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Serological diagnosis of Pseudomonas aeruginosa infection in patients with non-CF bronchiectasis

Grant number: 21/12038-9
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): February 01, 2022
Effective date (End): January 31, 2023
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal researcher:Mônica Corso Pereira
Grantee:Isabelle Siqueira de Lacerda
Home Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil

Abstract

Bronchiectasis (BC) is a condition that includes bronchial dilatation, impaired mucociliary clearance, and susceptibility to persistent bacterial infections, mainly with Pseudomonas aeruginosa, known for its several virulence factors, including biofilm formation, which protects it against antibiotics and the immune system activity, leading to a chronic infection - followed by an intense and inefficient inflammatory immune response - that is virtually impossible to be eradicated by antibiotics. P. aeruginosa infection is associated with frequent pulmonary exacerbations, progressive decrease in lung function, and worse life expectancy for the BC patient. In this scenario, early detection of P. aeruginosa infection is crucial to allow early intervention, so to prevent or postpone chronic infection. The reference standard for the diagnosis of P. aeruginosa infection in most reference centers is based on sputum or oropharyngeal swab cultures performed every three months, which has several limitations, as many patients are not able to provide a representative respiratory sample, for which reason alternative, complementary methods are needed in the diagnostic routine of BC patients. Serological tests have proved useful in other settings, when used along with microbiological culture, for early infection diagnosis, as P. aeruginosa infection is followed by a systemic specific IgG-mediated response, which helps to discriminate between colonization and infection and to drive the most suitable treatment to each patient. The present study aims to evaluate the utility of an IgG-based enzyme-linked immunosorbent assay (ELISA) test - previously used for P. aeruginosa detection in patients with cystic fibrosis (CF) - for diagnosis of P. aeruginosa lung infection in adult patients with non-CF bronchiectasis seen at the University of Campinas Hospital (HC Unicamp). We will first evaluate the test's accuracy in comparison with the routinely performed microbiological respiratory culture and how the specific serum IgG levels compare among patients with different colonization/infection profiles (chronic infection, intermittent colonization, free of infection, and never colonized). As the present project is part of a broader project addressing different characteristics of patients with bronchiectasis, we will also assess the association between IgG levels and results of tests for functional and structural lung parameters, namely spirometry, lung clearance index, and radiologic scores. This is the first step for the test's longitudinal evaluation as a potential complementary diagnostic tool in our routine. (AU)

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