Specific IgG2 antibodies toPseudomonas aeruginosa lipid A and lipopolysaccharide are early markers of chronic infection in patients with cystic fibrosis
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Summary
The IgG subclass antibody response to the two parts ofPseudomonas aeruginosa lipopolysaccharide; endotoxic lipid A and the O-polysaccharide, were investigated in a retrospective longitudinal study involving 16 patients with cystic fibrosis and chronicP. aeruginosa lung infection. The purpose of the study was to see if any of the IgG subclasses of either specificity could be used as prognostic markers in the development and subsequent course of the lung disease. IgG2 anti-lipid A, IgG3 anti-lipid A, and IgG2 anti-polysaccharide showed a significant positive correlation with deteriorating pulmonary function already before chronicP. aeruginosa lung infection was diagnosed as well as in subsequent years. The findings suggest antigenic exposure of the patient before chronic infection is detected by routine sputum examinations, and further support our previous findings of a critical role of the IgG subclass response in modulating the course of inflammatory lung damage in these patients.
Keywords
Cystic Fibrosis Lung Infection Specific IgG2 Antigenic Exposure Specific IgG2 AntibodySpezifische IgG2 Antikörper von Pseudomonas aeruginosa — Lipid A und Lipopolysaccharide sind frühzeitige Marker einer chronischen Infektion bei Patienten mit Cystischer Fibrose
Zusammenfassung
In einer retrospektiven longitudinalen Studie wurde bei 16 Patienten mit zystischer Fibrose und chronischer Lungeninfektion durchPseudomonas aeruginosa die IgG-Subklassen-Antikörperreaktion auf die beiden Anteile desP. aeruginosa-Lipopolysaccharids, das Endotoxin Lipoid A und O-Polysaccharid, untersucht. Dabei sollte geprüft werden, ob sich aus der spezifischen Antikörperantwort einer der IgG-Subklassen prognostische Marker für die Entwicklung und den weiteren Verlauf der Lungenerkrankung ableiten lassen. Eine positive Korrelation mit einer Verschlechterung der Lungenfunktion zeigte sich für anti-Lipoid A-IgG2- und IgG3-und anti-Polysaccharid IgG2-Antikörper schon bevor die chronischeP. aeruginosa-Infektion der Lunge diagnostiziert wurde und auch in den nachfolgenden Jahren. Diese Befunde lassen darauf schließen, daß es schon vor dem Nachweis der chronischen Infektion in Routine-Sputumuntersuchungen zu einer Antigenexposition kommt. Sie bestätigen frühere Studien, in denen wir feststellen konnten, daß die IgG-Subklassen-Reaktion in kritischer Weise den Verlauf der entzündlichen Lungenschädigung bei diesen Patienten mitbestimmt.
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