Identification of soluble immune markers for the diagnosis of aspergillosis and pneumocystosis: an exploratory study.

BALF shotgun proteomics in 27 immunocompromised patients shows the most pronounced heterogeneity within invasive pulmonary aspergillosis, with two distinct IPA clusters linked to immune status and transplant history.

• Why it matters: Diagnosis of invasive fungal diseases is difficult because pathogen-targeted tests perform variably across different immune backgrounds, leaving a need for disease-specific soluble immune signatures.
• What they did: Bronchoalveolar lavage fluid from IPA (n=7), CPA (n=4), Pneumocystis pneumonia (PCP, n=4), Pneumocystis colonization (PCC, n=4), bacterial infection (BI, n=4), and controls (n=4) was profiled by Q Exactive Plus shotgun proteomics, identifying 2,278 proteins, and 77 soluble immune mediators were analyzed for clustering.
• The result: Hierarchical clustering largely separated controls, BI, PCC, and PCP by diagnosis, while aspergillosis profiles were more variable; complement proteins and antimicrobial peptides emerged as candidate biomarkers needing validation in larger independent cohorts.

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