Stereoisomeric Configuration of Arabinitol in Serum, Urine, and Tissues in Invasive Candidiasis

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Abstract
Because routine analytical methods cannot differentiate d- from l-arabinitol, a combined microbiological and gas chromatographic method was developed to study the stereoisomeric configuration of the arabinitol in humans and rats with invasive candidiasis. d-Arabinitol was defined as the difference between arabinitol concentrations measured with and without incubation with 5.0 × 105 blastospores of Candida tropicalis strain CT 12 at 37 C for 24 hr. The yeast consumed at least 95% of the n-arabinitol and none of the l-arabinitol added to normal serum and urine. d-Arabinitol as a fraction of d, l-arabinitol was 0.43 ± 0.15 (mean ± SD) in the urine of 10 normal humans, 0.82 ± 0.12 in the serum or urine of five patients with cancer and invasive candidiasis (P < .001), and 1.0 in the kidneys of rats with candidiasis. Because most or all of the excessarabinitol in body fluids or tissues in candidiasis was the D isomer, which is produced by fungal metabolism, stereospecific quantitation of arabinitol should improve the sensitivity of this approach to diagnosis of candidiasis.