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Role of cations and IgA in saliva-mediated aggregation of Pseudomonas aeruginosa in cystic fibrosis patients.

Oral colonization by Pseudomonas aeruginosa possibly precedes the pulmonary infection process in cystic fibrosis (CF) patients. As bacterial aggregates may play a role in establishment of pulmonary infections, involvement of IgA and cations in CF patient saliva-mediated aggregation of P. aeruginosa was investigated. For colonized patients, P. aeruginosa aggregation correlated with bacterial-specific and total salivary IgA. Cation or IgA depletion reduced P. aeruginosa aggregation by saliva from all patients. However, if cations were removed before IgA, and saliva was then reconstituted with calcium, only colonized patient saliva showed reduced aggregation. Aggregation by IgA-depleted saliva was augmented by reconstituting with original IgA. CF patient saliva-mediated aggregation of P. aeruginosa thus is cation-dependent and enhanced by bacterial-specific IgA. Characterizing the interactions among bacterial aggregating factor(s), cations, and antibodies in CF saliva will help clarify the link between P. aeruginosa oral colonization and pulmonary infections in CF patients.