The Use of Plasmapheresis in Bronchiectasis Patients with Pseudomonas aeruginosa Infection and Inhibitory Antibodies

Research output: Contribution to journalArticlepeer-review

Authors

  • John Davison
  • Emma Sheehan
  • Suren Kanagasundaram
  • Gavin Spickett
  • Robert Stockley
  • Anthony De Soyza

External organisations

  • Newcastle University

Abstract

Chronic Pseudomonas aeruginosa lung infections commonly occur in patients suffering from bronchiectasis, leading to increased morbidity and mortality (1-4). Severe bronchiectasis often affects patients beyond the age where lung transplantation is indicated resulting in a high mortality rate (5).
Recently, we identified that ~20% of patients with bronchiectasis and chronic P. aeruginosa infection had excess IgG2 specific to the bacterial O-antigen (6). In contrast to the serum bactericidal effect normally associated with antibody, this IgG2 inhibited immune killing of the infecting strain (6). Crucially, patients with inhibitory antibody had worse lung disease (6).
We hypothesised that removal of inhibitory antibody might restore host immune killing and improve patient health. Plasmapheresis is typically used to treat conditions where injurious auto-antibodies arise (7, 8). Here we used plasmapheresis to remove inhibitory IgG2 from the serum of two critically ill patients with chronic P. aeruginosa infections (6)

Details

Original languageEnglish
Pages (from-to)955-958
Number of pages4
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume195
Issue number7
Publication statusPublished - 1 Apr 2017

Keywords

  • Aged, Bronchiectasis/etiology, Drug Resistance, Multiple, Bacterial, Female, Forced Expiratory Volume, Humans, Immunoglobulin G/blood, Male, Middle Aged, Oxygen/administration & dosage, Plasmapheresis, Pseudomonas Infections/immunology, Pseudomonas aeruginosa/immunology, Respiratory Insufficiency/etiology, Salvage Therapy/methods