Colonisation and infection of the paranasal sinuses in cystic fibrosis patients is accompanied by a reduced PMN response

TY - JOUR

T1 - Colonisation and infection of the paranasal sinuses in cystic fibrosis patients is accompanied by a reduced PMN response

AU - Johansen, Helle Krogh

AU - Aanaes, Kasper

AU - Pressler, Tania

AU - Nielsen, Kim Gjerrum

AU - Fisker, Jacob

AU - Skov, Marianne

AU - Høiby, Niels

AU - von Buchwald, Christian

N1 - Copyright © 2012 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

PY - 2012/12

Y1 - 2012/12

N2 - Background: We studied whether the sinuses might be foci for Pseudomonas aeruginosa lung infection. Methods: Endoscopic Sinus Surgery was performed in 78 CF patients; PFGE was used for bacterial genotyping. Material from sinuses and lungs were Gram-stained to detect biofilms. Immunoglobulins were measured in serum and saliva. Results: When P. aeruginosa was cultured simultaneously from the sinuses and the lungs they were genetically identical in 38 of the 40 patients (95%). In the sinuses, P. aeruginosa formed biofilms with minimal cellular inflammation, probably because of a significantly higher local production of secretory IgA compared with IgG (p<. 0.001). Conclusions: We have shown that P. aeruginosa form biofilm in the sinuses, which constitute an important bacterial reservoir for subsequent lung infection. The high amount of IgA in the upper airways probably protects P. aeruginosa from the inflammatory immune system, and they can proceed unnoticed into a permanent infectious focus that cannot be eradicated with antibiotics.

AB - Background: We studied whether the sinuses might be foci for Pseudomonas aeruginosa lung infection. Methods: Endoscopic Sinus Surgery was performed in 78 CF patients; PFGE was used for bacterial genotyping. Material from sinuses and lungs were Gram-stained to detect biofilms. Immunoglobulins were measured in serum and saliva. Results: When P. aeruginosa was cultured simultaneously from the sinuses and the lungs they were genetically identical in 38 of the 40 patients (95%). In the sinuses, P. aeruginosa formed biofilms with minimal cellular inflammation, probably because of a significantly higher local production of secretory IgA compared with IgG (p<. 0.001). Conclusions: We have shown that P. aeruginosa form biofilm in the sinuses, which constitute an important bacterial reservoir for subsequent lung infection. The high amount of IgA in the upper airways probably protects P. aeruginosa from the inflammatory immune system, and they can proceed unnoticed into a permanent infectious focus that cannot be eradicated with antibiotics.

KW - Adolescent

KW - Adult

KW - Antibodies, Bacterial

KW - Biofilms

KW - Child

KW - Cystic Fibrosis

KW - Endoscopy

KW - Female

KW - Gram-Negative Bacterial Infections

KW - Humans

KW - Immunoglobulin A

KW - Immunoglobulin G

KW - Male

KW - Middle Aged

KW - Neutrophils

KW - Paranasal Sinuses

KW - Pseudomonas Infections

KW - Pseudomonas aeruginosa

KW - Sinusitis

KW - Sputum

KW - Streptococcal Infections

KW - Young Adult

U2 - 10.1016/j.jcf.2012.04.011

DO - 10.1016/j.jcf.2012.04.011

M3 - Journal article

C2 - 22595452

SN - 1569-1993

VL - 11

SP - 525

EP - 531

JO - Journal of Cystic Fibrosis

JF - Journal of Cystic Fibrosis

IS - 6

ER -