Immune complexes and Pseudomonas aeruginosa antibodies in cystic fibrosis.

Serum samples from 57 patients with cystic fibrosis were tested for the presence of IgG, IgA, IgM, IgE, and circulating immune complexes containing IgG, IgA, and IgM. Titres of class specific antibodies to Pseudomonas aeruginosa, and class specific antibodies to Ps aeruginosa in circulating immune complexes, were also measured. According to the Shwachman score the patients were divided into three clinical groups: group 1-moderate and severe disease, group 2-mild disease, and group 3-well. The results of the immunological investigations were correlated with the clinical state of the patients as assessed by the Shwachman score. Serum concentrations of IgG, IgA, and IgM were inversely correlated with the Shwachman score, but the differences between the groups were only significant for IgG and IgA. The same correlations were found for circulating immune complexes containing IgG and IgA. Antibodies to Ps aeruginosa could be detected in most of the patients' serum samples. IgA antibody specific to Ps aeruginosa was the most often raised, even in patients in group 3. It is therefore suggested that IgA antibody specific to Ps aeruginosa could be an early marker of colonisation by Ps aeruginosa and a sensitive measurement of infection with Ps aeruginosa in young children with cystic fibrosis. Moreover, in the circulating immune complexes, class specific antibodies to Ps aeruginosa were found in nearly half the patients. The highest titres of IgG and IgA antibodies specific to Ps aeruginosa in the circulating immune complexes were detected in the patients with the worst clinical state (group 1).