Significance of galactomannan antigen for aspergillosis diagnosis: A review

Invasive aspergillosis is one the major causes of death in hematopoietic and solidtransplantrecipients. One of the most critical problems in medical mycology is theinability to consistently make a convincing and early diagnosis of invasive fungalinfection. Conventional diagnosis methods such as culture-based approaches are limitedby the insufficient accessibility sensitivity and the non-culture-based approaches based onthe detection of specific fungal antigens, fungal metabolites, and fungal DNA are limitedby the slow speed of analysis. Early diagnosis of invasive aspergillosis is the maincomplication in its treatment. Galactomannan is a polysaccharide present in the cell wallof Aspergillus species. This carbohydrate is released into the serum during the invasion ofAspergillus. Recently, a double-sandwich enzyme-linked immunosorbent assay (ELISA)was developed for detecting galactomannan antigenemia in the serum. This assay is animportant advancement in the nonculture diagnosis of invasive aspergillosis. The level ofgalactomannan in the serum may be an important indication of therapeutic response. Inthis review, the role of galactomannan in the diagnosis of IA and its significance has beenhighlighted.