The role of pentraxin3 in plasma and bronchoalveolar lavage fluid in COPD patients with invasive pulmonary aspergillosis.
Aged
Aged, 80 and over
Aspergillosis
/ blood
Biomarkers
Bronchoalveolar Lavage Fluid
/ microbiology
C-Reactive Protein
/ analysis
China
Diagnosis, Differential
Female
Galactose
/ analogs & derivatives
Humans
Male
Mannans
/ blood
Middle Aged
Pulmonary Disease, Chronic Obstructive
/ blood
Retrospective Studies
Serum Amyloid P-Component
/ analysis
Bronchoalveolar lavage fluid
Galactomannan
Invasive pulmonary aspergillosis
Pentraxin 3
Journal
BMC pulmonary medicine
ISSN: 1471-2466
Titre abrégé: BMC Pulm Med
Pays: England
ID NLM: 100968563
Informations de publication
Date de publication:
16 Dec 2021
16 Dec 2021
Historique:
received:
10
09
2021
accepted:
13
12
2021
entrez:
17
12
2021
pubmed:
18
12
2021
medline:
5
3
2022
Statut:
epublish
Résumé
The use of galactomannan (GM) testing in plasma and bronchoalveolar lavage fluid (BALF) has improved the diagnosis of invasive pulmonary aspergillosis (IPA) in patients with chronic obstructive pulmonary disease (COPD); however, the high false-positive rate leads to overdiagnosis. Pentraxin 3 (PTX3) as an indicator of inflammation plays an important role in resistance to Aspergillus infections. This study aimed to investigate the diagnostic value of PTX3 for diagnosing IPA with COPD. We retrospectively collected data on patients with suspected COPD and IPA who had been hospitalized in the Third Affiliated Hospital of Soochow University between September 2017 and November 2020. PTX3 and GM were measured using enzyme-linked immunosorbent assays. A total of 165 patients were included in the study, of whom 35 had confirmed or probable IPA. The remaining 130 patients served as controls. The median plasma and BALF PTX3 levels were significantly higher in patients with IPA than in control patients (3.74 ng/mL vs. 1.29 ng/mL, P < 0.001; and 3.88 ng/mL vs. 1.58 ng/mL, P < 0.001 in plasma and BALF, respectively). The plasma GM, plasma PTX3, BALF GM, and BALF PTX3 assays had sensitivities of 60.0%, 77.1%, 78.6%, and 89.3%, respectively, and specificities of 73.8%, 69.2%, 80.7%, and 77.1%, respectively. The sensitivity of PTX3 in plasma and BALF was higher than that of GM. However, the specificity of PTX3 and GM did not differ significantly between the IPA group and the control group. The specificity of the assays for the diagnosis of IPA was > 90% in patients who were PTX3-positive and GM-positive in plasma and BALF. BALF and plasma PTX3 levels were significantly higher in COPD patients with IPA. The sensitivity of PTX3 was superior to that of GM for diagnosing IPA in patients with COPD. The combination of GM and PTX3 is useful for the diagnosis of IPA in patients with COPD.
Sections du résumé
BACKGROUND
BACKGROUND
The use of galactomannan (GM) testing in plasma and bronchoalveolar lavage fluid (BALF) has improved the diagnosis of invasive pulmonary aspergillosis (IPA) in patients with chronic obstructive pulmonary disease (COPD); however, the high false-positive rate leads to overdiagnosis. Pentraxin 3 (PTX3) as an indicator of inflammation plays an important role in resistance to Aspergillus infections. This study aimed to investigate the diagnostic value of PTX3 for diagnosing IPA with COPD.
METHODS
METHODS
We retrospectively collected data on patients with suspected COPD and IPA who had been hospitalized in the Third Affiliated Hospital of Soochow University between September 2017 and November 2020. PTX3 and GM were measured using enzyme-linked immunosorbent assays.
RESULTS
RESULTS
A total of 165 patients were included in the study, of whom 35 had confirmed or probable IPA. The remaining 130 patients served as controls. The median plasma and BALF PTX3 levels were significantly higher in patients with IPA than in control patients (3.74 ng/mL vs. 1.29 ng/mL, P < 0.001; and 3.88 ng/mL vs. 1.58 ng/mL, P < 0.001 in plasma and BALF, respectively). The plasma GM, plasma PTX3, BALF GM, and BALF PTX3 assays had sensitivities of 60.0%, 77.1%, 78.6%, and 89.3%, respectively, and specificities of 73.8%, 69.2%, 80.7%, and 77.1%, respectively. The sensitivity of PTX3 in plasma and BALF was higher than that of GM. However, the specificity of PTX3 and GM did not differ significantly between the IPA group and the control group. The specificity of the assays for the diagnosis of IPA was > 90% in patients who were PTX3-positive and GM-positive in plasma and BALF.
CONCLUSIONS
CONCLUSIONS
BALF and plasma PTX3 levels were significantly higher in COPD patients with IPA. The sensitivity of PTX3 was superior to that of GM for diagnosing IPA in patients with COPD. The combination of GM and PTX3 is useful for the diagnosis of IPA in patients with COPD.
Identifiants
pubmed: 34915889
doi: 10.1186/s12890-021-01793-z
pii: 10.1186/s12890-021-01793-z
pmc: PMC8680116
doi:
Substances chimiques
Biomarkers
0
Mannans
0
Serum Amyloid P-Component
0
galactomannan
11078-30-1
PTX3 protein
148591-49-5
C-Reactive Protein
9007-41-4
Galactose
X2RN3Q8DNE
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
414Subventions
Organisme : Changzhou Young Talent Technology Project
ID : QN201802
Informations de copyright
© 2021. The Author(s).
Références
J Clin Microbiol. 2017 Jul;55(7):2153-2161
pubmed: 28446576
Clin Infect Dis. 2015 Dec 15;61(12):1893-4
pubmed: 26261201
Clin Infect Dis. 2016 Aug 15;63(4):e1-e60
pubmed: 27365388
Front Immunol. 2021 May 20;12:666198
pubmed: 34093560
Mucosal Immunol. 2017 Mar;10(2):470-480
pubmed: 27301880
Blood. 2010 Dec 9;116(24):5170-80
pubmed: 20829368
Am J Respir Crit Care Med. 2017 Mar 1;195(5):557-582
pubmed: 28128970
Crit Care. 2012 Jul 27;16(4):R138
pubmed: 22835335
Clin Infect Dis. 2018 Jan 6;66(2):261-267
pubmed: 29020397
Biomed Res Int. 2015;2015:943691
pubmed: 25685819
J Pediatr Hematol Oncol. 2008 Dec;30(12):881-5
pubmed: 19131771
Intern Emerg Med. 2021 Sep;16(6):1619-1627
pubmed: 33751395
Mycobiology. 2020 Feb 8;48(1):1-8
pubmed: 32158600
Biomed Res Int. 2021 Jun 30;2021:6638622
pubmed: 34307663
N Engl J Med. 2014 Jan 30;370(5):421-32
pubmed: 24476432
Crit Care. 2014 Oct 15;18(5):562
pubmed: 25314919
Med Mycol. 2013 Oct;51(7):688-95
pubmed: 23527739
Front Immunol. 2021 Jul 09;12:641311
pubmed: 34305885
Respir Res. 2021 Jun 9;22(1):176
pubmed: 34107968
Clin Microbiol Infect. 2019 Apr;25(4):504-510
pubmed: 29964232
J Infect. 2016 Jun;72(6):738-744
pubmed: 27025205