Relation between antibody response to Pseudomonas aeruginosa exoproteins and colonization/infection in patients with cystic fibrosis.

Enzyme-linked immunosorbent assay (ELISA) was used to measure the antibody response to Pseudomonas aeruginosa exotoxin A, elastase, alkaline protease and phospholipase C in patients with cystic fibrosis (CF). Only the chronically colonized patients showed elevated antibody titres to phospholipase C (22/22 patients), alkaline protease (16/22 patients), exotoxin A (15/22 patients) and elastase (5/22 patients). In a few patients where serial specimens were available, rising titres were recorded to all four antigens during periods of active infection. Antibiotic treatment resulted in decrease of titres against all four antigens, but only the anti-exotoxin A and anti-elastase titres decreased to normal levels. Titres to phospholipase C were the least influenced by antibiotic treatment. The results imply different roles for these exoproteins in chronic colonization versus active infection. The levels of P. aeruginosa antibodies to exoproteins could probably be used in monitoring treatment of patients with CF.