Millares Laura, Martí Sara, Ardanuy Carmen, Liñares Josefina, Santos Salud, Dorca Jordi, García-Nuñez Marian, Quero Sara, Monsó Eduard
Department of Respiratory Medicine, Fundació Parc Taulí, Sabadell, Spain.
CIBER de Enfermedades Respiratorias, CIBERES, Bunyola, Spain.
Int J Chron Obstruct Pulmon Dis. 2017 Sep 30;12:2807-2811. doi: 10.2147/COPD.S141701. eCollection 2017.
The bronchial mucosa is protected by a specialized immune system focused on the prevention of colonization and infection by potentially pathogenic microorganisms (PPMs). Immunoglobulin A (IgA) is the principal antibody involved in this mechanism. A defective immune barrier may facilitate the recurrent presence of PPMs in COPD.
The aim of this study was to determine IgA-mediated bronchial specific immune responses against in stable patients with severe disease.
COPD patients with good-quality sputum samples obtained during stability were included and classified according to the presence or absence of chronic bronchial colonization by . Levels of specific IgA for in sputum were determined by ELISA and expressed as ratios, using the pooled level of 10 healthy subjects as reference (optical density patient/control).
Thirty-six stable COPD patients were included, 15 of whom had chronic colonization by . Levels of specific IgA against in stable non-colonized patients were lower than those in healthy subjects (IgA ratio: median =0.15 [interquartile range {IQR} 0.05-0.36]). Colonized patients had higher levels, (1.56 [IQR 0.59-2.79]) (<0.001, Mann-Whitney test), with figures equivalent but not exceeding the reference value.
IgA-based immune response against was low in severe COPD patients. Levels of specific IgA against this microorganism were higher in colonized patients, but did not attain clear-cut levels above the reference. An impaired local response against may favor chronic colonization and recurrent infections in severe COPD.
支气管黏膜受到一个专门的免疫系统保护，该系统专注于预防潜在致病微生物（PPMs）的定植和感染。免疫球蛋白A（IgA）是参与此机制的主要抗体。免疫屏障缺陷可能会促使PPMs在慢性阻塞性肺疾病（COPD）中反复出现。
本研究的目的是确定重度稳定期COPD患者中IgA介导的针对[具体微生物名称未给出]的支气管特异性免疫反应。
纳入在病情稳定期获得高质量痰液样本的COPD患者，并根据是否存在[具体微生物名称未给出]的慢性支气管定植进行分类。通过酶联免疫吸附测定（ELISA）法测定痰液中针对[具体微生物名称未给出]的特异性IgA水平，并以比率表示，以10名健康受试者的合并水平作为参考（患者光密度/对照光密度）。
纳入36例稳定期COPD患者，其中15例存在[具体微生物名称未给出]的慢性定植。稳定期未定植患者中针对[具体微生物名称未给出]的特异性IgA水平低于健康受试者（IgA比率：中位数 = 0.15[四分位间距{IQR}0.05 - 0.36]）。定植患者的水平较高，为（1.56[IQR 0.59 - 2.79]）（P < 0.001，曼-惠特尼检验），数值相当但未超过参考值。
重度COPD患者中针对[具体微生物名称未给出]的基于IgA的免疫反应较低。定植患者中针对该微生物的特异性IgA水平较高，但未达到明显高于参考值的水平。针对[具体微生物名称未给出]受损的局部反应可能有利于重度COPD中的慢性定植和反复感染。
