de Boeck K, Eggermont E, Smet M, van Reempts P, van Bever H P, Stevens W J
Department of Paediatrics, University Hospital of Leuven, Belgium.
Eur J Pediatr. 1995 Feb;154(2):157-60. doi: 10.1007/BF01991922.
In patients with cystic fibrosis (CF) and chronic colonisation with Pseudomonas aeruginosa, specific anti-pseudomonal IgG and IgA, as well as serum immunoreactive protein C, WBC and differential count, ESR, pulmonary function and chest radiograph score were determined before and after a 2 week intravenous course of anti-pseudomonal antibiotics in 32 cases of acute exacerbation of pulmonary infection. Specific anti-pseudomonal IgA but not specific anti-pseudomonal IgG decreased significantly after treatment. Log of anti-pseudomonal IgA but not log anti-pseudomonal IgG correlated well with disease severity as assessed by the Brasfield chest radiograph score (r 0.57), forced expiratory volume in 1 s (r 0.6) as well as C-reactive protein (r 0.62).
Specific anti-pseudomonal IgA may be a better parameter than specific IgG in the follow up of lung infection in patients with CF, probably because it more closely reflects ongoing endobronchial infection, the major pathology in CF lungs.
在32例囊性纤维化（CF）合并铜绿假单胞菌慢性定植且发生肺部感染急性加重的患者中，在进行为期2周的抗铜绿假单胞菌抗生素静脉治疗前后，测定了特异性抗铜绿假单胞菌IgG和IgA，以及血清免疫反应性蛋白C、白细胞及分类计数、红细胞沉降率、肺功能和胸部X线片评分。治疗后特异性抗铜绿假单胞菌IgA显著下降，但特异性抗铜绿假单胞菌IgG未下降。抗铜绿假单胞菌IgA的对数而非抗铜绿假单胞菌IgG的对数与通过布拉斯菲尔德胸部X线片评分（r = 0.57）、第1秒用力呼气量（r = 0.6）以及C反应蛋白（r = 0.62）评估的疾病严重程度密切相关。
在CF患者肺部感染的随访中，特异性抗铜绿假单胞菌IgA可能是比特异性IgG更好的指标，可能是因为它更能密切反映持续的支气管内感染，这是CF肺部的主要病理改变。
