title: Development of a highly sensitive and specific blastomycosis antibody enzyme immunoassay using Blastomyces dermatitidis surface protein BAD-1.
abstract: Serologic tests for antibodies to Blastomyces dermatitidis are not thought to be useful for the diagnosis of blastomycosis, in part due to the low sensitivity of immunodiffusion and complement fixation. Earlier studies have shown that the enzyme immunoassay improves the sensitivity of antibody detection for the diagnosis of blastomycosis. Microplates coated with the B. dermatitidis surface protein BAD-1 were used for testing sera from patients with proven blastomycosis or histoplasmosis and controls. Semiquantification was accomplished by using standards containing human anti-B. dermatitidis antibodies. The antibodies were detected in 87.8% of the patients with blastomycosis by the enzyme immunoassay compared to 15.0% by immunodiffusion. The specificities were 99.2% for patients with nonfungal infections and healthy subjects and 94.0% for patients with histoplasmosis. The results were highly reproducible on repeat testing. When combined with antigen testing, antibody testing improved the sensitivity from 87.8% to 97.6%. Enzyme immunoassay detection of antibodies against BAD-1 is highly specific, has greatly improved sensitivity over immunodiffusion, and may identify cases with negative results by antigen testing. This assay has the potential to aid in the diagnosis of blastomycosis.
authors.affiliation: MiraVista Diagnostics, Indianapolis, Indiana, USA.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Richer
authors.forename: Melinda L
authors.initials: ML
authors.lastname: Smedema
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Durkin
authors.forename: T Tristan
authors.initials: TT
authors.lastname: Brandhorst
authors.forename: Chadi A
authors.initials: CA
authors.lastname: Hage
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Connolly
authors.forename: Diane S
authors.initials: DS
authors.lastname: Leland
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Davis
authors.forename: Bruce S
authors.initials: BS
authors.lastname: Klein
authors.forename: L Joseph
authors.initials: LJ
authors.lastname: Wheat
mesh_terms: D000908:Antibodies, Fungal / Q000097:blood*; D000946:Antigens, Fungal; D001758:Blastomyces / Q000276:immunology*; D001759:Blastomycosis / Q000175:diagnosis*; D019411:Clinical Laboratory Techniques / Q000379:methods*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D006801:Humans; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D000908:Antibodies, Fungal; D000946:Antigens, Fungal