Plasmapheresis as rescue therapy in severe bronchiectasis with blocking anti pseudomonas antibodies

Rationale: There are few salvage therapies for advanced bronchiectasis. Recently, we identified a subset of patients with non-cystic fibrosis bronchiectasis and chronic Pseudomonas aeruginosa infection (1). These patients had an excess of IgG2 specific to the bacterial O-antigen. This IgG2 inhibited immune killing of the infecting strain. Patients with inhibitory antibody had worse lung disease (1). Here we describe the treatment of two critically ill patients with non-cystic fibrosis bronchiectasis. Each patient had inhibitory antibodies, chronic Pseudomonas infection and had experienced clinical decline despit…