Immunoglobulins G, M, And A Against Sporothrix Schenckii Exoantigens In Patients With Sporotrichosis Before And During Combination Drug Therapy

Sporotrichosis is a kind of chronic granulomatous fungal disease which is infected by Sporothrix schenckii.As an opportunistic pathogen it is widely found in nature, it always associated with trauma and mosquito bites . Sporotrichosis has four clinical types these are the fixed type, lymphatic vessel type, disseminated cutaneous and extracutaneous type.The current statistics show that fixed and lymphatic vessels are the most common types in northeast of China .We still use the pathological examination and fungal culture in diagnosis of Sporotrichosis as the gold standard. In recent years, molecular biology, immunohistochemistry and other methods have been used in the detection and research of Sporothrix schenckii. Serological methods can always detect antigen ,antibody,specific activity of enzymes and metabolites so that we may rapidly diagnosis and conduct observation of drug efficacy. In recent years, before and during treatment of Itraconazole in patients with Sporothrix serum IgG, IgM, IgA levels detected by ELISA test has been widely used as a high specificity and sensitivity of both serological diagnostic methods and gradually accepted by all , operability and feasibility of the basic be confirmed.Objective:Foreign scholars have used ELISA as to be a laboratory test of Sporotrichosis, but rarely in China.After all, the study could be undertaken in a new direction. Serological aspects of the work of the current application of actual clinical laboratory test method was not so common used, so this test was measured using an indirect antibody ELISA which was observation of antibody levels before and during two drugs therapy ,then it would guide diagnosis and efficacy of drugs for further observation study.Materials and Methods:Several strains in our hospital from different clinical forms of Sporothrix schenckii clinical isolates, conventional mycological identification, and they were passaged repeatedly after culture for extraction of fungal antigens, using ELISA indirect method of measuring antibodies for positive rate of serum IgG, IgM, IgA detection.Then we conducted these OD values in both fixed and lymphatic-type groups before and during Treatment with Itraconazole and Potassium iodide.Conclusions:1.Sporothrix schenckii can be induced early in the treatment of at least one specific antibody in serum, which single IgA antibodies reached the highest positive rate of 92.70%. And positive rate of any two antibody reached 95.10%.2.After 1 month treatment of the potassium iodide and itraconazole both fixed and Lymphatic types can be seen the similar results that IgM and IgA were less than before the treatments, there was statistical difference( P <0.05 ), while the IgG antibody had no significant difference between before and after treatment, so IgM and IgA can be used as follow-up of patients on drug efficacy and disease progress tracking indices dynamic analysis.3.Specific serologic test can be used as a method of rapid diagnosis for sporotrichosis.In short, Sporotrichosis serology test is a high sensitivity and specificity of laboratory testing methods, because there we don't have detection kit ,and many fungi or bacteria cross-reactivations still exist, it still has some questions.Further clinical researches and combination with traditional detection methods are still needed.They are all helpful to rapidly diagnosis and treatment for patients .