title: Elevated exoenzyme expression by Pseudomonas aeruginosa is correlated with exacerbations of lung disease in cystic fibrosis.
abstract: Two studies were conducted to determine whether Pseudomonas aeruginosa exoenzyme expression was increased during pulmonary exacerbations of cystic fibrosis (CF) and if it was reduced by antibiotic therapy. The first study was retrospective comparing in vitro exoenzyme levels expressed by P. aeruginosa sputum isolates from seriously ill, hospitalized patients with CF to those from P. aeruginosa strains isolated from CF clinic patients who were in relatively better health. Exoenzyme values were significantly greater in P. aeruginosa strains isolated from ill, hospitalized patients than in clinic patients (P = 0.0001). In the prospective study, in vitro exoenzyme levels were measured from sputum P. aeruginosa isolates of 9 hospitalized patients with CF. Exoenzyme values were greatest in nonmucoid strains on admission (P < 0.0025), and P. aeruginosa exoenzyme expression decreased significantly during hospitalization (P < 0.0025). Deterioration in CF lung disease was accompanied by increased P. aeruginosa exoenzyme production, especially by nonmucoid strains. Antibiotic treatment during hospitalization resulted in mean improvement of % predicted forced expiratory volume in 1 sec (FEV1) from 39 to 53% (P = 0.002). Thus, antibiotics may improve pulmonary function in patients with CF by decreasing P. aeruginosa exoenzyme expression.
authors.affiliation: Department of Microbiology and Infectious Diseases, University of Calgary Health Sciences Centre, Alberta, Canada.
authors.forename: K
authors.initials: K
authors.lastname: Grimwood
authors.forename: R A
authors.initials: RA
authors.lastname: Semple
authors.forename: H R
authors.initials: HR
authors.lastname: Rabin
authors.forename: P A
authors.initials: PA
authors.lastname: Sokol
authors.forename: D E
authors.initials: DE
authors.lastname: Woods
mesh_terms: D036002:ADP Ribose Transferases; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001426:Bacterial Proteins; D001427:Bacterial Toxins; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D004798:Enzymes / Q000096:biosynthesis*; D005098:Exotoxins / Q000096:biosynthesis; D005260:Female; D006801:Humans; D008297:Male; D008666:Metalloendopeptidases / Q000096:biosynthesis; D010740:Phospholipases / Q000096:biosynthesis; D011065:Poly(ADP-ribose) Polymerases / Q000096:biosynthesis; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000145:classification / Q000201:enzymology*; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology; D037521:Virulence Factors; D000097668:Pseudomonas aeruginosa Exotoxin A
chemical_list: D036002:ADP Ribose Transferases; D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001427:Bacterial Toxins; D004798:Enzymes; D005098:Exotoxins; D008666:Metalloendopeptidases; D010740:Phospholipases; D011065:Poly(ADP-ribose) Polymerases; D037521:Virulence Factors; D000097668:Pseudomonas aeruginosa Exotoxin A; C444820:exoenzyme S; C043859:pseudolysin, Pseudomonas aeruginosa