BPI-ANCA Provides Additional Clinical Information to Anti-Pseudomonas Serology: Results from a Cohort of 117 Swedish Cystic Fibrosis Patients.
BPI-ANCA Provides Additional Clinical Information to Anti-Pseudomonas Serology: Results from a Cohort of 117 Swedish Cystic Fibrosis Patients.
复制标题
DOI：
10.1155/2015/947934
复制
发表时间：
2015
影响因子：
4.1
通讯作者：
Segelmark M
中科院分区：
文献类型：
--
作者：
Lindberg U;Carlsson M;Hellmark T;Segelmark M
铜绿假单胞菌定植的囊性纤维化患者预后较未定植铜绿假单胞菌的患者差。BPI-ANCA是一种抗中性粒细胞胞浆抗体，与铜绿假单胞菌的定植和不良的长期预后相关。与标准的抗P抗体相比，它是否提供了额外的信息。铜绿假单胞菌血清学测试尚不清楚。在瑞典隆德的CF中心，117名未移植的CF患者被前瞻性地跟踪了10年。细菌定植根据利兹标准进行分类。免疫球蛋白BPI-ANCA与抗碱性蛋白酶(AP)、弹性蛋白酶(ELA)和外毒素A(ExoA)抗体的检测结果进行了比较。记录肺功能和患者预后，包括活着、肺移植或死亡。BPI-ANCA与肺功能损害的相关性最高，相关系数为0.44。117名患者中有48名慢性定植有铜绿假单胞菌。这些患者中有20人经历了不良结局。受试者操作曲线(ROC)分析显示，与血清学试验相比，BPI-ANCA能更好地预测这一点(AUC=0.77，p=0.002)。BPI-ANCA与肺功能损害和远期预后的相关性优于抗-P。铜绿假单胞菌血清学，并具有类似的能力来识别慢性铜绿假单胞菌患者。
Patients with cystic fibrosis (CF) colonized with Pseudomonas aeruginosa (P. aeruginosa) have worse prognosis compared with patients who are not. BPI-ANCA is an anti-neutrophil cytoplasmic antibody against BPI (bactericidal/permeability increasing protein) correlating with P. aeruginosa colonization and adverse long time prognosis. Whether it provides additional information as compared to standard anti-P. aeruginosa serology tests is not known. 117 nontransplanted CF patients at the CF centre in Lund, Sweden, were followed prospectively for ten years. Bacterial colonisation was classified according to the Leeds criteria. IgA BPI-ANCA was compared with assays for antibodies against alkaline protease (AP), Elastase (ELA), and Exotoxin A (ExoA). Lung function and patient outcome, alive, lung transplanted, or dead, were registered. BPI-ANCA showed the highest correlation with lung function impairment with an r-value of 0.44. Forty-eight of the 117 patients were chronically colonized with P. aeruginosa. Twenty of these patients experienced an adverse outcome. Receiver operator curve (ROC) analysis revealed that this could be predicted by BPI-ANCA (AUC = 0.77), (p = 0.002) to a better degree compared with serology tests. BPI-ANCA correlates better with lung function impairment and long time prognosis than anti-P. aeruginosa serology and has similar ability to identify patients with chronic P. aeruginosa.