Effects of clinical and environmental factors on bronchoalveolar antibody responses to Pneumocystis jirovecii: A prospective cohort study of HIV+ patients.

BACKGROUND:Humoral immunity plays an important role against Pneumocystis jirovecii infection, yet clinical and environmental factors that impact bronchoalveolar antibody responses to P. jirovecii remain uncertain. METHODS:From October 2008-December 2011 we enrolled consecutive HIV-infected adults ad...

Full description

Bibliographic Details
Main Authors: Robert J Blount, Kieran R Daly, Serena Fong, Emily Chang, Katherine Grieco, Meredith Greene, Stephen Stone, John Balmes, Robert F Miller, Peter D Walzer, Laurence Huang
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC5503245?pdf=render
id doaj-a48123d359254b329a8bbb3cbde69af2
record_format Article
spelling doaj-a48123d359254b329a8bbb3cbde69af22020-11-25T01:36:30ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01127e018021210.1371/journal.pone.0180212Effects of clinical and environmental factors on bronchoalveolar antibody responses to Pneumocystis jirovecii: A prospective cohort study of HIV+ patients.Robert J BlountKieran R DalySerena FongEmily ChangKatherine GriecoMeredith GreeneStephen StoneJohn BalmesRobert F MillerPeter D WalzerLaurence HuangBACKGROUND:Humoral immunity plays an important role against Pneumocystis jirovecii infection, yet clinical and environmental factors that impact bronchoalveolar antibody responses to P. jirovecii remain uncertain. METHODS:From October 2008-December 2011 we enrolled consecutive HIV-infected adults admitted to San Francisco General Hospital (SFGH) who underwent bronchoscopy for suspected Pneumocystis pneumonia (PCP). We used local air quality monitoring data to assign ozone, nitrogen dioxide, and fine particulate matter exposures within 14 days prior to hospital admission. We quantified serum and bronchoalveolar lavage fluid (BALF) antibody responses to P. jirovecii major surface glycoprotein (Msg) recombinant constructs using ELISA. We then fit linear regression models to determine whether PCP and ambient air pollutants were associated with bronchoalveolar antibody responses to Msg. RESULTS:Of 81 HIV-infected patients enrolled, 47 (58%) were diagnosed with current PCP and 9 (11%) had a prior history of PCP. The median CD4+ count was 51 cells/μl (IQR 15-129) and 44% were current smokers. Serum antibody responses to Msg were statistically significantly predictive of BALF antibody responses, with the exception of IgG responses to MsgC8 and MsgC9. Prior PCP was associated with increased BALF IgA responses to Msg and current PCP was associated with decreased IgA responses. For instance, among patients without current PCP, those with prior PCP had a median 73.2 U (IQR 19.2-169) IgA response to MsgC1 compared to a 5.00 U (3.52-12.6) response among those without prior PCP. Additionally, current PCP predicted a 22.5 U (95%CI -39.2, -5.82) lower IgA response to MsgC1. Ambient ozone within the two weeks prior to hospital admission was associated with decreased BALF IgA responses to Msg while nitrogen dioxide was associated with increased IgA responses. CONCLUSIONS:PCP and ambient air pollutants were associated with BALF IgA responses to P. jirovecii in HIV-infected patients evaluated for suspected PCP.http://europepmc.org/articles/PMC5503245?pdf=render
collection DOAJ
language English
format Article
sources DOAJ
author Robert J Blount
Kieran R Daly
Serena Fong
Emily Chang
Katherine Grieco
Meredith Greene
Stephen Stone
John Balmes
Robert F Miller
Peter D Walzer
Laurence Huang
spellingShingle Robert J Blount
Kieran R Daly
Serena Fong
Emily Chang
Katherine Grieco
Meredith Greene
Stephen Stone
John Balmes
Robert F Miller
Peter D Walzer
Laurence Huang
Effects of clinical and environmental factors on bronchoalveolar antibody responses to Pneumocystis jirovecii: A prospective cohort study of HIV+ patients.
PLoS ONE
author_facet Robert J Blount
Kieran R Daly
Serena Fong
Emily Chang
Katherine Grieco
Meredith Greene
Stephen Stone
John Balmes
Robert F Miller
Peter D Walzer
Laurence Huang
author_sort Robert J Blount
title Effects of clinical and environmental factors on bronchoalveolar antibody responses to Pneumocystis jirovecii: A prospective cohort study of HIV+ patients.
title_short Effects of clinical and environmental factors on bronchoalveolar antibody responses to Pneumocystis jirovecii: A prospective cohort study of HIV+ patients.
title_full Effects of clinical and environmental factors on bronchoalveolar antibody responses to Pneumocystis jirovecii: A prospective cohort study of HIV+ patients.
title_fullStr Effects of clinical and environmental factors on bronchoalveolar antibody responses to Pneumocystis jirovecii: A prospective cohort study of HIV+ patients.
title_full_unstemmed Effects of clinical and environmental factors on bronchoalveolar antibody responses to Pneumocystis jirovecii: A prospective cohort study of HIV+ patients.
title_sort effects of clinical and environmental factors on bronchoalveolar antibody responses to pneumocystis jirovecii: a prospective cohort study of hiv+ patients.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2017-01-01
description BACKGROUND:Humoral immunity plays an important role against Pneumocystis jirovecii infection, yet clinical and environmental factors that impact bronchoalveolar antibody responses to P. jirovecii remain uncertain. METHODS:From October 2008-December 2011 we enrolled consecutive HIV-infected adults admitted to San Francisco General Hospital (SFGH) who underwent bronchoscopy for suspected Pneumocystis pneumonia (PCP). We used local air quality monitoring data to assign ozone, nitrogen dioxide, and fine particulate matter exposures within 14 days prior to hospital admission. We quantified serum and bronchoalveolar lavage fluid (BALF) antibody responses to P. jirovecii major surface glycoprotein (Msg) recombinant constructs using ELISA. We then fit linear regression models to determine whether PCP and ambient air pollutants were associated with bronchoalveolar antibody responses to Msg. RESULTS:Of 81 HIV-infected patients enrolled, 47 (58%) were diagnosed with current PCP and 9 (11%) had a prior history of PCP. The median CD4+ count was 51 cells/μl (IQR 15-129) and 44% were current smokers. Serum antibody responses to Msg were statistically significantly predictive of BALF antibody responses, with the exception of IgG responses to MsgC8 and MsgC9. Prior PCP was associated with increased BALF IgA responses to Msg and current PCP was associated with decreased IgA responses. For instance, among patients without current PCP, those with prior PCP had a median 73.2 U (IQR 19.2-169) IgA response to MsgC1 compared to a 5.00 U (3.52-12.6) response among those without prior PCP. Additionally, current PCP predicted a 22.5 U (95%CI -39.2, -5.82) lower IgA response to MsgC1. Ambient ozone within the two weeks prior to hospital admission was associated with decreased BALF IgA responses to Msg while nitrogen dioxide was associated with increased IgA responses. CONCLUSIONS:PCP and ambient air pollutants were associated with BALF IgA responses to P. jirovecii in HIV-infected patients evaluated for suspected PCP.
url http://europepmc.org/articles/PMC5503245?pdf=render
work_keys_str_mv AT robertjblount effectsofclinicalandenvironmentalfactorsonbronchoalveolarantibodyresponsestopneumocystisjiroveciiaprospectivecohortstudyofhivpatients
AT kieranrdaly effectsofclinicalandenvironmentalfactorsonbronchoalveolarantibodyresponsestopneumocystisjiroveciiaprospectivecohortstudyofhivpatients
AT serenafong effectsofclinicalandenvironmentalfactorsonbronchoalveolarantibodyresponsestopneumocystisjiroveciiaprospectivecohortstudyofhivpatients
AT emilychang effectsofclinicalandenvironmentalfactorsonbronchoalveolarantibodyresponsestopneumocystisjiroveciiaprospectivecohortstudyofhivpatients
AT katherinegrieco effectsofclinicalandenvironmentalfactorsonbronchoalveolarantibodyresponsestopneumocystisjiroveciiaprospectivecohortstudyofhivpatients
AT meredithgreene effectsofclinicalandenvironmentalfactorsonbronchoalveolarantibodyresponsestopneumocystisjiroveciiaprospectivecohortstudyofhivpatients
AT stephenstone effectsofclinicalandenvironmentalfactorsonbronchoalveolarantibodyresponsestopneumocystisjiroveciiaprospectivecohortstudyofhivpatients
AT johnbalmes effectsofclinicalandenvironmentalfactorsonbronchoalveolarantibodyresponsestopneumocystisjiroveciiaprospectivecohortstudyofhivpatients
AT robertfmiller effectsofclinicalandenvironmentalfactorsonbronchoalveolarantibodyresponsestopneumocystisjiroveciiaprospectivecohortstudyofhivpatients
AT peterdwalzer effectsofclinicalandenvironmentalfactorsonbronchoalveolarantibodyresponsestopneumocystisjiroveciiaprospectivecohortstudyofhivpatients
AT laurencehuang effectsofclinicalandenvironmentalfactorsonbronchoalveolarantibodyresponsestopneumocystisjiroveciiaprospectivecohortstudyofhivpatients
_version_ 1725062781678387200