Secretory IgA response against Pseudomonas aeruginosa in the upper airways and the link with chronic lung infection in cystic fibrosis

• Published in: Pathogens and disease 2017-08, Vol.75 (6)
• Main Authors: Mauch, Renan M., Rossi, Claudio L., Aiello, Talita B., Ribeiro, José D., Ribeiro, Antônio F., Høiby, Niels, Levy, Carlos E.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Antibodies, Bacterial - analysis; Case-Control Studies; Child; Child, Preschool; Chronic infection; Colonization; Cross-Sectional Studies; Cystic fibrosis; Cystic Fibrosis - complications; Cystic Fibrosis - diagnosis; Cystic Fibrosis - immunology; Cystic Fibrosis - microbiology; Enzyme-Linked Immunosorbent Assay; Female; Gram-negative bacteria; Humans; Immunoglobulin A; Immunoglobulin A, Secretory - analysis; Immunoglobulin G; Immunoglobulin G - analysis; Infections; Lung - immunology; Lung - microbiology; Lung - pathology; Lungs; Male; Medical diagnosis; Microbiological culture; Opportunistic Infections - complications; Opportunistic Infections - diagnosis; Opportunistic Infections - immunology; Opportunistic Infections - microbiology; Patients; Pseudomonas aeruginosa; Pseudomonas Infections - complications; Pseudomonas Infections - diagnosis; Pseudomonas Infections - immunology; Pseudomonas Infections - microbiology; Saliva; Saliva - chemistry; Saliva - immunology; Saliva - microbiology; Sensitivity and Specificity; Sinusitis
• ISSN: 2049-632X; 2049-632X
• DOI: 10.1093/femspd/ftx069

Abstract We assessed the diagnostic ability of an enzyme-linked immunosorbent assay test for measurement of specific secretory IgA (sIgA) in saliva to identify cystic fibrosis (CF) patients with Pseudomonas aeruginosa chronic lung infection and intermittent lung colonization. A total of 102 Brazilian CF patients and 53 healthy controls were included. Specific serum IgG response was used as a surrogate to distinguish CF patients according to their P. aeruginosa colonization/infection status. The rate of sIgA positivity was 87.1% in CF chronically infected patients (median value = 181.5 U/mL), 48.7% in intermittently colonized patients (median value = 45.8 U/mL) and 21.8% in free of infection patients (median value = 22.1 U/mL). sIgA levels in saliva were significantly associated with serum P. aeruginosa IgG and microbiological culture results. The sensitivity, specificity, PPV and NPV for differentiation between presence and absence of chronic lung infection were 87%, 63%, 51% and 92%, respectively. Measurement of sIgA in saliva may be used for screening patients in risk of developing P. aeruginosa chronic lung infection in CF and possibly also for paranasal sinusitis, and, most importantly, to efficiently rule out chronic P. aeruginosa lung infection. A potential rapid, easy and feasible alternative for early diagnosis of Pseudomonas aeruginosa chronic lung infection in cystic fibrosis.