title: Extensive endoscopic image-guided sinus surgery decreases BPI-ANCA in patients with cystic fibrosis.
abstract: Antineutrophil cytoplasm autoantibodies (ANCA) directed against bactericidal/permeability-increasing protein (BPI) are common in patients with cystic fibrosis (CF), and serum levels are correlated with lung colonization by Pseudomonas aeruginosa and the severity of lung damage. The production of BPI-ANCA may be due to the costimulation of BPI when mounting an immune response against P. aeruginosa. The effect of surgery aiming to eradicate bacteria and infected tissue on BPI-ANCA levels is sparsely described. A cohort of patients with CF were included: 53 patients having extensive image-guided sinus surgery (EIGSS) with topical postoperative antibiotic treatment, 131 non-operated controls and 36 who had double lung transplantation (LTX). In all 219 patients, serum samples before and after surgery or at similar intervals were analysed for IgG and IgA BPI-ANCA. The EIGSS group showed a highly significant decrease in both IgA and IgG BPI-ANCA levels compared with their own preoperative values and control group values (P < 0.001-0.02). The LTX patients also showed a highly significant decrease in both IgA and IgG BPI-ANCA levels (P < 0.001). EIGSS and LTX decrease IgA and IgG BPI-ANCA levels in patients with CF, indicating that extensive removal of infected tissue influences the pathogenic process of autoantibody production. The results shown herein are in favour of applying EIGSS in selected patients with CF and for using BPI-ANCA as a surrogate marker for guiding further therapeutic interventions.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Rigshospitalet, Copenhagen, Denmark. kasper.aanaes@rh.regionh.dk
authors.forename: K
authors.initials: K
authors.lastname: Aanaes
authors.forename: N
authors.initials: N
authors.lastname: Rasmussen
authors.forename: T
authors.initials: T
authors.lastname: Pressler
authors.forename: M
authors.initials: M
authors.lastname: Segelmark
authors.forename: H K
authors.initials: HK
authors.lastname: Johansen
authors.forename: U
authors.initials: U
authors.lastname: Lindberg
authors.forename: N
authors.initials: N
authors.lastname: Høiby
authors.forename: M
authors.initials: M
authors.lastname: Carlsson
authors.forename: J
authors.initials: J
authors.lastname: Wieslander
authors.forename: C
authors.initials: C
authors.lastname: Buchwald
mesh_terms: D000293:Adolescent; D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000096:biosynthesis* / Q000097:blood; D000907:Antibodies, Bacterial / Q000276:immunology; D023181:Antimicrobial Cationic Peptides / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins / Q000276:immunology; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications / Q000276:immunology / Q000628:therapy*; D004724:Endoscopy; D005260:Female; D006801:Humans; D056747:Immunomodulation; D008297:Male; D008875:Middle Aged; D010256:Paranasal Sinuses / Q000276:immunology / Q000382:microbiology / Q000601:surgery*; D011552:Pseudomonas Infections / Q000150:complications / Q000276:immunology / Q000628:therapy*; D011550:Pseudomonas aeruginosa / Q000276:immunology*; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D000907:Antibodies, Bacterial; D023181:Antimicrobial Cationic Peptides; D015415:Biomarkers; D001798:Blood Proteins; C021623:bactericidal permeability increasing protein