Abstract
The use of broad-spectrum antibiotics in empirical antimicrobial therapy is a lifesaving strategy for patients in intensive care. At the same time, antibiotics dramatically increase the risk for nosocomial infections, such as hospital‑acquired pneumonia caused by Pseudomonas aeruginosa, and other antibiotic-resistant bacteria. In this issue of the JCI, Robak and colleagues identified a mechanism by which depletion of resident gut and lung microbiota by antibiotic treatment results in secondary IgA deficiency and impaired anti-P. aeruginosa host defense. Impaired defenses could be improved by substitution of polyclonal IgA via the intranasal route in a mouse model of pneumonia. Importantly, antibiotic treatment caused lung IgA deficiency that involved reduced TLR-dependent production of a proliferation-inducing ligand (APRIL) and B cell-activating factor (BAFF) in intensive care unit patients. These patients might therefore benefit from future strategies to increase pulmonary IgA levels.
References
Aug 3, 2002·Nature Immunology·Mikhail B LitinskiyAndrea Cerutti
Aug 23, 2003·Infection and Immunity·Cameron P SimmonsGordon Dougan
Jun 16, 2007·Immunity·Bing HeAndrea Cerutti
Aug 24, 2007·Nature·Hiroyuki TezukaToshiaki Ohteki
Dec 3, 2009·JAMA : the Journal of the American Medical Association·Jean-Louis VincentUNKNOWN EPIC II Group of Investigators
Jan 19, 2010·Nature Medicine·Thomas B ClarkeJeffrey N Weiser
Mar 16, 2011·Proceedings of the National Academy of Sciences of the United States of America·Takeshi IchinoheAkiko Iwasaki
Jul 12, 2011·The Journal of Hospital Infection·A G VenierUNKNOWN REA-RAISIN group
Jun 19, 2012·Immunity·Michael C AbtDavid Artis
Oct 30, 2012·Nature Reviews. Immunology·Oliver Pabst
Nov 23, 2012·Euro Surveillance : Bulletin Européen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin·P ZarbUNKNOWN Hospital Contact Points for the ECDC pilot point prevalence survey
Apr 30, 2013·The Lancet Infectious Diseases·Wilhelmina G MelsenMarc J M Bonten
Jul 17, 2013·American Journal of Respiratory and Critical Care Medicine·Yuichiro ShindoYoshinori Hasegawa
Oct 8, 2013·Nature Reviews. Immunology·Charlie G Buffie, Eric G Pamer
Apr 11, 2014·Critical Care Medicine·Ricard FerrerMitchell M Levy
Dec 30, 2015·The Journal of Experimental Medicine·Darren RuaneSaurabh Mehandru
Apr 30, 2016·Science·Eric G Pamer
Jul 8, 2016·Nature·Kenya Honda, Dan R Littman
Aug 2, 2016·Cell Host & Microbe·Myunghoo KimChang H Kim
Oct 19, 2016·PLoS Medicine·Alessandro CassiniCarl Suetens
Feb 6, 2018·Annual Review of Immunology·Andrew J MacphersonStephanie C Ganal-Vonarburg
May 16, 2018·Nature Immunology·Tim RollenskeHedda Wardemann
May 18, 2018·The Journal of Clinical Investigation·Oliver H RobakBastian Opitz