Aspergillus Newsletter

eNewsletter: January 18th, 2011

Living with it, Working with it, Treating it

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In this issue

Advances Against Aspergillosis (AAA)

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Aspergillosis:from Allergy to Invasive Disease

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Detection and investigation of invasive mould disease

Hyphae elements invading cardiac tissue, detected with use of calcofluor white stain2011 sees the publication of this comprehensive review which surveys the strengths and limitations of each type of diagnostic tool available for the detection of invasive fungal infection.

The long standing time honoured practices of culturing specimens and of histological staining and microscopic examination are still of some practical use for superficial infections but are far too slow and very insensitive for the early diagnosis of systemic mycoses.

New techniques include the detection of antibodies produced by the infected patient, but that is of little use when the patient is immunocompromised (as most acute patients are) and doesn't produce antibodies well. This shifted the focus to detecting signs of the fungus itself - if it is present we should be able to detect it in this way. PCR (DNA detection) and Galactomannan detection (Platelia) stand out as the most developed methods in this respect and are both highly sensitive and rapid technologies that contribute to early diagnosis. Galactomannan detection has gained acceptance in combination with high resolution CT scans for patients with haematological disease. b-D-glucan detection (Fungitell) is not specific to Aspergillus and is gaining acceptance for use in critically ill patients, particularly as a test to rule out Aspergillus infections.

PCR is a technique with very high potential for detecting tiny quantities of specific DNA sequences so should be useful for the direct detection of fungal DNA and thus provide strong evidence for the detection of specific fungi. The authors state that there has been a lack of standardisation of protocol & reagents which has made experimental comparison and development difficult. On this point they make a cursory reference to commercial kits (i.e. Roche's Septifast) and mention that they are being used in several ongoing studies.

NB Users of these kits (also see Myconostica's Aspergillus MycAssay. Affigene's Aspergillus tracer)) benefit from standardised reagents and protocols (each in their own proprietary world) and their makers do claim high sensitivity for the detection of Aspergillus in serum and respiratory samples, so perhaps these kits will provide a commercial solution for the use of PCR.

The review goes on to discuss antifungal susceptibility testing and therapeutic drug monitoring.

In the same month we have two further highly relevant reviews:

Optimizing management of invasive mould diseases

Treatment and timing in invasive mould disease

Latest News and Articles

Our blog warned of the imminent dangers of mould that need to be taken in for account after the recent catastrophic floods in Brisbane, Australia. Moulds are often thought to be minor irritants in the aftermath of a flood but the reality is that for many people they can be the source of chronic allergic illness, while for some this can be combined with a real risk of an infection which has a very poor prognosis in terms of quality of life.

The British Medical Journal covered a tragic story of a patients' death by overdose with an antifungal drug being caused by a series of errors.

"After his death the National Patient Safety Agency issued a rapid response alert on the safer use of amphotericin to all NHS trusts in September 2007. But AvMA research published in February 2010 found that 10 NHS trusts had still not implemented it. "

 

Articles: There have been 68 additions to the Articles section (63 full papers), of which 12 are reviews and 19 historical. We have picked out a few of the highlights here:

Extremely low frequency magnetic field effects on metabolite of Aspergillus niger

60-80% increase in citric acid production and a transient 25% increse in cellulase activity claimed after treatment with a low frequency magnetic field.

Extracellular biosynthesis and characterization of silver nanoparticles using Aspergillus flavus NJP08: A mechanism perspective

An eco-friendly and low cost protocol for synthesis of silver nanoparticles (17nm) using the cell-free filtrate of Aspergillus flavus NJP08 when supplied with aqueous silver (Ag(+)) ions. The mechanism of particle formation is discussed.

Protein expression profiles distinguish between experimental invasive pulmonary aspergillosis and Pseudomonas pneumonia

Analysing the expression profiles and temporal progression of a series of serum proteins and proteins in broncheolar lavage in an animal model of invasive pulmonary aspergillosis (IPA) was effective in distinguishing IPA from Pseudomonas pneumonia.

Human Tissue Distribution of Voriconazole

Voriconazole levels determined in 8 patients at autopsy after treatment for an average of 7 days. Good penetration of the antifungal was found in all organs, though levels in brain where half of that in other organs.

An alternate method of classifying allergic bronchopulmonary aspergillosis based on high-attenuation mucus

The authors argue that high-attenuation mucus (HAM), a marker of inflammatory activity, should be used as part of the classification of ABPA. In this study, they evaluated the severity and clinical outcomes of ABPA with different radiological classifications.

Reviews

Aspergillus as a multi-purpose cell factory: current status and perspectives

Aspergillus has a long history as an expression host for the production of food ingredients, pharmaceuticals and enzymes. The achievements made during the last years, however, have the potential to revolutionize Aspergillus biotechnology and to assure Aspergillus a dominant place among microbial cell factories. This mini-review highlights the most recent breakthroughs in fundamental and applied Aspergillus research with a focus on new molecular tools, techniques and products.

Fungal infections of the ear in immunocompromised host: a review

In immunocompromised patients, it is important that the treatment of otomycosis be vigorous, to minimize complications such as hearing loss, tympanic membrane perforations and invasive temporal bone infection. Fungal cultures are essential to confirm the diagnosis.

Hematological investigations play a very important role in confirming the diagnosis and immunity status of the patients. In diabetic patients with otomycosis, along with antifungal therapy blood sugar levels should be controlled with medical therapy to prevent complications.

Conference Abstracts

The following have been added to our Conference Abstracts:

24th Fungal Genetics Conference (2007 - 144 abstracts)

52nd American Society of Haematologists (2010 - 47 abstracts)

Conferences

Highlights of ASH New York, NY Feb 4-5th 2011

Highlights of ASH San Diego, CA Feb 4-5th 2011

The sixth official Highlights of American Society of Haematologists, will feature leading hematology experts who will present unbiased analysis of the annual meeting abstracts and sessions, evolving therapies, and the latest treatment options and their clinical applications.

26th Fungal Genetics Conference at Asilomar March 15th-20th 2011

Many more here...

Patients

Research A recordings of the live webcast run at the latest Aspergillosis Patients meeting is at the National Aspergillosis Centre (NAC)is available to watch here. This month we had a presentation by Dr Paul Bowyer who is a research team leader at the NAC, who gave a great and easy to understand account of how we do research and an example of a discoveries made at the NAC. Slides are available here.

Help the National Aspergillosis Centre carry out research. We are trying to contact patients willing to try to get their GP practice involved in some research with us on prevelence of ABPA and SAFS. The GP practice must be within 2 hours drive of Manchester. All you will have to do is hand over our documentation to the practice which will explain everything. If you want to help out please contact us at admin@aspergillus.org.uk.

Don't forget to order your shopping through our buy.at store - there are dozens of High Street stores to choose from and you will be donating to the Fungal Research Trust at no cost to yourselves!

New research shows that 6 out of 10 Severe Asthmatics have Aspergillus in their Lungs. This strongly suggests that Aspergillus has a powerful influence on hte severity of asthma and earlier research carried out at the NAC has shown that treating severe asthmatics with an antifungal drug brings them relief from symptoms. In many cases this could allow the patient to reduce their intake of steroids, reducing side effects.


There are plans developing to hold a second meeting for patients outside of Manchester in London in mid 2011. If you are interested in attending as a patient or carer suffering from aspergillosis please let us know Email

A patient volunteer is making & selling handmade cards for birthdays in aid of the Fungal Research Trust. 6 cards for £6 and 75% of that goes to the FRT. Order here.

There is a newly designed Patients website now entitled 'Aspergillosis Patient Support'. Much more comprehensive than before and easier to navigate but with the same successful support group (850 members) and Q & A board

Jobs

Fifteen jobs are currently being advertised:

    1. Two Positions for PhD Students, Graz University of Technology, Austria. Closing date 25th January 2011
    2. Head of Infectious Diseases/Microbiology 68202, Frankston Hospital, Mornington Peninsula, Victoria, Australia. Closing date 31st January 2011
    3. Clinical Research Fellow (Translational Medicine), South Manchester University Hospital NHS FT and the Stopford Building, The University of Manchester. Closing date 11th February 2011
    4. Postdoctoral Research Fellow (Evolution of fungal pathogens within mouse hosts), Singapore Immunology Network, Agency for Science, Technology and Research, Singapore. Closing date 31st March 2011
    5. Postdoctoral Research Fellow (Genome evolution of fungal pathogens), Singapore Immunology Network, Agency for Science, Technology and Research, Singapore. Closing date 31st March 2011
    6. Nine MRC Clinical Research Training Fellowships in Clinical Pharmacology & Therapeutics, Universities of Liverpool and Manchester, UK. Closing date 31st May 2011

Advertise your vacancy free of charge on the Aspergillus Website here.

*Optional donation to the Fungal Research Trust to cover costs incurred in providing this newsletter.

Courses and Workshops

We keep a listing of courses and workshops including 'one off' events and courses that repeat regularly. Course subjects are wide ranging and include medical mycology, lab ID, young scientists symposia and much more. Those coming up next are:

  1. Course on Medical Mycology, Utrecht, Uppsalalaan 8, The Netherlands. 7 - 18th March 2011 Link
  2. British Society for Medical Mycology Diagnostic Medical Mycology Course. 19 - 23rd March 2011 Link

And certainly don't miss ESCMID Postgraduate Technical Workshop. Aspergillosis: from Allergy to Invasive Disease. Manchester, UK. 25 – 26 May 2011  Link

If you know of a course that should be added to this list please add it by contacting us here

Veterinary

Effects of compounding on pharmacokinetics of itraconazole in black-footed penguins (Spheniscus demersus).

Itraconazole is used to treat and prevent aspergillosis in captive penguin colonies. Although commercial formulations of itraconazole are available, compounding is sometimes performed to decrease cost or to provide a different concentration of the drug.

The objectives of this study were to determine the pharmacokinetic properties of a
commercially available itraconazole oral solution in black-footed penguins (Spheniscus demersus) and to determine whether a compounded itraconazole formulation has similar pharmacokinetic properties

NB Vets in the UK in need of assistance with acquiring antifungals please contact us here

Blog

  1. 6 out of 10 Severe Asthmatics have Aspergillus in their Lungs
  2. First Catastrophic Flooding, then Biblical 'Pestilence' (mould)
  3. Are We Going to Run Out of Antibiotics??

Recent Books

Genetics and Evolution of Infectious Diseases (Elsevier Insights) by Michel Tibayrenc (Hardcover - 17 Dec 2010). The power of evolutionary biology in the development of treatments for infectious diseases

Systematics and Evolution: Part A (The Mycota) by David J. McLaughlin, Meredith Blackwell, and Joseph W. Spatafora (Paperback - 15 Dec 2010). An overview of the systematics and evolution of fungi.

Agricultural Applications (The Mycota) by F. Kempken (Paperback - 8 Dec 2010). This volume of the series Mycota … covers many of the aspects where fungi are of relevance to agriculture.

Human Fungal Pathogens (The Mycota) by Judith E. Domer and George S. Kobayashi(Paperback - 5 Dec 2010). Reviews and recent results of studies with medically important fungi. Throughout the volume, outstanding mycologists treat the ecological role of pathogenic fungi, how they cause disease, their interactions with the immune system, and their responses to antifungal agents.

NB Use these links to support the Fungal Research Trust

Recent Theses

Aspergillosis in sea fans: Fungal community, patterns of prevalence, and genetic variability of Aspergillus flavus
by Zuluaga Montero, Ana Bella, Ph.D., University of Puerto Rico, Rio Piedras (Puerto Rico), 2009, 120 pages View

Disease in the Caribbean sea fan coral Gorgonia ventalina
by Toledo-Hernandez, Carlos, Ph.D., University of Puerto Rico, Rio Piedras (Puerto Rico), 2009, 137 pages . View.

Surrogate Markers of Infection Suitable for Monitoring Infectious Burden in Animal Models of Aspergillosis. by Shrief, Raghdaa, University of Manchester, UK 2010. View

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Laboratory Protocols

We are always looking for more for our collection - please send your suggestions here

Technical Tips

Our discussion group (email and/or website) designed to promote discussion on technical issues for laboratory workers.

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