Pseudomonas aeruginosa: Immune Status in Patients with Cystic Fibrosis
Pseudomonas aeruginosa: Immune Status in Patients with Cystic Fibrosis
复制标题
铜绿假单胞菌：囊性纤维化患者的免疫状态
作者：
R. Doggett;G. Harrison
为了更好地了解铜绿假单胞菌的临床意义，测量了循环和分泌抗体。在 100 名被诊断患有囊性纤维化 (CF) 的患者中，从他们的痰中培养出非典型粘液样铜绿假单胞菌，每人都含有血清沉淀素。然而，在 40 名 CF 患者的血清中没有检测到这些免疫沉淀物，其中一些患者患有慢性疾病，肺部被典型的铜绿假单胞菌菌株定植。未被铜绿假单胞菌定植的 46 名 CF 患者和 27 名 CF 患者父母的血清中沉淀素呈阴性。然而，45 名未患有 CF 但含有铜绿假单胞菌的慢性病患者中有 15 名的血清也含有血清沉淀素。来自 85 名未患 CF 且未临床感染铜绿假单胞菌的受试者的血清沉淀素呈阴性。在患有晚期肺部疾病并感染粘液铜绿假单胞菌的老年 CF 患者中，血清血凝滴度高达 1:4096。唾液滴度范围为 1:8 至 1:64。 CF 患者体内 A 类和 G 类免疫球蛋白的循环和分泌抗体水平升高。一旦患有CF的患者被铜绿假单胞菌定植，从粗糙和光滑形式向粘液形式的转化过程几乎是不可避免的。尽管痰中以粘液形式为主，但也经常存在各种菌落类型的中间体。只有在 CF 患者的痰液中出现粘液菌株后，才能证实血清沉淀素。尽管抗生素往往会减少粘液微生物的数量，但它们很少（如果有的话）从这些患者的肺部根除。严重肺部感染的反复发作和针对粘液菌株的抗体形成增加的证据表明这些特定菌株的侵袭性。
In order to have a better understanding of the clinical significance of Pseudomonas aeruginosa, circulating and secretory antibodies were measured. Of 100 patients diagnosed as having cystic fibrosis (CF) and an atypical mucoid P. aeruginosa cultured from their sputum, each possessed serum precipitins. These immunoprecipitates, however, were not detected in the sera of 40 CF patients, some of whom were chronically ill with pulmonary colonization by typically rough-smooth strains of P. aeruginosa. The sera of 46 CF patients and 27 CF patient parents not colonized by P. aeruginosa were negative for the precipitins. The sera from 15 of 45 chronically ill patients not having CF, however, but harboring P. aeruginosa, also possessed serum precipitins. The sera from 85 subjects not having CF and not clinically infected with P. aeruginosa were negative for precipitins. Serum hemagglutination titers as high as 1:4096 were measured in older CF patients having advanced pulmonary disease and who were infected with mucoid P. aeruginosa. Salivary titers ranged from 1:8 to 1:64. Increased levels of both circulating and secretory antibodies of the immunoglobulin A and G classes were demonstrated in patients with CF. Once a patient with CF becomes colonized with P. aeruginosa a process of conversion from the rough and smooth forms to the mucoid form is almost inevitable. Although the mucoid form predominates in the sputum, intermediates of the various colony types are often present. Serum precipitins were demonstrable only after the appearance of mucoid strains in the sputum of patients with CF. Although antibiotics tend to reduce the number of mucoid microorganisms, they are rarely, if ever, eradicated from these patients' lungs. Recurrent episodes of servere pulmonary infection and the evidence of increasing antibody formation to mucoid strains indicates the invasiveness of these particular strains.