来自HIV感染者的肺液免疫球蛋白对肺炎球菌的调理功能受损。
Lung fluid immunoglobulin from HIV-infected subjects has impaired opsonic function against pneumococci.
作者信息
Eagan Roger, Twigg Homer L, French Neil, Musaya Janelisa, Day Richard B, Zijlstra Eduard E, Tolmie Helen, Wyler David, Molyneux Malcolm E, Gordon Stephen B
机构信息
Division of Pulmonary, Allergy, Critical Care, and Occupational Medicine, Indiana University Medical Center, Indianapolis, IN, USA.
出版信息
Clin Infect Dis. 2007 Jun 15;44(12):1632-8. doi: 10.1086/518133. Epub 2007 May 10.
BACKGROUND
The incidence of pneumococcal pneumonia is greatly increased among human immunodeficiency virus (HIV)-infected subjects, compared with among non-HIV-infected subjects. Lung fluid levels of immunoglobulin G (IgG) specific for pneumococcal capsular polysaccharide are not reduced in HIV-infected subjects; therefore, we examined immunoglobulin subtypes and compared lung fluid IgG opsonic function in HIV-infected subjects with that in healthy subjects.
METHODS
Bronchoalveolar lavage (BAL) fluid and serum samples were collected from 23 HIV-infected and 26 uninfected subjects. None of the subjects were receiving highly active antiretroviral therapy, and none had received pneumococcal vaccination. Pneumococcal capsule-specific IgG levels in serum and BAL fluid were measured by enzyme-linked immunosorbent assay, and IgG was concentrated from 40 mL of BAL fluid. Opsonization and opsonophagocytosis of pneumococci with serum, BAL fluid, and BAL IgG were compared between HIV-infected subjects and healthy subjects.
RESULTS
The effect of type 1 pneumococcal capsular polysaccharide-specific IgG in opsonizing of pneumococci was significantly less using both serum and BAL IgG from HIV-infected subjects, compared with serum and BAL IgG from healthy subjects (mean level, 8.9 fluorescence units [95% confidence interval, 8.1-9.7 fluorescence units] vs. 12.1 fluorescence units [95% confidence interval, 9.7-15.2 fluorescence units]; P=.002 for lung BAL IgG). The opsonophagocytosis of pneumococci observed using BAL IgG from HIV-infected subjects was significantly less than that observed using BAL IgG from healthy subjects (37 fluorescence units per ng of IgG [95% confidence interval, 25-53 fluorescence units per ng of IgG] vs. 127 fluorescence units per ng of IgG [95% confidence interval, 109-145 fluorescence units per ng of IgG]; P<.001).
CONCLUSION
HIV infection is associated with decreased antipneumococcal opsonic function in BAL fluid and serum.
背景
与未感染人类免疫缺陷病毒（HIV）的受试者相比，HIV感染受试者中肺炎球菌肺炎的发病率大幅增加。HIV感染受试者中针对肺炎球菌荚膜多糖的免疫球蛋白G（IgG）的肺液水平并未降低；因此，我们检测了免疫球蛋白亚型，并比较了HIV感染受试者与健康受试者肺液IgG的调理功能。
方法
从23名HIV感染受试者和26名未感染受试者中采集支气管肺泡灌洗（BAL）液和血清样本。所有受试者均未接受高效抗逆转录病毒治疗，且均未接种肺炎球菌疫苗。采用酶联免疫吸附测定法测量血清和BAL液中肺炎球菌荚膜特异性IgG水平，并从40 mL BAL液中浓缩IgG。比较HIV感染受试者与健康受试者血清、BAL液和BAL IgG对肺炎球菌的调理作用和调理吞噬作用。
结果
与健康受试者的血清和BAL IgG相比，HIV感染受试者的血清和BAL IgG对1型肺炎球菌荚膜多糖特异性IgG调理肺炎球菌的作用明显较弱（平均水平，8.9荧光单位[95%置信区间，8.1 - 9.7荧光单位]对12.1荧光单位[95%置信区间，9.7 - 15.2荧光单位]；肺BAL IgG的P = 0.002）。HIV感染受试者的BAL IgG观察到的肺炎球菌调理吞噬作用明显低于健康受试者的BAL IgG（每纳克IgG 37荧光单位[95%置信区间，每纳克IgG 25 - 53荧光单位]对每纳克IgG 127荧光单位[95%置信区间，每纳克IgG 109 - 145荧光单位]；P < 0.001）。
结论
HIV感染与BAL液和血清中抗肺炎球菌调理功能降低有关。
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