Breaking the mould - novel diagnostic and therapeutic strategies for invasive pulmonary aspergillosis in the immune deficient patient

Expert Rev Clin Immunol. 2014 Jun;10(6):771-80. doi: 10.1586/1744666X.2014.904747. Epub 2014 Apr 1.

Abstract

Invasive pulmonary aspergillosis (IPA) caused by the ubiquitous environmental fungus Aspergillus is a frequently fatal lung disease of immunocompromised humans accounting for more than 200,000 infections each year, with an associated mortality rate of 30-90%. This review addresses the current status of IPA diagnosis and treatment and the urgent need to develop accurate, non-invasive strategies for identifying pulmonary infections in the ever-expanding population of immune deficient patients at risk of acquiring opportunistic fungal infections including hematological malignancy and hematopoetic stem cell transplant patients. Recent advances in the use of an Aspergillus-specific monoclonal antibody, JF5, for point-of-care diagnosis of IPA using lateral-flow technology is examined, as is its use in PET/MRI bioimaging and radio-immunotherapy using radionuclide-labeled single chain antibody fragments, Fab fragments, and a fully humanized JF5 derivative.

Keywords: PET/MRI; bioimaging; hematological malignancy; invasive pulmonary aspergillosis; monoclonal antibody; radioimmunotherapy; stem cell transplant; vaccine.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antibodies, Fungal* / immunology
  • Antibodies, Fungal* / therapeutic use
  • Antibodies, Monoclonal, Humanized* / immunology
  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • Aspergillus / immunology*
  • Common Variable Immunodeficiency*
  • Humans
  • Immunoglobulin Fab Fragments* / immunology
  • Immunoglobulin Fab Fragments* / therapeutic use
  • Positron-Emission Tomography*
  • Pulmonary Aspergillosis / diagnostic imaging
  • Pulmonary Aspergillosis / immunology
  • Pulmonary Aspergillosis / therapy
  • Radiography

Substances

  • Antibodies, Fungal
  • Antibodies, Monoclonal, Humanized
  • Immunoglobulin Fab Fragments