Pentraxin 3 levels in bronchoalveolar lavage fluid of lung transplant recipients with invasive aspergillosis

Dima Kabbani, Archana Bhaskaran, Lianne G. Singer, Alyajahan Bhimji, Coleman Rotstein, Shaf Keshavjee, W. Conrad Liles, Shahid Husain

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Background Invasive aspergillosis is the most common invasive fungal infection in lung transplant recipients. The use of galactomannan testing in bronchoalveolar lavage (BAL) fluid has improved diagnosis of invasive aspergillosis; however, false-positive results can lead to overdiagnosis and unnecessary treatment. The use of proinflammatory markers such as pentraxin 3 (PTX3) may help differentiate between Aspergillus colonization and disease. Methods BAL PTX3 concentrations were measured by enzyme-linked immunosorbent assay in 151 lung transplant recipients and 9 healthy control subjects. Patients were characterized as having Aspergillus colonization or invasive disease according to International Society of Heart and Lung Transplantation criteria. Concomitant PTX3values were compared using Mann-Whitney U and Kruskal-Wallis tests. Results We analyzed 322 BAL stored samples and identified 15 invasive aspergillosis events, 38 Aspergillus colonizations, and 17 positive galactomannan with negative Aspergillus cultures. Median BAL PTX3 level was significantly higher in patients with invasive aspergillosis compared with patients with Aspergillus colonization and healthy control subjects (439.20 pg/ml [interquartile range (IQR) 168.18–778.90], 68.93 pg/ml [IQR 13.67–156.74], and 13.67 pg/ml [IQR 13.67–121.18]; p < 0.001). Patients with BAL PTX3 value >319 pg/ml with positive galactomannan and patients with BAL PTX3 value >312 pg/ml with positive Aspergillus culture were 4.5 and 5.5 times more likely to have invasive pulmonary aspergillosis, respectively. Conclusions Our study shows that PTX3 measurements in BAL samples were significantly higher among patients with invasive aspergillosis and may help to identify patients with Aspergillus colonization and false-positive galactomannan in BAL samples.

Original languageEnglish (US)
Pages (from-to)973-979
Number of pages7
JournalJournal of Heart and Lung Transplantation
Volume36
Issue number9
DOIs
StatePublished - Sep 2017

Keywords

  • BAL PTX3
  • BAL galactomannan
  • inflammatory marker
  • invasive aspergillosis
  • lung transplantation

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