IgG subclass responses to Pseudomonas aeruginosa a- and b-type flagellins in patients with cystic fibrosis: a prospective study.

Sera from 20 cystic fibrosis patients, whose lungs were colonised by Pseudomonas aeruginosa, were examined in a 3-5-year prospective study for any relationship between IgG subclass antibody levels to P. aeruginosa a- and b-type flagellins and pulmonary function (FEV1 and radiological score). Patients were divided into two groups according to their pulmonary status: group 1 comprised 11 patients with poor pulmonary status; group 2 comprised nine patients with relatively good pulmonary status. High concentrations of IgG1, IgG2 and IgG3 antibodies to flagellins, particularly to the b-type, were found in most patients. IgG4 reactivity was observed in only a few patients. Comparison of the two groups of patients showed that those with poor pulmonary status (group 1) had a significantly higher concentration (p < 0.05) of IgG3 for two of the three periods studied and of IgG2 for the last period studied. Moreover, IgG3 and IgG1 reactivities to b-type flagellin and IgG3 to a-type flagellin were also increased significantly (p < 0.05) in group 1 patients between the first and the last period studied. These patients also showed a significant (p < 0.05) time-dependent increase in IgG3 and IgG1 antibody concentrations. These data demonstrate that cystic fibrosis patients with poorer pulmonary status have higher IgG3 levels to flagellin than other cystic fibrosis patients. High concentrations of strong opsonic IgG3 and, to a lesser degree, of IgG1 antibodies may increase pulmonary inflammation and induce heightened pulmonary deterioration.