Gliotoxin and bis(methylthio)gliotoxin are not reliable as biomarkers of invasive aspergillosis.
Mycoses. 2019 Jul 17;:
Authors: Mercier T, Reséndiz Sharpe A, Waumans D, Desmet K, Lagrou K, Maertens J
BACKGROUND: Invasive pulmonary aspergillosis (IPA) remains a life-threatening opportunistic infection, but can be difficult to diagnose. New biomarkers are therefore needed. Gliotoxin (GT), a secondary metabolite of Aspergillus fumigatus, and bis(methylthio)gliotoxin (bmGT), a degradation product of GT, have been proposed as potential biomarkers. However, these findings have yet to be confirmed.
OBJECTIVES: To identify the diagnostic potential of GT and bmGT in serum and bronchoalveolar lavage fluid (BALf) in haematology patients, compared to galactomannan.
MATERIALS AND METHODS: We prospectively collected culture supernatant, serum and BALf from patients with culture positive IPA and measured GT and bmGT concentrations using ultra-high-performance liquid chromatography – quadrupole time of flight mass spectrometry. Galactomannan was detected using a commercially available enzyme immunoassay.
RESULTS: We included 18 patients with proven (n=6) and probable (n=12) IPA, all with positive cultures for Aspergillus fumigatus. BmGT was only detected in serum from one patient (5.6%), whereas galactomannan was positive (optical density ≥ 0.5) in 11/18 patients (61.1%, p=0.002). We could not find GT in any serum sample. In BALf, bmGT was detected in 8/18 patients (44.4%) and GT in 9/18 patients (50%), compared to GM (optical density ≥ 1.0) in all patients (100%).
CONCLUSIONS: GT and bmGT had a very poor performance for diagnosing IPA. As other biomarkers are more sensitive and easier to detect, we would not recommend serum or BALf GT/bmGT to be used in the diagnosis of IPA. This article is protected by copyright. All rights reserved.
PMID: 31313395 [PubMed – as supplied by publisher]