More Than 10 Years' Continuous Oral Treatment with Specific Immunoglobulin Y for the Prevention of Pseudomonas aeruginosa Infections: A Case Report

다국어 초록 (Multilingual Abstract)

Immunotherapy with specific antibodies is an alternative to antibiotics for the prevention of infections in hu-mans and animals. We have used orally administered immunoglobulin Y (IgY) preparations, purified from eggs of hens im-munized with Pseudomonas aeruginosabacteria, to prevent pulmonary P. aeruginosainfections in a group of patients withcystic fibrosis (CF). Respiratory infections are major problems for CF patients because of the thick mucus in the airways, andchronic P. aeruginosalung infections occur in virtually all CF patients and cause morbidity and mortality. The IgY-treatedgroup had only 2.5 P. aeruginosa-positive sputum cultures per 100 months, and none of the IgY-treated patients becamechronically colonized with P. aeruginosa. In the control group, 13.7 of the cultures per 100 months were positive for P. aerug-inosa, and 24% of patients became chronically colonized with P. aeruginosa. The first enrolled patient in this study has nowbeen treated continuously for more than 10 years. During the first 8 years she only had four P. aeruginosa-positive cultures.After 8 years she became chronically infected, but still after 10 years the bacteria have not turned mucoid. No negative sideeffects of IgY treatment have been noted during these 10 years. To our knowledge this is the longest treatment with specificyolk antibodies for therapeutic purposes.

참고문헌 (Reference)

1 "cloning and characterization of comple-mentary DNA. Science1989"

2 Larsson A, "Use of chicken anti-bodies in enzyme immunoassays to avoid interference by rheuma-toid factors. Clin Chem 1991"

3 Pier GB, "Rationale for development of immunotherapies that tar-get mucoid Pseudomonas aeruginosainfection in cystic fibrosispatients. Behring Inst Mitt1997 Prevention of chronic Pseudo-monas aeruginosacolonization in cystic fibrosis by early treat-ment. Lancet1991"

4 "Protection of rats against dental caries by passiveimmunization with hen-egg-yolk antibody"

5 "Prevention ofmurine rotavirus infection with chicken egg yolk immunoglobu-lins. J Infect Dis1980"

6 Yokoyama H, "Passive protection against bovine rotavirus-induceddiarrhea in murine model by specific immunoglobulins fromchicken egg yolk. Vet Microbiol1993"

7 "Passive protection against bovine rotavirus in calves byspecific immunoglobulins from chicken egg yolk. Arch Virol1994"

8 "Passive immu-nization against dental plaque formation in humans: effect of amouth rinse containing egg yolk antibodies (IgY) specific toStreptococcus mutans" 31 : 268274-, 1997

9 "Oral passive immunization against dentalcaries in rats by use of hen egg yolk antibodies specific for cell-associated glucosyltransferase of Streptococcus mutans. Infect Im-mun 1991"

10 Masuda K, "Oral de-livery of antigens in liposomes with some lipid compositions mod-ulates oral tolerance to the antigens" 46 : 5558-, 2002

11 Lindemann RA, "Oral colo-nization and susceptibility testing of Pseudomonas aeruginosaoral isolates from cystic fibrosis patients" 5457-,

12 Carlander D, "Oral administration of specific yolk antibodies(IgY) may prevent Pseudomonas aeruginosainfections in patientswith cystic fibrosis: a phase I feasibility study" 35 : 433440-, 2003

13 "Lung injury" BMJ Publishing Group, London 6278-, 1996

14 Tummler B, "Infectionswith Pseudomonas aeruginosain patients with cystic fibrosis" 98 : 249255-, 1997

15 "Immunoglobulins in the egg" 1520-,

16 "Immunoglobulins from egg yolk"

17 Carlander D, "Immunoglobuline Y (IgY)a new tool for the pro-phylaxis against Pseudomonas aeruginosain cystic fibrosis pa-tients [abstract]" 240-, 1999

18 Sugita-Konishi Y, "Immune functions of immunoglobuline Y isolatedfrom egg yolk of hens immunized with various infectious bacte-ria" 60 : 886888-, 1996

19 "Identification of the cys-tic fibrosis gene" geneticanalysis.science1989

20 "Identifi-cation of the cystic fibrosis gene"

21 Szaff M, "Frequent antibiotic therapy im-proves survival of cystic fibrosis patients with chronicPseudomonas aeruginosainfection"

22 Elborn JS, "Elective versus symptomaticantibiotic treatment in cystic fibrosis patients with chronicPseudomonasinfection of the lungs" 55 : 355358-, 2000

23 "Egg yolk immunoglobuline Y as an al-ternative antibody in the serology of echinococcosis"

24 "Duration of specific yolkIgY in the human oral cavity" 6 : 433437-, 2002

25 "Drug therapy: management of pulmonary diseasein patients with cystic fibrosis" 335 : 179188-, 1996

26 "Diagnosis of chronicPseudomonas aeruginosainfection in cystic fibrosis by enzyme-linked immunosorbent assay. J Clin Microbiol1987" 18301836.

27 Rosenstein BJ, "Cystic fibrosis" 351 : 277282-, 1998

28 "Chicken anti-bodies: taking advantage of evolutiona review" 18071812.

29 Frederiksen B, "Changing epidemiology ofPseudomonas aeruginosainfection in Danish cystic fibrosis pa-tients (19741995)" 28 : 159166-, 1999

30 Song CS, "Antibodies to thealpha-subunit of insulin receptor from eggs of immunized hens"

31 "Acquisition ofPseudomonas aeruginosa in younginfants" 133134-, 1997