Significance of galactomannan antigen for aspergillosis diagnosis: A review

Invasive aspergillosis is one the major causes of death in hematopoietic and solidtransplant recipients. One of the most critical problems in medical mycology is the inability to consistently make a convincing and early diagnosis of invasive fungal infection. Conventional diagnosis methods such as culture-based approaches are limited by the insufficient accessibility sensitivity and the non-culture-based approaches based on the detection of specific fungal antigens, fungal metabolites, and fungal DNA are limited by the slow speed of analysis. Early diagnosis of invasive aspergillosis is the main complication in its treatment. Galactomannan is a polysaccharide present in the cell wall of Aspergillus species. This carbohydrate is released into the serum during the invasion of Aspergillus. Recently, a double-sandwich enzyme-linked immunosorbent assay (ELISA) was developed for detecting galactomannan antigenemia in the serum. This assay is an important advancement in the nonculture diagnosis of invasive aspergillosis. The level of galactomannan in the serum may be an important indication of therapeutic response. In this review, the role of galactomannan in the diagnosis of IA and its significance has been highlighted.