IMMUNOGLOBULIN-COATED BACTERIA IN EFFUSIONS OBTAINED DURING CHRONIC MAXILLARY SINUSITIS

Local protection of the maxillary sinuses against bacterial invasion t akes both specific and non-specific forms. The present study is intend ed to evaluate the participation of the specific protective factors, i mmunoglobulins IgG, secretory IgA, IgM and complement, in protecting t he maxillary sinuses during chronic maxillary sinusitis (CMS). We coll ected 47 sinus effusion samples from 37 patients (17 male, 20 female) with current CMS of at least 3 months' duration. Patients' ages ranged from 3 to 80 years. The effusion material was subjected to qualitativ e and quantitative bacteriological analyses, while bacterial coating w ith IgG, SIgA, IgM and C3b was determined using an immunofluorescence technique. Detectable bacteria were harboured by 55% of the samples, t he most common species being Moraxella catarrhalis, Streptococcus pneu moniae and Staphylococcus aureus. The bacterial counts ranged from 0 t o 10(9) per mi effusion. Half of the samples hosting detectable bacter ia showed microorganisms coated with protective immunoglobulins. Antib acterial factors had completely eradicated the microorganisms in 45% o f the CMS cases and coated the organisms with specific immunoglobulins in a further 28%.