Basic Knowledge of Fungal Biomarkers for the Diagnosis of Invasive Fugal Disease in Hematological Patients

• Published in: Nihon Ishinkin Gakkai Zasshi Vol. 65; no. 3; pp. 67 - 72
• Main Author: Kimura, Shun-ichi
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society for Medical Mycology 31.07.2024; 一般社団法人 日本医真菌学会
• Subjects: Aspergillus; Candida; culture; fungal biomarker; invasive fungal disease; アスペルギルス; カンジダ; 侵襲性真菌感染症; 培養; 真菌バイオマーカー
• ISSN: 2434-5229; 2434-5237
• DOI: 10.11534/ishinkin.24.006

The diagnosis of invasive fungal disease relies fundamentally on culture tests. Culture tests and histopathological examinations are necessary for achieving a proven diagnosis. However, culture tests often lack sensitivity and can take considerable time to yield results, limiting their utility for monitoring and early diagnosis of invasive fungal disease. Therefore, non-culture-based tests, also known as biomarkers, become crucial. Fungal biomarkers that have been widely used in Japan include (1→3)-β-D-glucan (BDG), a pan-fungal (excluding Mucor and Cryptococcus) biomarker that detects the fungal cell wall component, and Aspergillus galactomannan antigen (GM), a component of the Aspergillus cell wall. The usefulness of novel biomarkers such as GM lateral flow assay and Aspergillus PCR for diagnosing invasive aspergillosis, as well as T2 Candida for diagnosing invasive candidiasis, has been reported overseas. This review summarizes the basic knowledge of fungal biomarkers for diagnosing invasive fungal disease in hematological patients, focusing on BDG and GM while touching upon novel biomarkers. The content of this review has been supplemented and revised based on Symposium 12, “Basic Knowledge of Biomarkers for the Diagnosis of Invasive Fungal Disease in Hematological Patients” at the 67th Annual Meeting of the Japanese Society for Medical Mycology held in October 2023.