Pneumocystis jirovecii infection: Cell wall (1→3)-β-D-glucan biology and diagnostic utility

Abstract

Pneumocystis jirovecii has emerged as an important pulmonary pathogen. Historically associated with the immunocompromised, it is being increasingly observed in immunocompetent populations. (1→3)-β-D-glucan (BG) is a major component of the cyst cell wall and plays an important role in the inflammatory response to the organism. Inflammatory synergy by co-stimulation with BG and Toll-like receptor ligands has been demonstrated in vitro and may be a factor in the pathophysiology of Pneumocystis pneumonia. Detection of highly elevated serum concentrations of BG in the serum of patients has been shown to be highly sensitive for the presence of pulmonary P. jirovecii.

Keywords::

• Beta-glucan
• Pneumocystis
• Diagnostic
• Pneumonia
• Inflammation

Acknowledgements

The author wishes to thank Drs. Melanie Cushion, Patricia Roux, Amalia Del Palacio, and Michael Dawson for their critical reading of the manuscript and thoughtful suggestions.

Declaration of interest

Malcolm A. Finkelman is an employee of Associates of Cape Cod, Inc., a wholly-owned subsidiary of Seikagaku Biobusiness Corporation.