Specific Pseudomonas immunoglobulin E antibodies in sera of patients with cystic fibrosis

Haemophilus influenzae and smoking-related obstructive airways disease

Background

Intralumenal bacteria play a critical role in the pathogenesis of acute infective episodes and airway inflammation. Antigens from colonizing bacteria such as nontypeable Haemophilus influenzae (NTHi) may contribute to chronic lung disease through an immediate hypersensitivity response. The objective of this study was to determine the presence of specific NTHi-IgE antibodies in subjects with chronic bronchitis (CB) and COPD who had smoked.

Methods

Serum, sputum, and saliva samples were collected from subjects with CB and moderate–severe COPD and healthy aged-matched controls. Total IgE and specific NTHi IgE were measured by enzyme linked immmunosorbent assay. Throat swabs were examined for the presence of NTHi.

Results

The results demonstrate that: i) specific NTHi IgE antibodies occur at a low level in healthy subjects; ii) those with both CB and moderate–severe COPD have elevated specific NTHi IgE antibody compared with healthy controls, with higher levels in those with most severe disease; iii) IgE levels are greater in those with moderate–severe COPD than in those with CB. They demonstrate specific NTHi IgE antibody is regularly found at higher than normal levels in COPD.

Conclusion

The detection of IgE antibody to colonizing bacteria in all subjects with CB or moderate–severe COPD identifies a possible mechanism of bronchospasm in these subjects amenable to specific intervention therapy.

Haemophilus somnus-induced IgE in calves vaccinated with commercial monovalent H. somnus bacterins

The ability of commercially available Haemophilus somnus bacterins to elicit an immunoglobulin E (IgE) response was examined in healthy calves using enzyme-linked immunosorbent assay (ELISA) and western blotting techniques. Thirty five calves were utilized in this study. Calves in Group 1 (n=7) did not receive any H. somnus vaccination and served as negative controls. Calves in each of Groups 2-5 (n=7 each) were vaccinated on days 0 (primary) and 14 (booster) with one of four commercially available H. somnus bacterins. Sera were harvested on days 0 and 14 and at weekly intervals for a total of 45 days. Sera were tested for the presence of IgE antibodies using a bovine IgE-specific ELISA. Low levels of H. somnus-specific IgE were detected by ELISA in all animals prior to the initiation of the study. All bacterins induced IgE levels that were significantly higher than control levels. Two bacterins elicited higher IgE levels at all time points. Sera were adsorbed against washed whole cells of either Salmonella typhimurium, P. multocida, or H. somnus or extracts of H. somnus. ELISA absorbance values were significantly decreased by adsorption with washed whole cells or extracts of H. somnus, whereas adsorption with other gram-negative bacteria only minimally decreased ELISA absorbance values. These results indicate that commercially available H. somnus bacterins can induce IgE antibody as early as 14 days post-vaccination. This IgE can be detected 45 days after the primary vaccination. Results also indicate that H. somnus-specific IgE antibodies can be found in serum of some cattle, possibly induced by existing or previous sensitization.

Immunoglobulin E and G responses to pertussis toxin in children immunised with adsorbed and non-adsorbed whole cell pertussis vaccines

The IgE and IgG responses to pertussis toxin were measured in blood samples from 70 children (age 1.5-2.9 years) after primary immunisation with either a non-aluminium adsorbed, whole cell vaccine (n = 34) or an aluminium adsorbed whole cell vaccine (n = 36). Two years later, they received a booster immunisation with either the non-adsorbed (n = 24) or the aluminium adsorbed vaccine (n = 14). Neutralising antibodies to pertussis toxin were higher (P < 0.05) after the three priming doses of the adsorbed vaccine than of the non-adsorbed vaccine, although both groups showed > 90% seropositives after the third dose. IgE antibodies to PT (PT-IgE) were detected in samples from 11/52 children after completed primary immunisation and the levels were low (median < or = 0.1 PRU ml-1) in both groups. No significant differences between the groups were found. PT-IgE levels did not increase after the booster injection. Thus, the aluminium content of the whole cell vaccines influenced the IgG response but not the IgE responses to pertussis toxin. The high rates of PT-IgE responses noted after a booster dose of acellular or whole cell pertussis vaccine to children primed with acellular vaccine in previous studies can therefore be mainly ascribed to the nature of the priming vaccine rather than the aluminium adjuvant.

Immune responses to Aspergillus fumigatus and Pseudomonas aeruginosa antigens in cystic fibrosis and allergic bronchopulmonary aspergillosis

Allergic bronchopulmonary aspergillosis (ABPA) in Cystic Fibrosis (CF) is well documented. Aspergillus fumigatus is the causative agent of ABPA, and Pseudomonas aeruginosa particularly the mucoid variety has been frequently isolated from the sputum of patients with CF. This study investigates the cellular and humoral immune response to both A fumigatus and P aeruginosa antigens in patients with CF and ABPA (CF/ABPA), CF only, and healthy controls. The A fumigatus and P aeruginosa antigen specific IgE and IgG in sera and peripheral blood mononuclear cell culture supernatants (PBMC sups), lymphoproliferation to antigens, and leukotriene B4 (LTB4) were measured. Results indicate significant elevated levels of A fumigatus specific IgG (A fumigatus-IgG) and Paeruginosa-IgE in serum. Significant Paeruginosa-IgG was measured in PBMC sups. The concanavalin A nonbinding A fumigatus antigen, previously shown to induce specific T-cell responses in vitro in patients with ABPA, elicited significant lymphoproliferative response in a greater proportion of patients with CF/ABPA and not in CF or controls, underlining the importance of this antigen in the diagnosis of ABPA. In contrast, a greater proportion of the CF group responded to P aeruginosa antigens compared with the controls and CF/ABPA. Hence, the CF and CF/ABPA groups respond to both P aeruginosa and A fumigatus antigens with the former group responding strongly to P aeruginosa and the latter to A fumigatus antigens.

Cystic fibrosis. Infection and immunity to Pseudomonas

Chronic pulmonary infection with P. aeruginosa in CF may result from: 1. An initial failure of clearance mechanisms (increased adherence) leading to the development of a highly compartmentalized inflammatory reaction; 2. Inhibition of clearing mechanisms for bacteria present in the bronchial lumen; and 3. A largely ineffective, and possibly damaging, hyperactivity of inflammatory cells in the lumen and bronchial wall. The special relationship between the CF host and P. aeruginos, always long-term, and frequently subtle in its complexity, needs further understanding in order to develop new strategies for the treatment of chronic lung infections with this organism.

Immunologic aspects of surface infections in the lung

The hallmark of cystic fibrosis is progressive bronchopulmonary damage associated with chronic infection with Pseudomonas aeruginosa, leading to respiratory failure and, ultimately, death. P. aeruginosa is an essentially nonvirulent organism in an immunocompetent host, but it has been shown to colonize the respiratory tract progressively in more than 80% of patients with CF. Patients with CF do not exhibit any evidence of immunologic compromise, and the infection is limited to the mucosal surfaces of the respiratory tract. Thus, P. aeruginosa in bronchopulmonary disease is a unique chronic mucosal infection resulting in a progressive pathologic process. It is therefore conceivable that locally induced alteration in the pulmonary mucosal defense is a major mechanism underlying the development of lung disease in patients with CF. An understanding of immunologic homeostasis in the mucous membranes and in the bronchopulmonary epithelium should provide a better perspective on the factors contributing to the acquisition and chronicity of P. aeruginosa infection in the lower respiratory tract and the development of progressive pulmonary damage unique to CF.

Pneumococcus-specific immunoglobulin E in cigarette smokers

A relationship between elevated serum immunoglobulin E levels and smoking has been demonstrated in epidemiological studies. Allergy skin test data suggest that the excess immunoglobulin E of smokers is not specific for aeroallergens. It is possible that the excess immunoglobulin E is specific for microorganisms that often infect the lower respiratory tract of smokers. To investigate this possibility we utilized a radioallergosorbent test assay for detecting serum immunoglobulin E specific for Streptococcus pneumoniae, an organism commonly isolated from the respiratory tract of smokers with chronic bronchitis. We assayed sera of thirty smokers and thirty nonsmokers for immunoglobulin E specific for Streptococcus pneumoniae. Individual sera were considered positive for pneumococcus-specific immunoglobulin E if the binding was at least twice the non-specific binding at the total immunoglobulin E concentration of the particular serum. Eleven of the thirty sera of smokers and two of the thirty nonsmokers were positive for pneumococcus-specific immunoglobulin E. By chi-square analysis of these data, the prevalence of pneumococcus-specific immunoglobulin E was significantly greater in the smoking group compared with the non-smoking group (P less than 0.02). These results suggest that the excess immunoglobulin E of smokers is, at least in part, specific for microorganisms that infect the airways.