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| The first 150 words of the full text of this article appear below. |
Thirty years ago Staphylococcus
aureus and not Pseudomonas aeruginosa
was considered to be the most important lung pathogen in cystic
fibrosis.1 Those who believed that P
aeruginosa was a pathogen in cystic fibrosis thought that
various virulence factors such as exotoxin A, exoenzyme S, elastase,
alkaline protease, phospholipase C, lipopolysaccharide and phenazine
pigments were responsible for the lung tissue damage by drawing
parallels with acute P aeruginosa infections
in patients with burns or leukaemia.2 Only acute
exacerbations, frequently caused by a virus,3 were therefore treated with antibiotics, although invasive disseminating P aeruginosa infection including bacteraemia
was never found in cystic fibrosis.4 However, a very
pronounced antibody response to P aeruginosa
antigens, including its virulence factors, was detected in patients
with cystic fibrosis and the pathogenesis of the lung tissue damage was
subsequently found to be caused by immune complex mediated inflammation
dominated by polymorphonuclear leucocytes releasing proteolytic
enzymes.5-7 Since the
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