Scientists at the Charité – Universitätsmedizin Berlin and the Universität zu Köln have achieved a breakthrough through their development of a new test procedure that can detect invasive fungal infections. The method serves to analyze the body's own fungus-reactive T-cells. The results of their study have been published in the current edition of the medical journal American Journal of Respiratory and Critical Care Medicine*.
Patients with a severely weakened immune systems, for instance due to leukemia therapy or complicated or severe forms of diabetes, often suffer from internal infections brought about by fungi. Mucor mold can cause infections of the nasal sinus or even in the brain, while Aspergillus causes lung infections. It is particularly problematic that these fungi reproduce rapidly throughout the organs, at times as many a several centimeters per day. In advanced stages the mortality rate can reach 100 percent. Early diagnosis and treatment of a fungal infection have not been possible until now, due to the lack of a fast and low-risk test procedure.
Scientists working with Prof. Dr. Alexander Scheffold, Head of the Cellular Immunology Working Group of the Medical Department, Division of Rheumatology and Clinical Immunology, have succeeded in developing just such a test in the context of an interdisciplinary and translational research project. The researchers utilize a method, with whose help, the body's own immune cells that react specifically to a fungal infection are rendered visible in the blood of patients. The procedure was developed by Dr. Petra Bacher and Prof. Dr. Alexander Scheffold from the Charité and the Deutsches Rheuma Forschungszentrum (DRFZ) Berlin, in cooperation with the biotech company Miltenyi Biotec GmbH and the working group surrounding Prof. Axel Brakhage at the Hans-Knoell Institute in Jena. In this method, the immune cells assume the role of highly sensitive and specific sensors of pathogens.
This is a new approach – inasmuch as conventional diagnostic procedures are generally based on demonstrating the presence of the pathogen, but not identifying the specific immune reaction. "Our immune systems specialize in rapidly and specifically recognizing pathogens, what our procedure does is to make these cells visible in the blood", says Alexander Scheffold. "The high specificity of the immune cells permits a clear differentiation of which fungus elicits an infection." A preliminary study of 69 patients was conducted by Prof. Dr. Oliver Cornely at the University of Cologne, which consisted of counting the number of defense cells and molds in their blood. "We were able to identify which type of fungi infected the patient. After surgically removing the source of infection the number of defense cells diminished", explains Oliver Cornely.
The researchers are hoping that their findings will be confirmed in a large reference study. The analysis of antigenspecific T-cells could become a new standard diagnostic procedure, one that is able to considerably improve the chances of survival of the affected patients. The scope of the testing system is not limited to fungi, it can also be used for nearly any pathogen. This is why researchers are now working hard to improve diagnostic methods that can tackle autoimmune diseases, allergies, as well as chronic intestinal or lung infections.
*Petra Bacher, Angela Steinbach, Olaf Kniemeyer, Axel Hamprecht, Mario Assenmacher, Maria J. G. T. Vehreschild, Jörg J. Vehreschild, Axel A. Brakhage, Oliver A. Cornely, Alexander Scheffold: Fungus-Specific CD4+ T Cells for Rapid Identification of Invasive Pulmonary Mold Infection. American Journal of Respiratory and Critical Care Medicine. Vol. 191, No. 3 (2015), pp. 348-352. doi: 10.1164/rccm.201407-1235LE
Prof. Dr. Alexander Scheffold
Medical Department, Division of Rheumatology and Clinical Immunology
Charité – Universitätsmedizin Berlin
t: +49 30 450 513 450
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