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Here, we sought to differentiate the <jats:italic>P. aeruginosa<\/jats:italic> isolates from early versus established stages of infection in CF patients and to determine if LasB was associated with either stage. The <jats:italic>lasB<\/jats:italic> gene was amplified from 255 <jats:italic>P. aeruginosa<\/jats:italic> clinical isolates from 70 CF patients from the Toulouse region (France). Nine LasB variants were identified and 69% of the isolates produced detectable levels of LasB activity. Hierarchical clustering using experimental and clinical data distinguished two classes of isolates, designated as \u2018Early\u2019 and \u2018Established\u2019 infection. Multivariate analysis revealed that the isolates from the Early infection class show higher LasB activity, fast growth, tobramycin susceptibility, non-mucoid, pigmented colonies and wild-type <jats:italic>lasR<\/jats:italic> genotype. These traits were associated with younger patients with polymicrobial infections and high pFEV<jats:sub>1<\/jats:sub>. Our findings show a correlation between elevated LasB activity in <jats:italic>P. aeruginosa<\/jats:italic> isolates and early-stage infection in CF patients. Hence, it is this patient group, prior to the onset of chronic disease, that may benefit most from novel therapies targeting LasB.<\/jats:p>","DOI":"10.1038\/s41598-023-41333-9","type":"journal-article","created":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T10:02:50Z","timestamp":1693389770000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Higher levels of Pseudomonas aeruginosa LasB elastase expression are associated with early-stage infection in cystic fibrosis patients"],"prefix":"10.1038","volume":"13","author":[{"given":"Agustina","family":"Llanos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Achard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justine","family":"Bousquet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarisse","family":"Lozano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Zalacain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole","family":"Sable","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9l\u00e8ne","family":"Revillet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marl\u00e8ne","family":"Murris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Mittaine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Lemonnier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Everett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,8,30]]},"reference":[{"key":"41333_CR1","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/S2213-2600(19)30337-6","volume":"8","author":"SC Bell","year":"2020","unstructured":"Bell, S. 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