强效抗体介导的中和作用限制了噬菌体治疗肺部脓肿分枝杆菌感染。
Potent antibody-mediated neutralization limits bacteriophage treatment of a pulmonary Mycobacterium abscessus infection.
机构信息
Biological Sciences, University of Pittsburgh, Pittsburgh, PA, USA.
Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
出版信息
Nat Med. 2021 Aug;27(8):1357-1361. doi: 10.1038/s41591-021-01403-9. Epub 2021 Jul 8.
Abstract
An 81-year-old immunocompetent patient with bronchiectasis and refractory Mycobacterium abscessus lung disease was treated for 6 months with a three-phage cocktail active against the strain. In this case study of phage to lower infectious burden, intravenous administration was safe and reduced the M. abscessus sputum load tenfold within one month. However, after two months, M. abscessus counts increased as the patient mounted a robust IgM- and IgG-mediated neutralizing antibody response to the phages, which was associated with limited therapeutic efficacy.
摘要
一位 81 岁免疫功能健全的支气管扩张症患者，患有难治性脓肿分枝杆菌肺病，用针对该菌株的三噬菌体鸡尾酒治疗了 6 个月。在这项噬菌体降低感染负担的病例研究中，静脉给药是安全的，并且在一个月内将 M. abscessus 的痰负荷降低了十倍。然而，两个月后，随着患者对噬菌体产生强烈的 IgM 和 IgG 介导的中和抗体反应，M. abscessus 的计数增加，这与有限的治疗效果有关。
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