1429. Role of Pentaxrin 3 in differentiating invasive aspergillosis (IA) from Aspergillus colonization (Ac) in lung transplant recipients
Session: Poster Abstract Session: Fungal Infections
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • IDSA%20poster%202013[2].pdf (728.7 kB)
  • Role of Pentaxrin 3 in differentiating invasive aspergillosis (IA) from Aspergillus colonization (Ac) in lung transplant recipients

     

    Background: Ac is a unique clinical syndrome in lung transplant recipients (LTRs). Surrogate markers may aid in differentiating colonization from invasive disease as diagnostic imaging may not be of assistance. The use of pro inflammatory biomarkers may improve the accuracy of diagnosis. We hypothesized that PTX3 levels in the bronchoalveolar lavage (BAL) will be lower in LTRs with colonization as compared to those with IA.

    Methods: BAL samples from LTRs from June 2010 were analyzed for the quantification of PTX3 by sandwich enzyme linked immunosorbant assay (ELISA). IA was determined as per the EORTC-MSG criteria. Statistical comparison was performed for PTX3 median values from BAL samples of LTRs with IA, Ac and from healthy controls.

     

    Results: A total of 110 BAL samples from 57 LTRs and 9 controls were analyzed.  Four cases of probable IA and 16 Ac were noted, while 90 episodes were characterized as negative for fungal infection. Median time to PTX3 sample from transplantation was 269 days (96.17-373.25) Median values of PTX 3 (25th-75th  percentiles) were 911 pg/ml (218.04- 2365) in episodes of IA, 13.67 pg/ml (13.67-27.66) with Ac, 13.67 pg/ml ( 13.67 -137.03) in episodes of negative fungal culture and13.67 pg/ml (13.67- 72.05) in controls.  PTX3 levels were significantly higher in patients with IA compared to Ac with a P value of 0.0024 as shown below in figure 1.

    Conclusion: Our data suggests that measurement of surrogate pro inflammatory markers such as PTX3 in BAL may assist in differentiating patients with Aspergillus colonization and IA. These finding have diagnostic and therapeutic implications and should be validated in a larger cohort.  

     

    Dima Kabbani, MD1, Lianne Singer, MD1, Taisa Pipkin2, Coleman Rotstein, MD2, Tony Mazzulli, MD1 and Shahid Husain, MD, MS2, (1)University Health Network, Toronto, ON, Canada, (2)University of Toronto, Toronto, ON, Canada

    Disclosures:

    D. Kabbani, None

    L. Singer, None

    T. Pipkin, None

    C. Rotstein, None

    T. Mazzulli, None

    S. Husain, None

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