmacológico Infecções Oculares Virais/imunologia Feminino Ganciclovir/administração & dosagem Ganciclovir/uso terapêutico Glucocorticoides/administração & dosagem Glucocorticoides/uso terapêutico Soronegatividade para HIV Seres Humanos Masculino Meia-Idade Reação em Cadeia da Polimerase Precipitinas/imunologia Prednisolona/administração & dosagem Prednisolona/análogos & derivados Prednisolona/uso terapêutico Estudos Retrospectivos Resultado do Tratamento Uveíte Anterior/tratamento farmacológico Uveíte Anterior/imunologia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Antiviral Agents); 0 (DNA, Viral); 0 (Glucocorticoids); 0 (Precipitins); 8B2807733D (prednisolone acetate); 9PHQ9Y1OLM (Prednisolone); P9G3CKZ4P5 (Ganciclovir) [Em] Mês de entrada: 1110 [Cu] Atualização por classe: 170927 [Lr] Data última revisão: 170927 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 110617 [St] Status: MEDLINE

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[PMID]: 20693254 [Au] Autor: Tillie-Leblond I; Grenouillet F; Reboux G; Roussel S; Chouraki B; Lorthois C; Dalphin JC; Wallaert B; Millon L [Ad] Endereço: Dept of Pneumology, University of Lille, Lille, France. I-Tillie@chru-lille.fr [Ti] Título: Hypersensitivity pneumonitis and metalworking fluids contaminated by mycobacteria. [So] Source: Eur Respir J;37(3):640-7, 2011 Mar. [Is] ISSN: 1399-3003 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Metalworking fluids (MWF) are responsible for hypersensitivity pneumonitis (HP). The aim of the present study was to identify the antigen (Ag) responsible for MWF-associated HP, and to optimise serological diagnosis by definition of a threshold allowing discrimination between HP patients and asymptomatic exposed workers. 13 patients, who were workers at a car engine manufacturing plant, were suspected of MWF-associated HP. Microbial analysis of 83 used MWFs was carried out. Sera from 13 MWF-associated HP patients, 12 asymptomatic exposed workers and 18 healthy unexposed controls were tested to determine their immunological responses to three Ags, including Mycobacterium immunogenum. M. immunogenum was identified in 40% of used fluids by culture and confirmed by DNA sequencing. The threshold for differentiating MWF-associated HP patients from asymptomatic exposed workers was five arcs of precipitation (sensitivity 77% and specificity 92%), as determined by electrosyneresis (ES). Using ELISA methods with protein extract from M. immunogenum, a threshold leading to 92% sensitivity and 100% specificity was established. The detection of specific antibodies against M. immunogenum Ag at high levels in case sera suggests that M. immunogenum-contaminated MWF is responsible for MWF-associated HP. To discriminate MWF-associated HP patients from asymptomatic exposed workers, we suggest a five-arc threshold for ES and a 1.6-AU threshold for ELISA methods. [Mh] Termos MeSH primário: Alveolite Alérgica Extrínseca/microbiologia Óleos Industriais/microbiologia Mycobacterium/metabolismo Doenças Profissionais/microbiologia [Mh] Termos MeSH secundário: Adulto Alveolite Alérgica Extrínseca/patologia Celulose/análogos & derivados Celulose/química Ensaio de Imunoadsorção Enzimática/métodos Seres Humanos Hipersensibilidade Masculino Metalurgia Meia-Idade Doenças Profissionais/diagnóstico Exposição Ocupacional Precipitinas/química Análise de Sequência de DNA [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Precipitins); 3J2P07GVB6 (acetylcellulose); 9004-34-6 (Cellulose) [Em] Mês de entrada: 1106 [Cu] Atualização por classe: 151119 [Lr] Data última revisão: 151119 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 100810 [St] Status: MEDLINE [do] DOI: 10.1183/09031936.00195009

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[PMID]: 20805703 [Au] Autor: Bang HI; Yoo JY; Kim KH; Park R; Shin JW; Choi TY; Lee SC; Park HS; Won JH [Ad] Endereço: Department of Laboratory Medicine, Soonchunhyang University Hospital, Seoul, Korea. [Ti] Título: [A case of central nervous system myelomatosis with complex chromosome aberrations]. [So] Source: Korean J Lab Med;30(4):334-8, 2010 Aug. [Is] ISSN: 1598-6535 [Cp] País de publicação: Korea (South) [La] Idioma: kor [Ab] Resumo: Involvement of the central nervous system is very uncommon in multiple myeloma, observed in approximately 1% of the multiple myeloma patients. We report a case of central nervous system myelomatosis with complex chromosome aberrations in a 62-yr-old female patient, who had previously been diagnosed as multiple myeloma. Fluorescent in situ hybridization revealed 13q deletion, p53 gene deletion and IGH/FGFR3 rearrangement and chromosomal study showed complex chromosome aberrations. After four cycles of chemotherapy, the patient was admitted to the hematology department with severe headache. Plasma cells were found in the cerebrospinal fluid (CSF), and CSF immunoelectrophoresis revealed abnormal precipitin arcs against anti-IgG and anti-lambda antisera. She was given systemic chemotherapy and eight courses of intrathecal chemotherapy, which cleared plasma cells in the CSF. Two months later, she was given autologous stem cell transplantation. Three months after stem cell transplantation, central nervous system myelomatosis progressed to plasma cell leukemia and two months later, the patient expired. [Mh] Termos MeSH primário: Neoplasias do Sistema Nervoso Central/diagnóstico Deleção Cromossômica Mieloma Múltiplo/diagnóstico Translocação Genética [Mh] Termos MeSH secundário: Antineoplásicos/uso terapêutico Neoplasias do Sistema Nervoso Central/tratamento farmacológico Neoplasias do Sistema Nervoso Central/genética Líquido Cefalorraquidiano/citologia Terapia Combinada Progressão da Doença Feminino Deleção de Genes Seres Humanos Imunoeletroforese Hibridização in Situ Fluorescente Leucemia Plasmocitária/diagnóstico Meia-Idade Mieloma Múltiplo/tratamento farmacológico Mieloma Múltiplo/genética Plasmócitos/patologia Precipitinas/metabolismo Receptor Tipo 3 de Fator de Crescimento de Fibroblastos/genética Transplante de Células-Tronco Transplante Autólogo Proteína Supressora de Tumor p53/genética [Pt] Tipo de publicação: CASE REPORTS; ENGLISH ABSTRACT; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Antineoplastic Agents); 0 (Precipitins); 0 (Tumor Suppressor Protein p53); EC 2.7.10.1 (FGFR3 protein, human); EC 2.7.10.1 (Receptor, Fibroblast Growth Factor, Type 3) [Em] Mês de entrada: 1011 [Cu] Atualização por classe: 140530 [Lr] Data última revisão: 140530 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 100901 [St] Status: MEDLINE [do] DOI: 10.3343/kjlm.2010.30.4.334

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[PMID]: 20631331 [Au] Autor: Fricker-Hidalgo H; Coltey B; Llerena C; Renversez JC; Grillot R; Pin I; Pelloux H; Pinel C [Ad] Endereço: Parasitologie-Mycologie, Pôle Biologie, Centre Hospitalier Universitaire, Grenoble Cedex 9, France. Hfricker-hidalgo@chu-grenoble.fr [Ti] Título: Recombinant allergens combined with biological markers in the diagnosis of allergic bronchopulmonary aspergillosis in cystic fibrosis patients. [So] Source: Clin Vaccine Immunol;17(9):1330-6, 2010 Sep. [Is] ISSN: 1556-679X [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Allergic bronchopulmonary aspergillosis (ABPA) is a frequent complication in cystic fibrosis patients. The diagnosis remains difficult and requires a combination of clinical, radiological, biological, and mycological criteria. The aim of this study was to analyze the added value of two recombinant antigens, rAspf4 and rAspf6, associated with the detection of specific IgG; precipitins; total IgE; and Aspergillus fumigatus in sputum for the diagnosis of ABPA. In a retrospective study, we determined the specific IgE responses to these recombinants in 133 sera of 65 cystic fibrosis patients. We selected an average of five serum samples from each of the 17 patients with ABPA (13 proven and 4 probable ABPA) and from 3 patients with Aspergillus bronchitis and rhinosinusitis. One serum sample for the 45 patients without ABPA was tested. The sensitivity of specific IgE detection against rAspf4 calculated per patient (92.3%) was significantly higher (P < 0.05) than that of rAspf6 (53.8%). When rAspf4 IgE detection was associated with anti-Aspergillus IgG enzyme-linked immunosorbent assay (ELISA) and precipitin detection, the sensitivity rose to 100%. The specificities of rAspf4 and rAspf6 IgE detection were 93.7% and 91.6%, respectively. Other diagnostic criteria had slightly lower specificities (87.5% for anti-Aspergillus IgG ELISA, 89.6% for precipitins, 84.4% for total IgE, and 85.0% for positive A. fumigatus culture in sputum). In conclusion, this retrospective study showed the relevance of rAspf4 IgE detection, in combination with other biological markers (Aspergillus IgG ELISA, precipitins, and total IgE), for improving the biological diagnosis of ABPA. [Mh] Termos MeSH primário: Alérgenos Aspergilose Broncopulmonar Alérgica/diagnóstico Biomarcadores Fibrose Cística/complicações Micologia/métodos [Mh] Termos MeSH secundário: Adolescente Adulto Anticorpos Antifúngicos/sangue Aspergillus fumigatus/isolamento & purificação Criança Pré-Escolar Ensaio de Imunoadsorção Enzimática/métodos Feminino Seres Humanos Imunoglobulina E/sangue Imunoglobulina G/sangue Lactente Masculino Meia-Idade Precipitinas/sangue Proteínas Recombinantes Estudos Retrospectivos Sensibilidade e Especificidade Escarro/microbiologia Adulto Jovem [Pt] Tipo de publicação: EVALUATION STUDIES; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Allergens); 0 (Antibodies, Fungal); 0 (Biomarkers); 0 (Immunoglobulin G); 0 (Precipitins); 0 (Recombinant Proteins); 37341-29-0 (Immunoglobulin E) [Em] Mês de entrada: 1012 [Cu] Atualização por classe: 170220 [Lr] Data última revisão: 170220 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 100716 [St] Status: MEDLINE [do] DOI: 10.1128/CVI.00200-10

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[PMID]: 20100013 [Au] Autor: Madani Y; Barlow A; Taher F [Ad] Endereço: Department of Respiratory Medicine, Watford General Hospital, Watford, Hertfordshire, WD18 0HB, United Kingdom. yasser.madani@doctors.org.uk [Ti] Título: Severe asthma with fungal sensitization: a case report and review of literature. [So] Source: J Asthma;47(1):2-6, 2010 Feb. [Is] ISSN: 1532-4303 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: There is a substantial body of evidence supporting an association between asthma severity and fungal exposure and sensitization. Fungal allergens are a recognized risk factor for severe asthma. We describe the case of a 44-year-old asthmatic whose asthma control deteriorated after moving to a new flat with walls covered in mould. Allergic bronchopulmonary aspergillosis was excluded. Although sensitization to Candida was demonstrated by a positive Candida-specific radioallergosorbent test, the patient did not entirely satisfy the criteria for a diagnosis of allergic bronchopulmonary candidiasis. The patient's asthma control improved after engaging in a monthly washing regimen of the walls. This case further demonstrates the association between fungal sensitization and asthma severity. The term severe asthma with fungal sensitization has been recently coined to describe this phenomenon. [Mh] Termos MeSH primário: Asma/imunologia Asma/fisiopatologia Fungos/imunologia [Mh] Termos MeSH secundário: Adulto Poluição do Ar em Ambientes Fechados/efeitos adversos Asma/diagnóstico por imagem Asma/terapia Candida albicans/imunologia Feminino Seres Humanos Imunoglobulina E/sangue Imunoglobulina E/imunologia Precipitinas/sangue Precipitinas/imunologia Radiografia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Precipitins); 37341-29-0 (Immunoglobulin E) [Em] Mês de entrada: 1002 [Cu] Atualização por classe: 161125 [Lr] Data última revisão: 161125 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 100127 [St] Status: MEDLINE [do] DOI: 10.3109/02770900903362684

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