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Chronic Chlamydia pneumoniae infection and
asthma exacerbations in children. A.F. Cunningham, S.L.
Johnston, S.A. Julious, F.C. Lampe, M.E. Ward. ©ERS
Journals Ltd 1998.
ABSTRACT: This study was undertaken to investigate
the reported association between Chlamydia pneumoniae
and Mycoplasma pneumoniae infection and the
expression of asthma-related symptoms.
One hundred and eight children with asthma symptoms, aged
9-11 yrs, completed a 13 month longitudinal study. The
children maintained a daily diary of respiratory symptoms
and peak flow rates. When respiratory symptoms were reported
an investigator was called and a nasal aspirate obtained. In
total 292 episodes were reported. After the study 65
children provided samples when asymptomatic. The presence of
infection was investigated by the polymerase chain reaction
for C. pneumoniae and M. pneumoniae and C.
pneumoniae secretory immunoglobulin A (IgA) was detected
by amplified enzyme immunoassay.
C. pneumoniae detections were similar between the
symptomatic and asymptomatic episodes (23 versus 28%,
respectively). Children who reported multiple episodes also
tended to remain PCR positive for C. pneumoniae
suggesting chronic infection (p<0.02). C.
pneumoniae-specific secretory-IgA antibodies were more
than seven times greater in subjects who reported four or
more exacerbations in the study compared to those who
reported just one (p<0.02). M. pneumoniae was
found in two of 292 reports and in two of 65 asymptomatic
samples.
In conclusion, chronic Chlamydia pneumoniae infection
is common in schoolage children and immune responses to
C. pneumoniae are positively associated with
frequency of asthma exacerbations. We suggest that the
immune response to chronic C. pneumoniae infection
may interact with allergic inflammation to increase asthma
symptoms. In contrast Mycoplasma pneumoniae was not
found to be important in this study.
Eur Respir J 1998; 11: 345-349.
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*Molecular Microbiology, +University
Medicine and §Dept of Medical Statistics and Computing,
Southampton University Medical School, Southampton General
Hospital, Southampton, UK.
Correspondence: A. Cunningham
Dept of Infection
University of Birmingham
Edgbaston
Birmingham B15 2TT
UK
Fax: 44 1214146956
Keywords: Asthma exacerbations
Chlamydia pneumoniae
Mycoplasma pneumoniae
polymerase chain reaction
secretory immunoglobulin A
Received: March 4, 1997
Accepted after revision October 28 1997
A.F.C. was a recipient of a Medical
Research Council Studentship. S.L.J. was supported by a
British Medical Association HC Roscoe Fellowship, Action
Research, The National Asthma Campaign and the British Lung
Foundation.
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