The Candida Immunome as a Mine for Clinical Biomarker Development for Invasive Candidiasis: From Biomarker Discovery to Assay Validation
Aída Pitarch, César Nombela and Concha Gil
from: Pathogenic Fungi: Insights in Molecular Biology (Edited by: Gioconda San-Blas and Richard A. Calderone). Caister Academic Press, U.K. (2008)
Invasive candidiasis (IC) is a major cause of morbidity and mortality in intensive care, post-surgical, and cancer patients if not diagnosed and treated early. However, IC diagnosis at an early stage remains extremely difficult, leading to delayed therapy and ensuing poor prognosis. This clinical setting has motivated researchers to urgently search for prompt and accurate biomarkers for IC to direct appropriate diagnostic and therapeutic decision-making. Intriguingly, the characterization of molecular fingerprints of serum anti-Candida IgG antibodies in IC patients through the study of the Candida immunome (the subset of the Candida proteome targeted by the immune system) by classical immunoproteomics or serological proteome analysis (SERPA) provides a promising tool for discovering potential clinical biomarkers for IC. These may be used to improve early diagnosis, estimate patient outcome, predict therapy response, and/or monitor disease progression. Reminiscent of the development process of new therapeutic drugs, three sequential phases (discovery, validation and implementation) are also needed for the routine clinical use of a biomarker. Here we review the current status of these clinical biomarker development phases as applied to IC investigations using SERPA as an effective strategy to discover potential diagnostic, prognostic, predictive and monitoring biomarkers for IC read more ...