Lymphocyte transformation assay for C neoformans antigen is not reliable for detecting cellular impairment in patients with Neurocryptococcosis
Lymphocyte transformation assay for C neoformans antigen is not reliable for detecting cellular impairment in patients with Neurocryptococcosis
Cryptococcus neoformans causes meningitis and disseminated infection in healthy individuals, but more commonly in hosts with defective immune responses. Cell-mediated immunity is an important component of the immune response to a great variety of infections, including yeast infections. We aimed to evaluate a specific lymphocyte transformation assay to Cryptococcus neoformans in order to identify immunodeficiency associated to neurocryptococcosis (NCC) as primary cause of the mycosis.Healthy volunteers, poultry growers, and HIV-seronegative patients with neurocryptococcosis were tested for cellular immune response. Cryptococcal meningitis was diagnosed by India ink staining of cerebrospinal fluid and cryptococcal antigen test (Immunomycol-Inc, SP, Brazil). Isolated peripheral blood mononuclear cells were stimulated with C. neoformans antigen, C. albicans antigen, and pokeweed mitogen. The amount of 3H-thymidine incorporated was assessed, and the results were expressed as stimulation index (SI) and log SI, sensitivity, specificity, and cut-off value (receiver operating characteristics curve). We applied unpaired Student t tests to compare data and considered significant differences for p<0.05.The lymphotoxin alpha showed a low capacity with all the stimuli for classifying patients as responders and non-responders. Lymphotoxin alpha stimulated by heated-killed antigen from patients with neurocryptococcosis was not affected by TCD4+ cell count, and the intensity of response did not correlate with the clinical evolution of neurocryptococcosis.Response to lymphocyte transformation assay should be analyzed based on a normal range and using more than one stimulator. The use of a cut-off value to classify patients with neurocryptococcosis is inadequate. Statistical analysis should be based on the log transformation of SI. A more purified antigen for evaluating specific response to C. neoformans is needed.
- Sao Paulo State University Brazil
- Universidade de São Paulo Brazil
- Faculdade de Medicina do ABC Brazil
- Universidade Federal de São Carlos Brazil
- Universidade Estadual Paulista - UNESP Brazil
Adult, Male, Biases, Statistical, Antigens, Fungal, Adolescent, 610, Infectious and parasitic diseases, RC109-216, Meningitis, Cryptococcal, Lymphocyte Activation, Young Adult, Methods, Humans, Lymphocytes, Antigens, Aged, Statistical, Middle Aged, Cryptococcus, Infectious Diseases, Cryptococcus neoformans, Female, Biases, Research Article
Adult, Male, Biases, Statistical, Antigens, Fungal, Adolescent, 610, Infectious and parasitic diseases, RC109-216, Meningitis, Cryptococcal, Lymphocyte Activation, Young Adult, Methods, Humans, Lymphocytes, Antigens, Aged, Statistical, Middle Aged, Cryptococcus, Infectious Diseases, Cryptococcus neoformans, Female, Biases, Research Article
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