Milagres Lucimar G, Castro Tatiana L A, Garcia Daniely, Cruz Aline C, Higa Laurinda, Folescu Tânia, Marques Elizabeth A
Department of Microbiology, Immunology and Parasitology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Pediatr Pulmonol. 2009 Apr;44(4):392-401. doi: 10.1002/ppul.21022.
Cystic fibrosis (CF) is the most frequent life threatening autosomal recessive disease in white subjects. The primary cause of morbidity and mortality in children with CF is chronic pulmonary infection, mainly caused by Pseudomonas aeruginosa. The purpose of this study was to assess the value of the measurement of antibodies to P. aeruginosa in diagnosing lung infection by the bacteria in CF patients. We assessed P. aeruginosa antibody titers in CF patients from Rio de Janeiro, Brazil, using cell lysate antigens as well as recombinant PcrV, a Type III Secretion System protein. Sputum (more than 70% of the specimens) or oropharyngeal swabs were obtained whenever patients were regularly followed for their pulmonary disease. Blood samples were obtained with an average interval of 6 months for a period of 2 years. The ELISA cut-offs were assigned as the positive 95% confidence interval of the mean antibody levels from non-fibrocystic controls. Our data showed that most CF patients (81%) of whom were not chronically infected by P. aeruginosa (Groups I and II), had their first serology positive for rPcrV. Cell-lysate ELISA was able to detect P. aeruginosa antibodies before positive culture in the first serum sample of 44% of the patients from Groups I and II. When serum reactivity to rPcrV and cell lysate were combined, 94% of CF patients from Groups I and II (n = 16) had the first serology positive for P. aeruginosa over a mean time of 20 months before the first isolation of P. aeruginosa. In conclusion, longitudinal P. aeruginosa serology should become part of respiratory care follow-up, in conjunction with other lung parameter functions.
囊性纤维化（CF）是白人中最常见的危及生命的常染色体隐性疾病。CF患儿发病和死亡的主要原因是慢性肺部感染，主要由铜绿假单胞菌引起。本研究的目的是评估检测抗铜绿假单胞菌抗体在诊断CF患者肺部该细菌感染中的价值。我们使用细胞裂解物抗原以及重组PcrV（一种III型分泌系统蛋白）评估了来自巴西里约热内卢的CF患者的铜绿假单胞菌抗体滴度。每当患者因肺部疾病接受定期随访时，采集痰液（超过70%的标本）或口咽拭子。在2年的时间里，平均每隔6个月采集一次血样。ELISA临界值被设定为非纤维囊性对照者平均抗体水平的阳性95%置信区间。我们的数据显示，大多数CF患者（81%）未被铜绿假单胞菌慢性感染（I组和II组），其首次血清学检测rPcrV呈阳性。细胞裂解物ELISA能够在I组和II组44%患者的首次血清样本中，在培养结果呈阳性之前检测到铜绿假单胞菌抗体。当血清对rPcrV和细胞裂解物的反应性相结合时，I组和II组的94%CF患者（n = 16）在首次分离出铜绿假单胞菌之前平均20个月时，其首次血清学检测铜绿假单胞菌呈阳性。总之，纵向铜绿假单胞菌血清学检测应与其他肺部参数功能一起，成为呼吸护理随访的一部分。
