Strain-specific immune response to Haemophilus influenzae in chronic obstructive pulmonary disease

被引:103
作者
Sethi, S
Wrona, C
Grant, BJB
Murphy, TF
机构
[1] VA WNY Healthcare Syst 151, Buffalo, NY 14215 USA
[2] SUNY Buffalo, Div Pulm & Crit Care Med, Buffalo, NY 14260 USA
[3] SUNY Buffalo, Div Infect Dis, Dept Med, Buffalo, NY 14260 USA
[4] SUNY Buffalo, Dept Microbiol, Buffalo, NY 14260 USA
关键词
chronic obstructive pulmonary disease; Hoemophilus influenzae; humoral immunity; exacerbation;
D O I
10.1164/rccm.200308-1181OC
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Previous studies of immune response to Haemophilus influenzae after exacerbations of chronic obstructive pulmonary disease (COPD) have yielded contradictory results. Using homologous (infecting) strains and immunoassays to surface-exposed epitopes, we tested the hypothesis that adults with COPD make new antibodies to strain-specific, surface-exposed epitopes on H. influenzae after exacerbations. We collected clinical information, sputum, and serum monthly and during exacerbations from 81 patients with COPD over 56 months. Serum antibodies to H. influenzae after exacerbations associated with H. influenzae in sputum were detected with whole bacterial cell ELISA and bactericidal assays. An immune response to homologous H. influenzae occurred after 22 of 36 (61.1%) exacerbations with newly acquired strains compared with 7 of 33 (21.2%) exacerbations with preexisting strains (odds ratio [OR] = 4.4; 95%, 1.8 to 10.8; p = 0.001). An absence of an immune response was strongly associated with complement sensitivity (OR = 0.03; 95% confidence interval, 0.003 to 0.22; p = 0.001). New bactericidal antibodies developed after exacerbations were highly strain specific, showing bactericidal activity for only 11 of 90 (12.2%) heterologous strains. Development of an immune response to H. influenzae supports its role in causing exacerbations. The strain specificity of the immune response likely represents a mechanism of recurrent exacerbations.
引用
收藏
页码:448 / 453
页数:6
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