The course of bismethylGliotoxin detection in serum from patients with probable aspergillosis and the effect of voriconazole treatment

Ref ID: 19362

Author:

E. M. Galvez, M. P. Domingo, M. Vida C. Colmenarejo,
M. J. Revillo, L. Roc, J. F. Meis, J. Pardo and A. Rezusta

Author address:

CSIC, Spain; Departamento Microbiolog ıa, Hospital
Universitario Miguel Servet, IIS Arag on, Zaragoza, Spain;
Department of Medical Microbiology and Infectious Diseases,
Canisius Wilhelmina, Nijmegen, the Netherlands and Dpto.
Bioqu ımi

Full conference title:

6th Trends in Medical Mycology 2013

Date: 11 October 2014

Abstract:

Objectives Invasive aspergillosis (IA) is the most common nosoco-
mial opportunistic infection caused by pathogens of the genus Aspergillus
(mainly by Aspergillus fumigatus) that carries a high mortality.
This is due in part to the absence of optimal diagnostic modalities,
which hamper early disease detection. We have previously shown
that the inactive derivative of the virulence factor gliotoxin, bis
(methylthio)gliotoxin (bmGT) is detected in serum from patients with
possible/probable aspergillosis.
It is the aim of this study to compare the detection of galactoman-
nan antigen and bmGT in sequential series of serum from patients at
risk of IA as well as in patients with proven IA. In addition, we plan
to monitor the course of bmGT concentration in the serum during
treatment with voriconazole.
Methods The presence of bmGT and voriconazole in sequential ser-
ies of serum from 75 patients at risk of IA (retrospective and prospec-
tive samples) or with proven aspergillosis (retrospective samples) is
simultaneously quantified by High Performance Thin Layer Chroma-
tography (HPTLC).
Results We have established a fast and sensitive technique for simulta-
neous separation, detection and quantification of bmGT and voriconaz-
ole in human serum. In most cases we found a good correlation between
bmGT and GMN values indicating that bmGT is a useful biomarker to
confirm GMN positive values. However, in some samples either GMN or
bmGT is negative. Preliminary analyses suggest that in some cases, in
which sporadic GMN positives are found in patients, bmGT detection
could be very useful to avoid false positives. Of note bmGT is detected
earlier than GMN in some patients. In addition, bmGT is detected in
sequential samples of some patients in which GMN was negative.
On the other hand we have found that bmGT concentration drops
faster than GMN index when therapeutic concentrations of vorico-
nazole are found in serum.
Conclusions Detection bmGT in serum for patients at risk of IA
would complement GMN index in order to improve diagnosis of IA.
Moreover, our data suggest that by including determination of bmGT
in routine management of patients at risk of IA we could improve
the rate of false negative and false positive cases due to GMN deter-
mination. Finally, since voriconazole concentration and efficacy cor-
relates with bmGT concentration in serum, our findings suggest that
bmGT detection could be an early marker of antifungal therapy effi-
cacy and drug resistance.

Abstract Number: o2.5

Conference Year: 2013

Link to conference website: NULL

New link: NULL

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