期刊
MEDICAL MICROBIOLOGY AND IMMUNOLOGY
卷 208, 期 2, 页码 205-213出版社
SPRINGER
DOI: 10.1007/s00430-019-00578-w
关键词
Cystic fibrosis; Pseudomonas aeruginosa; Respiratory tract infections; Diagnosis; Secretory IgA; Saliva
资金
- Sao Paulo Research Foundation (FAPESP) [2014/00007-8]
- Unicamp Support Fund for Teaching, Research and Community Issues (FAEPEX) [0112/17]
Pseudomonas aeruginosa (Pa) detection in the paranasal sinuses may help to prevent or postpone bacterial aspiration to the lower airways (LAW) and chronic lung infection in cystic fibrosis (CF). We assessed the ability of an ELISA test for measurement of specific Pa secretory IgA (sIgA) in saliva (a potential marker of sinus colonization) to early detect changes in the Pa LAW status (indicated by microbiological sputum or cough swab culture and specific serum IgG levels) of 65 patients for threeyears, in different investigation scenarios. Increased sIgA levels were detected in saliva up to 22months before changes in culture/serology. Patients who remained Pa-positive had significantly increased sIgA levels than patients who remained Pa-negative, both at the baseline (39.6 U/mL vs. 19.2 U/mL; p=0.02) and at the end of the follow-up (119.4 U/mL vs. 25.2 U/mL; p<0.001). No association was found between sIgA levels in saliva and emergence or recurrence of Pa in the LAW. A positive median sIgA result in the first year of follow-up implied up to 12.5-fold increased risk of subsequent Pa exposure in the LAW. Our test detected early changes in the P. aeruginosa LAW status and risk of exposure to P. aeruginosa in the LAW with twoyears in advance. Comparison with sinus culture is needed to assess the test's ability to identify CF patients in need of a sinus approach for Pa investigation, which could provide opportunities of Pa eradication before its aspiration to the lungs.
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