Evaluation of the diagnostic value of the measurement of (1-->3)-beta-D-glucan in patients with pulmonary aspergillosis.

The value of the measurement of (1-->3)-beta-D-glucan, a major and common cell wall constituent of fungi, for diagnosing pulmonary aspergillosis was assessed in comparison with that of conventional examinations. The concentrations of (1-->3)-beta-D-glucan in sera was elevated in 7 out of 8 patients with active aspergillosis, but not in cases without active diseases, except for one sample. Further, the concentrations well reflected the activity of the aspergillosis in each case. Regarding conventional examinations, with the immunodiffusion test it was difficult to detect the present activity of the disease. The radioallergosorbent test was useful for diagnosing bronchopulmonary aspergillosis, but not for other types of aspergillosis. The Aspergillus-specific component, galactomannan, was insensitive and the enzyme-linked immunosorbent assay gave highly variable results. Thus, although the assessment of the specificity of the assay is still necessary, compared with other tests, the assay of (1-->3)-beta-D-glucan has the advantage of diagnosing pulmonary aspergillosis and also of assessing the disease activity.