Molecular epidemiology of respiratory viruses in virus-induced
asthma. H Tsukagoshi, T Ishioka, M Noda, K Kozawa, H Kimura. Front
Microbiol 2013 Sep 12;4:278. Review.
"The family Mycoplasmataceae contains two genera that infect humans: Mycoplasma and Ureaplasma, which are usually referred to collectively as mycoplasmas. Although there are many species of mycoplasmas, only four are recognized as human pathogens; Mycoplasma pneumoniae, Mycoplasma hominis, Mycoplasma genitalium, and Ureaplasma urealyticum... The mycoplasmas are the smallest free-living bacteria. They range from 0.2 - 0.8 micrometers and thus can pass through some filters used to remove bacteria. They have the smallest genome size and, as a result, lack many metabolic pathways and require complex media for their isolation. The mycoplasmas are facultative anaerobes, except for M. pneumoniae, which is a strict aerobe. A characteristic feature that distinguishes the mycoplasmas from other bacteria is the lack of a cell wall. Thus, they can assume multiple shapes including round, pear shaped and even filamentous... Colonization of the respiratory tract by M. pneumoniae results in the cessation of ciliary movement. The normal clearance mechanisms of the respiratory tract do not function, resulting in contamination of the respiratory tract and the development of a dry cough... most children are infected from 2 - 5 years of age but disease is most common in children 5-15 years of age." (Bacteriology - Chapter Nineteen. Mycoplasma and Ureaplasma. Dr. Gene Mayer, University of South Carolina School of Medicine. Accessed 12-15-07.)Mycoplasma and Ureaplasma / U. of South Carolina School of Medicine
Mycoplasma pneumoniae and its role
as a human pathogen. KB Waites, DF Talkington. Clin Microbiol Rev 2004
Oct;17(4):697-728. Review. "M. pneumoniae infection leads to
deterioration of cilia in the respiratory epithelium, both structurally
and functionally. Cells may lose their cilia entirely, appear
vacuolated, and show a reduction in oxygen consumption, glucose
utilization, amino acid uptake, and macromolecular synthesis,
ultimately resulting in exfoliation of all or parts of the infected
cells (80, 83) These subcellular events can be translated into some of
the clinical manifestations of respiratory tract infection that are
associated with this organism, such as the persistent, hacking cough
that is so commonly associated with M. pneumoniae." "Mycoplasmas have
been detected by PCR in airways even when cultures and serological
results are negative, suggesting that low numbers of organisms may
evade detection by the immune system." "Lung abnormalities, including
reduced pulmonary clearance and airway hyperresponsiveness, may persist
for weeks to months after an infection with M. pneumoniae."
Association of Chlamydia pneumoniae (strain TWAR) infection with
wheezing, asthmatic bronchitis and adult-onset asthma. DL Hahn, R
Dodge, R Golubjatnikov. JAMA 1991;266:225-230. "Nine (47%) of 19
patients with acute C pneumoniae infection had bronchospasm during
respiratory illness, and there was a strong quantitative association of
C pneumoniae titer with wheezing at the time of enrollment in the study
(P = .01). In the matched study, C pneumoniae antibody was
significantly associated with asthmatic bronchitis after, but not
before, respiratory illness (odds ratio, 7.2; 95% confidence interval,
2.2 to 23.4). Four infected patients had newly diagnosed asthma after
illness, and four others had exacerbation of previously diagnosed
asthma. There was no serologic evidence of coexisting Mycoplasma
pneumoniae, Chlamydia trachomatis, or respiratory viral infection in
96% of patients with asthmatic bronchitis and asthma."
Chlamydial pneumonia and asthma: a potentially important
relationship. RC Bone. JAMA 1991 Jul 10;266(2):265. No abstract.
Viruses as precipitants of asthma symptoms. I. Epidemiology. PK Pattemore, SL Johnston, PG Bardin. Clin Exp Allergy 1992 Mar;22(3);325-336. Review.Pattemore - Clin Exp Allergy 1992 abstract / PubMed
Chlamydia pneumoniae infection and asthma. DL Hahn. The Lancet 1992 May 9;339:1173-1174. Letter. "I would add another possible explanation that has not received the attention it deserves -- increasing worldwide prevalence of Chlamydia pneumoniae infection." No abstract.
Chlamydia trachomatis infection in children with wheezing simulating asthma. M Bavastrelli, M Midulla, D Rossi, M Salzano. Lancet 1992 May 9;339:1174. Letter. "Our data indicate that wheezing may be another clinical expression of C trachomatis infection and that this organism should be sought as a routine in children who wheeze but have no demonstrable allergy and do not respond to the usual anti-asthmatic medications." No abstract.
Viruses as precipitants of asthma symptoms. II. Physiology and
mechanisms. PG Bardin, SL Johnston, PK Pattemore. Clin Exp Allergy 1992
Sep;22(9):809-822. Review. "As most hospital admissions for asthma
occur over the winter months and soon after the start of the school
terms, spread of viruses through the community to susceptible
individuals may be the single most important cause of sustained
exacerbations of asthma."
Relationship between viral antibodies and bronchial
hyperresponsiveness in 495 unselected children and adolescents. V
Backer, CS Ulrick, N Bach-Mortensen, G Glikmann, CH Mordhorst. Allergy
1993 May;48(4):240-247. "Bronchial hyperresponsiveness (BHR) to inhaled
histamine was found in 79 (16%) of the subjects, of whom 28 had asthma.
Forty-eight subjects (10%) had increased levels of serum IgM antibodies
against either parainfluenza, influenza, adenovirus, or respiratory
syncytial virus (RSV), reflecting a recently acquired infection. No
association between BHR and antibodies against respiratory viruses was
found, as 7 (8.9%) of the 79 subjects with BHR and 41 (9.9%) of the 416
subjects without BHR had viral antibodies. Furthermore, no association
between degree of bronchial responsiveness and viral antibodies was
Another possible risk factor for airway disease. DL Hahn. Chest 1993 Aug;104(2):649. Letter. "In an editorial that also appeared in the March 1992 issue of Chest, Casterline therefore asks, 'Will the real risk factor for airway disease please stand up?' I have a nomination for a possible culprit, who appears to be trying to get up, but will need some prodding from investigators." No abstract.
Persistent adenoviral infection and chronic airway obstruction in
children. V Macek, J Sorli, S Kopriva, J Marin. Am J Respir Crit Care
Med 1994 Jul;150(1):7-10. 34 children aged 14 months to 14 years "who
showed an unfavorable response to standard corticosteroid and
bronchodilator therapy. Analysis of cytospin preparations of BAL fluid
at the light-microscopic level, using a monoclonal antibody to detect
adenoviral antigens, demonstrated that capsid protein was present in 31
of 34 (94%) of the children examined. Limited repeat studies within 1
yr showed 6 of 8 (75%) were positive twice when tested on two
occasions, and that three were positive in all occasions when sampled
three times. Cultures of the BAL fluid were also positive for
adenovirus in six of six cultures performed, indicating that the virus
was in some cases replicating. Similar studies of control patients
without persistent asthma showed no evidence of adenovirus."
Acute acerbations of asthma in adults: role of Chlamydia pneumoniae
infection. L Allegra, F Blasi, S Centanni, R Cosentini, F Denti, R
Raccanelli, P Tarsia, V Valenti. Eur Respir J 1994 Dec;7(12):2165-2168.
Seventy four adult out-patients with a diagnosis of acute exacerbation
of asthma. "Fifteen patients (20%) presented seroconversion to at least
one of the studied pathogens. Seven were found to be infected by virus,
six by C. pneumoniae alone, and one by M. pneumoniae. One more patient
showed seroconversion to C. pneumoniae and cytomegalovirus."
Community study of role of viral infections in exacerbations of
asthma in 9-11 year old children. SL Johnston, PK Pattemore, G
Sanderson, S Smith, F Lampe, L Josephs, P Symington, S O'Toole, SH
Myint, DAJ Tyrrell, ST Holgate. BMJ 1995 May 13;310(6989):1225-1229.
108 children. "Viruses were detected in 80% of reported episodes of
reduced peak expiratory flow, 80% of reported episodes of wheeze, and
in 85% of reported episodes of upper respiratory symptoms, cough,
wheeze, and a fall in peak expiratory flow. The median duration of
reported falls in peak expiratory flow was 14 days, and the median
maximum fall in peak expiratory flow was 81 1/min. The most commonly
identified virus type was rhinovirus." Graph of seasonal patterns.
Serology of Chlamydia in relation to asthma and bronchial
hyperresponsiveness. E Bjornsson, E Hjelm, C Janson, E Fridell, G
Boman. Scand J Infect Dis 1996;28(1):63-69. 122 subjects with asthma vs
75 controls. "For Chlamydia pneumoniae, a relationship was found
between current or recent infection and wheezing (odds ratio (OR) 6.0,
confidence intervals (CI) 1.3-28) and also between IgA antibodies and
bronchial hyperresponsiveness (BHR) (OR 3.3, CI 1.3-8.3). For Chlamydia
trachomatis, serological signs of a previous infection were found
significantly more often in subjects who reported having had asthma at
some time: (OR 3.2, CI 1.4-7.1), asthma during the last year (OR 3.2,
CI 1.4-7.1), wheezing during the last year (OR 4.2, CI 1.6-6.6) and in
those who had BHR (OR 2.7, CI 1.2-6.1)."
The relationship between upper respiratory infections and hospital
admissions for asthma: a time-tend analysis. SL Johnston, PK Pattemore,
G Sanderson, S Smith, MJ Campbell, LK Josephs, A Cunningham, BS
Robinson, SH Myint, ME Ward, DA Tyrrell, ST Holgate. Am J Respir Crit
Care Med 1996 Sep;154(3 Pt 1):654-660. 108 school-age children
monitored for 1 year. "Strong correlations were found between the
seasonal patterns of upper respiratory infections and hospital
admissions for asthma (r = 0.72; p < 0.0001). This relationship was
stronger for pediatric (r = 0.68; p < 0.0001) than for adult
admissions (r = 0.53; p < 0.01). Upper respiratory infections and
admissions for asthma were more frequent during periods of school
attendance (87% of pediatric and 84% of total admissions), than during
school holiday periods (p < 0.001)."
Influence of viral and bacterial respiratory infections on exacerbations and symptom severity in childhood asthma. SL Johnston. Pediatr Pulmonol Suppl 1997;16:88-89. Review.Johnston - Pediatr Pulmonol Suppl 1997 abstract / PubMed
Evidence for Chlamydia pneumoniae infection in steroid-dependent asthma. DL Hahn, D Bukstein, A Luskin, H Zeitz. Ann Allergy Asthma Immunol 1998 Jan;80(1):45-49.Hahn - Ann Allergy Asthma Immunol 1998 abstract / PubMed
Can acute Chlamydia pneumoniae respiratory tract infection initiate chronic asthma? DL Hahn, R McDonald. Ann Allergy Asthma Immunol 1998 Oct;81:339-344.Hahn - Ann Allergy Asthma Immunol 1998 abstract / PubMed
Detection of mycoplasma pneumoniae in the airways of adults with
chronic asthma. M Kraft, GH Cassell, JE Henson, H Watson, J Williamson,
BP Marmion, CA Gaydos, RJ Martin. Am J Respir Crit Care Med
1998;158:998-1001. Eighteen asthmatics with chronic, stable asthma and
11 nonasthmatic controls. "M.
pneumoniae was detected by PCR in 10 of 18 asthmatics and one of
11 control subjects (p = 0.02). In nine of the 10 patients, the
organism was detected in bronchoalveolar lavage or bronchial biopsies.
Seven of 18 asthmatics and one of 11 control subjects were also
positive for M. fermentans and
M. genitalium by PCR. All
patients' cultures, EIAs, and serology were negative for M. pneumoniae. All PCR and cultures
were negative for C. pneumoniae,
and all EIAs for respiratory viruses were negative in all subjects.
Nine asthmatics and one control subject exhibited positive serology for
C. pneumoniae (p = 0.05)."
Chronic Chlamydia pneumoniae infection and asthma exacerbations in
children. AF Cunningham, SL Johnston, SA Julius, FC Lampe, ME Ward. Eur
Respir J 1998 Feb;11(2):345-349. One hundred and eight children with
asthma symptoms, aged 9-11 yrs. "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
Viruses and asthmatic syndromes. E Micillo, P Marcatili, S Palmieri, G Mazzarella. Monaldi Arch Chest Dis 1998 Feb;53(1):88-91. Review.Micillo / Monaldi Arch Chest Dis 1998 abstract / PubMed
Mechanisms of asthma exacerbation. SL Johnston. Clin Exp Allergy 1998;28(Suppl 5):181-186. Review.Johnston - Clin Exp Allergy 1998 (no abstract) / PubMed
Viruses and asthma. SL Johnston. Allergy 1998;53:922-932. Review.Johnston - Allergy 1998 (no abstract) / PubMed
Chlamydia pneumoniae and asthma. PJ Cook, P Davies, W Tunnicliffe, JG Ayres, D Honeybourne, R Wise. Thorax 1998 Apr;53(4):254-259.Cook / Thorax 1998 full article
Chlamydia pneumoniae and possible relationship to asthma. Serum immunoglobulins and histamine release in patients and controls. FO Larson, S Norn, CH Mordhorst, PS Skov, N Milman, P Clementsen. APMIS 1998 Oct;106(10):928-934.Larsen - APMIS 1998 abstract / PubMed
Viruses and asthma exacerbations. NG Papadopoulos, SL Johnston. Thorax 1998 Nov;53(11):913-914. Review.Papadopoulos / Thorax 1998 full article
Chlamydia pneumoniae and asthma. F Blasi, L Allegra, P Tarsia. Thorax 1998 Dec;53(12):1094. Letter re Cook 1998.Blasi / Thorax 1998 full article
Chlamydia pneumoniae and asthma. DL Hahn. Thorax 1998 Dec;53(12):1095-1096. Letter re Cook 1998.Hahn / Thorax 1998 full article
Bacterial infection as an important triggering factor in bronchial asthma. AK Oehling. J Investig Allergol Clin Immunol 1999 Jan-Feb;9(1):6-13. Review.Oehling - J Invstig Allergol Clin Immunol 1999 abstract / PubMed
PCR detection of viral nucleic acid in fatal asthma: is the lower respiratory tract a reservoir for common viruses? V Macek, A Dakhama, JC Hogg, FH Green, BK Rubin, RG Hegele. Can Respir J 1999 Jan-Feb;6(1):37-43.Macek - Can Respir J 1999 abstract / PubMed
Detection of viral, Chlamydia pneumoniae and Mycoplasma pneumoniae infections in exacerbations of asthma in children. F Freymuth, A Vabret, J Brouard, P Toutain, R Verdon, J Petitjean, S Gouarin, J-F Duhamel, B Guillois. J Clin Virol 1999;13:131-139.Freymouth - J Clin Virol 1999 abstract / PubMed
The role of viral and atypical bacterial pathogens in asthma pathogenesis. SL Johnston. Pediatric Pulmonol Suppl 1999;18:141-143. Review.Johnston - Pediatr Pulmonol Suppl 1999 abstract / PubMed
Not an ideal study. DL Hahn. J Family Pract 1999 Mar;48(3):230. (Letter re Smucny). "In addition to relevant clinical variables, I believe that meaningful studies of acute bronchitis must include objective measures of pulmonary function (including reversibility) and [italics] comprehensive evaluation of microbiologic causes for bronchitis; without subgroup analyses based on these variables, I doubt that clinicians will ever have access to the information they need to provide rational antibiotic prescribing for acute bronchitis in otherwise healthy patients." (No abstract).Hahn - J Fam Pract 1999 (no abstract) / PubMed
Treatment of late-onset asthma with fluconazole. GW Ward Jr, JA
Woodfolk, ML Hayden, S Jackson, TAE Platts-Mills. J Allergy Clin
Immunol 1999 Sep;104(3 Pt 1):541-546. Randomized controlled study of 11
patients. "At the end of the first 5 months of active treatment, there
was a highly significant decrease in bronchial sensitivity to
Trichophyton (P = .012) and in oral steroid requirement (P = .01). At
the end of phase 2, mean peak expiratory flow rates increased in 9 of
11 patients. An improvement in symptoms, peak flow, and steroid use was
maintained up to 36 months after starting fluconazole in patients who
continued to receive treatment."
New understanding of disease mechanisms: excitement and caution. DA Stempel. J Allergy Clin Immunol 1999 Sep;104(3 Pt 1):524-525. Editorial re Ward 1999.Stempel / J Allergy Clin Immunol 1999 full article
Community study using a polymerase chain reaction panel to determine the prevalence of common respiratory viruses in asthmatic and nonasthmatic children. JA West, A Dakhama, MA Khan, S Vedal, RG Hegele. J Asthma 1999 Oct;36(7):605-612.West - J Asthma 1999 abstract / PubMed
Chlamydia pneumoniae, asthma, and COPD: what is the evidence? DL Hahn. Ann Allergy Asthma Immunol 1999 Oct;83(4):271-292. Review, with CME examination.Hahn - Ann Allergy Asthma Immunol 1999 abstract / PubMed
Childhood viral infection and the pathogenesis of asthma and chronic obstructive lung disease. JC Hogg. Am J Respir Crit Care Med 1999 Nov;160(5 Pt 2):826-828. Review.Hogg - Am J Respir Crit Care Med 1999 abstract / PubMed
Respiratory infections and asthma. E Micillo, A Bianco, D D'Auria, G Mazzarella, GF Abbate. Allergy 2000;55 Suppl 61:42-45. Review.Micillo - Allergy 2000 abstract / PubMed
Serologic markers for Chlamydia pneumoniae in asthma. DL Hahn, RW Peeling, E Dillon, R McDonald, P Saikku. Ann Allergy Asthma Immunol 2000 Feb;84(2):227-233.Hahn - Ann Allergy Asthma Immunol 2000 abstract / PubMed
Serological evidence of infection with Chlamydia pneumoniae is
related to the severity of asthma. PN Black, R Scicchitano, CR Jenkins,
F Blasi, L Allegra, J Wlodarczyk, BC Cooper. Eur Respir J 2000
Feb;15(2):254-259. 619 subjects with asthma (18-60 yrs), by
microimmunofluoresence. "The use of high dose inhaled steroids was
associated with an increase of 74.1% in the titre of IgG antibodies
(p=0.04) and an increase of 70.6% in the titre of IgA antibodies
(p=0.0001) when compared with the use of low dose inhaled steroids.
There was an inverse association between IgG antibodies and forced
expiratory volume in one second (FEV1) as a percentage of predicted in
those subjects with elevated IgG and/or IgA (p=0.04). In this group IgA
antibodies were also associated with a higher daytime symptom score
Lack of correlation between Chlamydia pneumoniae antibody titers and
adult-onset asthma. JM Routes, HS Nelson, JA Noda, FT Simon. J Allergy
Clin Immunol 2000 Feb;105(2 Pt 1):391-392. 46 asthma patients and 46
age- and sex-matched controls. "Nearly two thirds of control and
asthmatic patients had never smoked. There was no significant
difference (Fig 1) in the proportion of asthmatic or control subjects
with IgG titers against C pneumoniae that would signify acute infection
(IgG ≥1:512), indeterminate exposure (1:16 ≥ IgG < 1:512) or
seronegativity (IgG <16) (chi-square test, P = .755)."
Viral and bacterial infections in the development and progression of asthma. JE Gem. J Allergy Clin Immunol 2000 Feb;105(2 Pt 2):S497-S502. Review.Gern / J Allergy Clin Immunol 2000 full article (pdf, 6 pp)
Persistence of viruses in the upper respiratory tract of children with asthma. J Marin, D Jeler-Kacar, V Levsiek, V Macek. J Infect 2000 Jul;41(1):69-72. "Conclusions: The persistent presence of viruses in the upper respiratory tract of asthmatic children shows a possible connection between viral infections and asthma."Marin - J Infect 2000 abstract / PubMed
The role of atypical organisms in asthma. CM Daian, AH Wolff, L Bielory. Allergy Asthma Proc 2000 Mar-Apr;21(2):107-111. Review.Daian - Allergy Asthma Proc 2000 abstract / PubMed
Chlamydia pneumoniae serological status is not associated with asthma in children or young adults. GD Mills, JA Lindeman, JP Fawcett, GP Herbison, MR Sears. Int J Epidemiol 2000 Apr;29(2):280-284. "The study has not, however, addressed the role this organism may play in specific asthmatic subjects or asthma exacerbations."Mills - Int J Epidemiol 2000 abstract / PubMed
[Chlamydia pneumoniae infection in patients with acute bronchitis and bronchial asthma]. M Oshima, Y Awaya, T Fujii, Y Kodomari, M Kuwabara. Arerugi 2000 May;49(5):412-419.Oshima - Arerugi 2000 abstract / PubMed
Sensitivity to fungal allergens is a risk factor for life-threatening asthma. PN Black, AA Udy, SM Brody. Allergy 2000 May;55(5):501-504.Black - Allergy 2000 abstract / PubMed
[Chronic Chlamydia pneumoniae infection in patients with asthma]. J Niedzwiadek, E Mazur, J Chmielewska-Badora, B Gryglicka, I Wegrzyn-Szkutnik, B Chabros, M Koziol-Montewka, J Milanowski. Pneumonol Alergol Pol 2000;68(5-6):255-260.Niedzwiadek - Pneumonol Alergol Pol 2000 abstract / PubMed
The role of bacterial infections in asthma. M Kraft. Clin Chest Med 2000 Jun;21(2):301-313. Review.Kraft - Clin Chest Med 2000 abstract / PubMed
The role of viruses in development or exacerbation of atopic asthma. J Schwarze, EW Gelfand. Clin Chest Med 2000 Jun;21(2):279-287. Review.Schwarze - Clin Chest Med 2000 abstract / PubMed
The role of respiratory viruses in acute and chronic asthma. A Tuffaha, JE Gern, RF Lemanske. Clin Chest Med 2000 Jun;21(2):289-300. Review.Tuffaha - Clin Chest Med 2000 abstract / PubMed
Specific and nonspecific obstructive lung disease in childhood: causes of changes in the prevalence of asthma. TA Platts-Mills, MC Carter, PW Heymann. Environ Health Perspect 2000 Aug;108 Suppl 4:725-731. Review.Platts-Mills - Environ Health Perspect 2000 abstract / PubMed
Chlamydia pneumoniae antibodies and adult-onset asthma. DL Hahn. J
Allergy Clin Immunol 2000 Aug;106(2):404. Letter re Routes 2000. "...In
any event, I agree with the authors' general conclusions that serologic
testing alone will not be clinically useful in selecting asthmatic
patients for antimicrobial therapy. Although C pneumoniae IgA antibody
testing can be specific (if C trachomatis and C psittaci antigens are
used as parallel controls), it is unlikely that IgA is sufficiently
sensitive; furthermore, serologic testing cannot identify the location
[Impact of Chlamydia pneumoniae infections on asthma]. G Jebrak, O Brugiere, ML Uffredi. Presse Med 2000 Sep 9;29(25):1425-1431. Review.Jebrak - Presse Med 2000 abstract / PubMed
[Percentage of asthmatic patients with acute bronchitis and Chlamydia pneumoniae seropositivity]. J Orfila, P Godard. Presse Med 2000 Sep 9;29(25):1439-1441.Orfila - Presse Med 2000 abstract / PubMed
Chlamydia pneumoniae and the lung. MR Hammerschlag. Eur Respir J
2000 Nov;16(5):1001-1007. Comment.
[The role of fungal allergy in bronchial asthma]. K Akiyama. Nippon Ishinkin Gakkai Zasshi 2000;41(3):149-155. Review.Akiyama - Nippon Ishinkin Gakkai Zasshi 2000 abstract / PubMed
Prevalence of Chlamydia pneumoniae in acute respiratory tract
infection and detection of anti-Chlamydia pneumoniae-specific IgE in
Japanese childen with reactive airway disease. S Ikezawa. Kurume Med J
2001;48(2):165-170. 411 children with acute respiratory tract
infection. "Evidence of infection with C. pneumoniae was detected in 58
children with pneumonia (34.5%), bronchitis (41.4%) and upper
respiratory tract infection (24.1%). Twenty-nine (50.0%) out of 58
patients were younger than 5 years old and 18 (31.0%) had wheezing at
first visit. A logistic test for anti-C. pneumoniae-specific IgE showed
the deference in the fluorescence unit between the patients with C.
pneumoniae infection with and without wheezing was statistically
significant (Po = 0.02748, to = 2.31891)."
Persistent airflow limitation in adult-onset nonatopic asthma is
associated with serologic evidence of Chlamydia pneumoniae infection. A
ten Brinke, JT van Dissell, PJ Sterk, AH Zwinderman, KF Rabe, EH Bel. J
Allergy Clin Immunol 2001 Mar;107(3):449-454. 32 men and 69 women
nonsmokers. "Patients with adult-onset nonatopic asthma and positive
IgG antibodies to C pneumoniae had a significantly steeper slope of the
regression line compared with the other subgroups of asthmatic patients
(P =.001), being indicative of a 4-fold greater estimated decline in
postbronchodilator FEV(1)/vital capacity (2.3% vs 0.5% predicted per
year of asthma duration)."
A link between chronic asthma and chronic infection. RJ Martin, M
Kraft, HW Chu, EA Berns, GH Cassell. J Allergy Clin Immunol 2001
Apr;107(4):595-601. 55 asthma patients vs 11 normal controls. "PCR for
Mycoplasma species showed that 23 asthmatic patients had positive test
results for M pneumoniae , and an additional 2 had positive test
results for either M genitalium or M fermentans... Four subjects had
positive results for either M genitalium or M fermentans plus M
pneumoniae . Thus 25 of 55 asthmatic patients had positive PCR results
for a Mycoplasma species pathogen compared with 1 of 11 control
subjects (P = .007). PCR for C pneumoniae demonstrated 7 asthmatic
patients with positive test results compared with zero such control
subjects (P = .04, Fig 1). Of these 7 asthmatic patients, one had
positive results for both C pneumoniae and M pneumoniae . Thus for the
55 asthmatic subjects, 31 (56.4%) had positive results for either
Mycoplasma species, Chlamydia species, or both."
Increased frequency of Chlamydia pneumoniae antibodies in patients
with asthma. M Gencay, JJ Rudiger, M Tamm, M Soler, AP Perruchoud, M
Roth. Am J Respir Crit Care Med 2001 Apr;163(5):1097-1100. 33 adults
with a clinical history of asthma, positive methacholine test, and
reduced FEV(1), versus 33 age-, sex-, and locality-matched controls.
"Chlamydia pneumoniae-specific IgA was detected in 52% of the patients
with asthma and in 15% of the healthy control subjects (p < 0.01).
Serological evidence of chronic infection with C. pneumoniae (high IgG
[> pr = 1:512] and high IgA [> or = 1:40]) was more frequent in
patients with asthma (18.2%) compared with control subjects (3.0%) (p
Host immune response to Chlamydia pneumoniae heat shock protein 60
is associated with asthma. T Huittinen, D Hahn, T Anttila, E Wahlstrom,
P Saikku, M Leinonen. Eur Respir J 2001 Jun;17(6):1078-1082. C
pneumoniae Hsp60 IgA antibodies were significantly associated with
asthma, p = 0.02. "Pulmonary function, as measured by forced expiratory
volume in one second, also inversely correlated (r=−0.23, p=0.04) with
the quantity of C. pneumoniae Hsp60 IgA antibodies, suggesting an
association with the severity of pulmonary obstruction."
Trial of roxithromycin in subjects with asthma and serological evidence of infection with Chlamydia pneumoniae. PN Black, F Blasi, CR Jenkins, R Scicchitano, GD Mills, AR Rubinfeld, RE Ruffin, PR Mullins, J Dangain, BC Cooper, DB David, L Allegra. Am J Respir Crit Care Med 2001 Aug 15;164(4):536-541. "Six weeks of treatment with roxithromycin led to improvements in asthma control but the benefit was not sustained."Black - Am J Respir Crit Care Med 2001 abstract / PubMed
Activated, cytotoxic CD8(+) T lymphocytes contribute to the
pathology of asthma death. S O'Sullivan, L Cormican, JL Faul, S
Ichinohe, SL Johnston, CM Burke, LW Poulter. Am J Respir Crit Care Med
2001 Aug 15;164(4):560-564. Seven patients who died an asthma death
(AD), seven asthmatic patients who died of unrelated causes (AUC), and
seven postmortem cases with no history of lung disease. "The percentage
of CD8(+) cells expressing the activation marker CD25 was higher in the
AD group than in both the AUC and control groups (11.91 +/- 1.92%
versus 3.93 +/- 1.63% and 1.09 +/- 0.56%, respectively (p < 0.001).
Perforin expression, a marker of cytotoxicity, was highest in the AD
group (9.16 +/- 1.5%) compared with 1.39 +/- 0.9; 1.8 +/- 0.6% in the
AUC and control groups respectively (p < 0.001). Expression of
interleukin-4 (IL-4) and interferon gamma (IFN-gamma) by CD8(+) T cells
was higher in the AD group than the control group (p < 0.05).
Furthermore, the IFN-gamma/IL-4 ratio in the AD group was less than
half that of the control group (1.46 +/- 0.2 versus 3.2 +/- 0.1; p =
0.02). Using polymerase chain reaction (PCR), viral genome for
rhinovirus (RV) was detected in lung tissue from three of the seven
cases in the AD group. Two of these cases also had detectable
respiratory syncytial virus (RSV). Viral genome for RSV was detected in
five of the AUC group and in one of these cases, RV was also detected.
No viral genome was detected in the lungs of the control group."
Chlamydia pneumoniae and severity of asthma. HL Von, T Vasankari, K Liippo, E Wahlstrom, M Puolakkainen. Scand J Infect Dis 2002;34(1):22-27. "Severe and moderate asthma were significantly associated with elevated IgA antibody levels to C. pneumoniae suggestive of chronic infection."Von - Scand J Infect Dis 2002 abstract / PubMed
Chlamydia pneumoniae immunoglobulin A reactivation and airway inflammation in acute asthma. PA Wark, SL Johnston, JL Simpson, MJ Hensley, PG Gibson. Eur Respir J 2002 Oct;20(4):834-840. "the serological features suggest that Chlamydia pneumoniae reactivation may trigger neutrophilic airway inflammation in acute asthma."Wark - Eur Respir J 2002 abstract / PubMed
Is asthma an infectious disease?: Thomas A. Neff lecture. RF
Lemanske Jr. Chest 2003 Mar;123(3 Suppl):385S-90S. Review. "The data to
support a potential role for these agents in asthma is most convincing
for C pneumoniae. The major impedance in studying the contribution of
this organism to asthma pathogenesis has been the lack of a sensitive,
specific, reliable, and convenient diagnostic laboratory test."
Anti-Chlamydia pneumoniae heat shock protein 10 antibodies in
asthmatic adults. F Betsou, JM Sueur, J Orfila. FEMS Immunol Med
Microbiol 2003 Mar 20;35(2):107-111. In 160 asthmatic adults and 88
non-asthmatic controls, "An association was observed between the
presence of anti-Chsp10 antibodies and adult onset asthma."
The development of asthma in children infected with Chlamydia
pneumoniae is dependent on the modifying effect of mannose-binding
lectin. A Nagy, GT Kozma, M Keszei, A Treszl, A Falus, C Szalai. J
Allergy Clin Immunol 2003 Oct;112(4):729-734. 139 children with asthma
and 174 healthy controls. "Among asthmatic children carrying variant
MBL alleles, there were significantly more patients with positive
results for C pneumoniae-specific IgG than among control children with
variant MBL genotypes (63.7% vs 40.7% of asthmatic vs control children,
respectively; odds ratio adjusted for age and sex, 2.21; 95% CI,
1.10-4.41; P =.02). Infected children with variant MBL alleles were
found to have a higher risk of asthma development than infected
children with normal MBL genotype. This risk was especially high in
children with chronic or recurrent infection (positive results for both
IgA and IgG; adjusted odds ratio, 5.38; 95% CI, 1.75-14.36; P =.01),
but no increased risk was seen in children with current C pneumoniae
infection (positive results for IgM)."
Chlamydia pneumoniae infection and inflammation in adults with
asthma. T Savykoski, T Harju, M Paldanius, H Kuitunen, Bloigu, E
Wahlstrom, P Rytila, V Kinnula, P Saikku, M Leinonen. Respiration 2004
Mar-Apr;71(2):120-125. Serum and sputum samples from 103 asthma
patients and 30 healthy volunteers. "The asthma patients, especially
those with moderate asthma, had higher serum IgA antibody levels to
CpHsp60 than the healthy controls (test for trend, p = 0.05), whereas
antibody levels to CpEB antigen did not differ between the study
groups. CRP levels were higher in both asthma groups compared to the
control group and moreover, the patients with moderate asthma had
higher CRP levels than those with mild asthma (test for trend, p <
0.01). The subjects with a slightly elevated CRP level, defined as >
or =1.8 mg/l, had higher CpEB IgA (p = 0.001), CpEB IgG (p = 0.008) and
CpHsp60 IgA (p = 0.023) antibody levels in serum compared to the
subjects with lower CRP levels."
Seroprevalence of Mycoplasma pneumoniae and Chlamydia pneumoniae in
stable asthma and chronic obstructive pulmonary disease. SJ Park, YC
Lee, YK Rhee, HB Lee. J Korean Med Sci 2005 Apr;20(2):225-228.
"Seroprevalences of M. pneumoniae and C. pneumoniae in the asthma group
(11.1% and 8.3%, respectively) were higher than in the control group
(4.4% and 2.2%, respectively) without statistical significance. The
seroprevalence of M. pneumoniae in the COPD group (16.9%) was
significantly higher than in the control group, and the seroprevalence
of C. pneumoniae in the COPD group (3.4%) was higher than in the
control group without statistical significance." 140 patients in all.
[Is there a link between chronic chlamydial infection and childhood
asthma?] J Tyl. Med Wieku Rozwoj 2004 Apr-Jun;8(2 Pt 2):411-417.
"Results were positive for Chlamydia pneumoniae in 7/51 children with
asthma compared with 1/36 controls. Specific IgA anti-Chlamydia
trachomatis antibodies were detected in 2/51 patients with asthma and
in one of the 36 controls. Infected children, more often than
asthmatics without specific chlamydial IgA, suffered from more severe
forms of asthma and required multiple-drug therapy, but none of the
differences appeared statistically significant."
Use of quantitative and objective enzyme immunoassays to investigate
the possible association between Chlamydia pneumoniae and Mycoplasma
pneumoniae antibodies and asthma.T Tuuminen, I Edelstein, A Punin, N
Kislova, L Stratchounski. Clin Microbiol Infect 2004 Apr;10(4):345-348.
"Sera from 150 consecutive patients with established asthma and 150
matched controls were examined for Chlamydia pneumoniae IgG and IgA
with commercially available enzyme immunoassays (EIAs) detecting immune
response solely to surface proteins of elementary bodies. The assays
were also modified to measure combined immune response to surface
proteins and family-specific lipopolysaccharide antigen. Mycoplasma
pneumoniae IgG and IgA were measured with new commercial EIAs utilising
P1-enriched protein fraction as an antigen. No statistically
significant differences between the patient groups in terms of
prevalence or levels of antibodies to either organism were found with
Mycoplasma pneumoniae and asthma in children. S Biscardi, M Lorrot,
E Marc, F Moulin, B Boutonnat-Faucher, C Heilbronner, JL Iniguez, M
Chaussain, E Nicand, J Raymond, D Gendrel. Clin Infect Dis 2004 May
15;38(10):1341-1346. "Of 119 patients with previously diagnosed asthma,
acute M. pneumoniae infection was found in 24 (20%) and C. pneumoniae
infection was found in 4 (3.4%) of the patients during the current
exacerbation. Of 51 patients experiencing their first asthma attack,
acute M. pneumoniae infection was proven in 26 (50%) of the patients
(P<.01) and C. pneumoniae in 4 (8.3%). In the control group of 152
children with stable asthma or rhinitis, 8 (5.2%) had M. pneumoniae
infection (P<.005). Of the 29 patients experiencing their first
asthma attack and infected with M. pneumoniae or C. pneumoniae, 18
(62%) had asthma recurrences but only 6 (27%) of the 22 patients who
did not have such infections had asthma recurrences (P<.05)."
Chlamydophila pneumoniae and Mycoplasma pneumoniae in respiratory
specimens of children with chronic lung diseases. N Teig, A Anders, C
Schmidt, C Rieger, S Gatermann. Thorax 2005 Nov;60(11):962-966. "We
investigated nasal brush specimens and induced sputum from 38 children
with stable chronic lung disease (asthma, n = 26; chronic bronchitis n
= 12) and from 42 healthy controls for the presence of M pneumoniae or
C. pneumoniae DNA by polymerase chain reaction (PCR) using nested
primers. RESULTS: None of the controls but 23.6% and 10.5% of the
children with lung disease had positive PCR for C pneumoniae (p =
0.001) and M pneumoniae (p = 0.044) respectively."
Bronchial asthma and Chlamydia pneumoniae antibodies in children
aged 4-8 years in Olomouc district. F Kopriva, J Szotkowska, M Zapalka.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2005
Dec;149(2):289-291. "In a group of 83 atopic children with chronic
cough, IgM and IgG antibodies to C. pneumoniae were demonstrated in 20
children (24 %). Among children with bronchial asthma, positive
antibody was present in 29 children (44 %; /p = 0,052/); of this
number, 24 (36 %; /p = 0,06/) had IgM and IgG antibodies while 5
children (8 %) had IgA and IgG antibodies against C. pneumoniae. A
group of non-atopic children with non-specific symptoms included 38
children (16 %) with antibody positivity; 27 children (11 %) with IgM
and IgG antibodies and 11 children (5 %) with IgA and IgG antibodies
against C. pneumoniae. CONCLUSIONS. Asthma in children was associated
with elevated levels of IgM and IgG antibodies to C. pneumoniae."
The effect of telithromycin in acute exacerbations of asthma. SL
Johnston, F Blasi, PN Black, RJ Martin, DJ Farrell, RB Nieman; TELICAST
Investigators. N Engl J Med 2006 Apr 13;354(15):1589-1600. Randomized
controlled trial in 278 adults with diagnosed asthma, enrolled within
24 hours after an acute exacerbation. "Of the two prespecified primary
outcomes, only asthma symptoms showed a significantly greater reduction
among patients receiving telithromycin than among those receiving
placebo." There was no change in morning peak expiratory flow.
"Although 61 percent of patients had evidence of infection with C.
pneumoniae, M. pneumoniae, or both, there was no relationship between
bacteriologic status and the response to asthma treatment."
[Evaluation of association between an acute attack of childhood
bronchial asthma and Chlamydia pneumoniae infection] Y Jiang, XL Liu,
FQ Xing, JS Yang, H Tu. Zhongguo Dang Dai Er Ke Za Zhi 2006
Apr;8(2):113-114. "Anti-CP IgM was demonstrated in 22 cases (18.3%) and
anti-CP IgG was demonstrated in 32 cases (26.7%) out of the 120
asthmatic patients. The incidence of CP infection in asthmatic children
was significantly higher than that in healthy controls (3.7%) (P <
Pathogenic bacteria and viruses in induced sputum or pharyngeal
secretions of adults with stable asthma. TH Harju, M Leinonen, J
Nokso-Koivisto, T Korhonen, R Räty, Q He, T Hovi, J Mertsola, A
P Rytilä, P Saikku. Thorax 2006 Jul;61(7):579-584. "Sputum samples
two of the 30 healthy controls (6.7%), five of 53 patients with mild
asthma (9.4%), and eight of 50 with moderate asthma (16.0%) were
positive for rhinovirus. Rhinovirus positive asthmatic subjects had
more asthma symptoms and lower forced expiratory volume in 1 second
(FEV(1)) (79% predicted) than rhinovirus negative cases (93.5%
predicted; p = 0.020). Chlamydia pneumoniae PCR was positive in 11
healthy controls (36.6%), 11 mild asthmatics (20.8%), and 11 moderate
asthmatics (22%), and PCR positive asthmatics had lower FEV(1)/FVC than
negative cases (78.2% v 80.8%, p = 0.023). Bordetella pertussis PCR was
positive in 30 cases: five healthy controls (16.7%), 15 mild asthmatics
(28.3%), and 10 moderate asthmatics (20%). Bordetella pertussis
positive individuals had lower FEV(1)/FVC (77.1% v 80.7%, p = 0.012)
and more asthma symptoms than B pertussis negative cases."
Association between Chlamydia pneumoniae antibodies and wheezing in
young children and the influence of sex. E Normann, J Gnarpe, B
Wettergren, C Janson, M Wickman, L Nordvall. Thorax 2006
Dec;61(12):1054-1058. In 1581 four-year-olds, "In girls, the occurrence
of anti-Cpn IgG was associated with wheezing at the ages of 1, 2, and 4
years (odds ratios (ORs) 3.41 (95% confidence interval (CI) 1.46 to
7.96), 2.13 (95% CI 1.02 to 4.44), and 2.01 (95% CI 1.14 to 3.54),
respectively), and even higher ORs were observed for each age category
when only high level antibody responses to Cpn were analysed. At the
time of blood sampling the association between anti-Cpn IgG and
wheezing was restricted to girls without atopic sensitisation (OR 2.39
(95% CI 1.25 to 4.57). No associations with wheezing were detected in
boys, in whom IgE sensitisation was inversely associated with the
presence of anti-Cpn IgG (OR 0.49 (95% CI 0.26 to 0.90)). CONCLUSIONS:
This study suggests an association between evidence of earlier Cpn
infection and a history of wheezing in young girls."
Role of viruses and atypical bacteria in asthma exacerbations among
children in Oporto (Portugal). M João Silva, C Ferraz, S
Cardoso, J Simões, A Bonito Vítor. Allergol Immunopathol
Jan-Feb;35(1):4-9. "In 54 eligible children, 37 nasal samples were
obtained. Infectious agents were detected in 78 % of the patients.
Rhinovirus was detected in 70.3 %, Mycoplasma pneumoniae in 16.2 %,
enterovirus in 10.8 %, and Chlamydia pneumoniae in 2.7 %. Coinfection
was identified in 21.6 % of the samples. There was no significant
correlation between current treatment status, severity of asthma or
exacerbations and the isolated agents."
Is there any relationship between asthma and asthma attack in
children and atypical bacterial infections; Chlamydia pneumoniae,
Mycoplasma pneumoniae and helicobacter pylori. A Annagür, SG
M Yilmaz, DU Altintas, A Inal. J Trop Pediatr 2007 Oct;53(5):313-318.
"Seventy-nine asthmatic children (46 males, aged 5-15 years) were
included in study. The study group was divided into two groups: group 1
consisted of 37 children with asthma attacks and group 2 consisted of
42 children with stable asthma. As a control group we studied 36
healthy children... Mycoplasma IgM and Chlamidia IgM were positive in
8.1% (3 patients) and 18.9% (7 patients) of group 1 patients,
respectively. There was a statistically significant difference for
Mycoplasma IgM (p = 0.031) and Chlamidia IgM (p = 0.03) between group1
and other two groups."
Modulation of pulmonary dendritic-cell function during mycobacterial
infection. MM Anis, SA Fulton, SM Reba, Y Liu, CV Harding, WH Boom.
Infect Immun 2008 Feb;76(2):671-677. "Interestingly, during peak
mycobacterial infection, CD11chi MHChi lung DCs had slightly decreased
chemotaxis toward the CCR7 ligand CCL21 and less efficiency in
activating naive CD4+ T cells than DCs from mice during late-stage
infection, when few bacilli are found in the lung."
Chronic Chlamydia pneumoniae infection and bronchial asthma: is
there a link? A Agarwal, Y Chander. Indian J Med Microbiol 2008
Oct-Dec;26(4):338-341. 60 adults with a clinical history of asthma and
100 healthy age and sex matched controls. "The IgG anti chlamydial
antibody-positivity rate in the patients with bronchial asthma (80%)
was significantly higher in all age groups than that in the healthy age
and sex matched controls (59%). No significant association was observed
for IgA and IgM anti chlamydial antibodies. C. pneumoniae species
specific IgG antibody seroprevalence was also found to be significantly
higher in all age groups in comparison to controls (61.66% vs 38%)."
Airflow limitation, asthma, and Chlamydia pneumoniae-specific heat
shock protein 60. DL Hahn, RW Peeling. Ann Allergy Asthma Immunol 2008
Dec;101(6):614-618. 138 C pneumoniae-exposed primary care patients (86
adult asthmatic cases and 52 nonasthmatic controls), evaluated for
seroreactivity against a C pneumoniae-specific hsp60 fragment and
against the C trachomatis hsp60 molecule. "Twenty-seven percent of
asthmatic patients were C pneumoniae hsp60 seropositive vs 8% of
controls (P < .01). Controlling for age, sex, and smoking, C
pneumoniae hsp60 seropositivity was associated with lower
postbronchodilator forced expiratory volume in 1 second in asthmatic
patients (P < .05). No comparable associations were present for C
Infectious Chlamydia pneumoniae is associated with elevated
interleukin-8 and airway neutrophilia in children with refractory
asthma. KK Patel, AG Vicencio, Z Du, K Tsirilakis, PS Salva, WC Webley.
Pediatr Infect Dis J 2010 Dec;29(12):1093-1098. "Of 18 Bronx samples
analyzed, 6 (33%) were PCR-positive for C. pneumoniae, 10 (56%) for C.
trachomatis, and 8 (44%) for Mycoplasma 16s DNA. IL-8 from C.
pneumoniae-positive samples was 3.3-fold higher compared with negative
samples (P = 0.003). There was no difference between patients tested
for C. trachomatis or Mycoplasma. Of 84 Massachusetts samples analyzed,
42 (50%) were PCR-positive for C. pneumoniae, 42 (50%) for C.
trachomatis, and 13 (16%) for Mycoplasma. IL-8 concentration from C.
pneumoniae-positive samples was 10.49-fold higher compared with
negative samples (P = 0.0001). As in the Bronx cohort, there were no
differences between patients tested for C. trachomatis or Mycoplasma.
Lastly, BAL neutrophilia predicted the presence of C. pneumoniae but
not Mycoplasma or C. trachomatis."
Chlamydia pneumoniae-specific IgE is prevalent in asthma and is associated with disease severity. DL Hahn, A Schure, K Patel, T Childs, E Drizik, W Webley. PLoS One 2012;7(4):e35945. "Of 66 asthma subjects (mean age 40.9 years, range 5-75, 59% male, 45% ever-smokers) 33 (50%) were Cp IgE positive and 16 (24%) were Cp DNA positive (P = 0.001 for association of Cp IgE and DNA). Cp IgE was detected in 21% of mild intermittent asthma v 79% of severe persistent asthma (test for trend over severity categories, P = 0.002). Cp IgE detection was significantly (P = 0.001) associated with asthma when compared to healthy blood donor controls but not when compared to clinic controls."Hahn - PLoS One 2012 full article / PubMed Central
Chlamydia Pneumoniae Infection Associated with Uncontrolled Asthma: A Hospital Based Cross Sectional Study. S Awasthi, KK Yadav, J Agarwal. Indian J Pediatr 2012 Oct;79(10):1318-1322. 44 hospitalized patients and 45 ambulatory patients age 1-12 years. "Anti-Cp IgM was positive in 25 % (n = 11/44) and 6.7 % (n = 3/45) patients with uncontrolled and partly controlled asthma, respectively (Odds ratio = 4.67, χ (2) = 5.64, 95 % CI 1.20-18.10, p 0.0 17). Among the patients of uncontrolled asthma, duration of hospital stay was longer in anti-Cp IgM positive patients (9 ± 2.19 vs. 7.19 ± 2.10 d, p 0.02)."Awasthi - Indian J Pediatr 2012 abstract / PubMed
Rhinovirus-induced VP1-specific Antibodies are Group-specific and Associated With Severity of Respiratory Symptoms. K Niespodziana, CR Cabauatan, DJ Jackson, D Gallerano, B Trujillo-Torralbo, A Del Rosario, P Mallia, R Valenta, SL Johnston. EBioMedicine 2014 Nov 18;2(1):64-70. N-terminal fragments of VP1 from strains RV14, 16, 89, C were tested in 28 asthmatic patients and 11 healthy controls. "Six weeks after infection with RV16, IgG1 antibodies showed a group-specific increase towards the N-terminal VP1 fragment, but not towards other capsid and non-structural proteins, which was highest in subjects with severe upper and lower respiratory symptoms."Niespodziana - EBioMedicine 2014 full article / PubMed Central
PD-L1 Promotes Early-life Chlamydia Respiratory Infection-induced Severe Allergic Airway Disease. MR Starkey, DH Nguyen, AC Brown, AT Essilfie, RY Kim, H Yagita, JC Horvat, PM Hansbro. Am J Respir Cell Mol Biol 2015 Sep 17 [Epub ahead of print]. "Infection increased PD-1 and PD-L1, but not PD-L2, mRNA expression in the lung. Flow cytometric analysis of whole lung homogenates identified monocytes, dendritic cells, CD4+ and CD8+ T cells as major sources of PD-1 and PD-L1. Inhibition of PD-1 and PD-L1, but not PD-L2, during infection ablated infection-induced AHR in later life. Given that PD-L1 was the most highly up-regulated and its targeting prevented infection-induced AHR, subsequent analyses focused on this ligand. Inhibition of PD-L1 had no effect on Chlamydia load, but suppressed infection-induced pulmonary inflammation. Infection decreased the levels of the IL-13 decoy receptor in the lung, which were restored to baseline levels by inhibition of PD-L1. Finally, inhibition of PD-L1 during infection prevented subsequent infection-induced severe allergic airways disease in later-life, by decreasing IL-13 levels, Gob-5 expression, mucus production and AHR."Starkey - Am J Respir Cell Mol Biol 2015 abstract / PubMed
Latent adenoviral infection modifies the steroid response in
allergic lung inflmmation. K Yamada, WM Elliott, S Hayashi, R
Brattsand, C Roberts, TZ Vitalis, JC Hogg. J Allergy Clin Immunol 2000
Nov;106(5):844-851. Guinea pigs with latent adenoviral (n = 12) or sham
(n = 12) infections. "Latent adenoviral infection increased CD8+ cells
in the airway wall and CD8+ cells, macrophages, B cells, and CD4+ cells
in the lung parenchyma. Ovalbumin challenge, on the other hand,
increased eosinophils, macrophages, B cells, and CD4+ cells in both the
airway wall and lung parenchyma independent of the effect of latent
adenoviral infection. In the sham-infected groups steroid treatment
caused the expected reduction in the eosinophilic infiltrate induced by
OA challenge in the airways without affecting the other cells. In the
presence of both latent adenoviral infection and OA challenge, steroid
treatment had no effect on allergen-induced eosinophilia but reduced
CD8+ cells in the airways and CD8+ cells, CD4+ cells, and B cells in
Interactions between allergic inflammation and respiratory viral inflammations. PC Avila. J Allergy Clin Immunol 2000 Nov;106(5):829-831. Editorial re Yamada.Avila / J Allergy Clin Immunol 2000 full article
Molecular mechanisms of decreased steroid responsiveness induced by latent adenoviral infection in allergic lung inflammation. K Yamada, WM Elliott, R Brattsand, A Valeur, JC Hogg, S Hayashi. J Allergy Clin Immunol 2002 Jan;109(1):35-42. In this guinea pig study, latent adenovirus infection inhibited the anti-inflammatory effects of glucocorticoids.Yamada - J Allergy Clin Immunol 2002 abstract / PubMed
Bordetella pertussis, Bordetella parapertussis, Mycoplasma
pneumoniae, Chlamydia pneumoniae and persistent cough in children. HO
Hallander, J Gnarpe, H Gnarpe, P Olin. Scand J Infect Dis
1999;31(3):281-286. "The most common single agent was B. pertussis,
representing 56%(64/115), with a median cough period of 51 d, followed
by M. pneumoniae 26%(30/115), 23 d, C. pneumoniae 17% (19/115), 26 d,
and B. parapertussis 2% (2/115). For co-infections, the median duration
of cough was about 60 d. Spasmodic cough for 21 d or more (clinical WHO
criteria for pertussis) was present in 82% (41/50) of infections with
B. pertussis as single agent, 38% (17/45) with B. parapertussis, 38%
(5/13) with C. pneumoniae, 26% (5/19) with M. pneumoniae and 30%(17/56)
in cases where no aetiology was found. In children with cough for more
than 100 d (n = 78) using all vaccine arms, B. pertussis was
responsible in 83% (65/78), in 21%(16/78) together with other agents."
Molecular aspects of Bordetella pertussis pathogenesis. C Locht. Int Microbiol 1999 Sep;2(3):137-144. Review.Locht - Int Microbiol 1999 abstract / PubMed
Bordetella pertussis and chronic cough in adults. NH Birkeback, M
Kristiansen, T Seefeldt, J Degn, A Moller, I Heron, PL Andersen, JK
Moller, L Ostergard. Clin Infect Dis 1999 Nov;29(5):1239-1242. 201
patients who had a cough for 2-12 weeks and no pulmonary disease. "Four
patients were B. pertussis culture-positive; 11 (including the
culture-positive patients) were B. pertussis PCR-positive; and 33,
including 10 of the 11 PCR-positive patients, had serological evidence
of recent B. pertussis infection."
Serological evidence of pertussis in patients presenting with cough at a general practice in Birmingham. E Miller, DM Fleming, LA Ashworth, DA Mabbett, JE Vurdien, TS Elliott. Commun Dis Public Health 2000 Jun;3(2):132-134. "Fifty-eight cases of pertussis in this population and time period was equivalent to an annual incidence of 330 per 100,000, whereas statutory notifications of pertussis in England and Wales suggest an incidence of less than 4 per 100,000 in the same period."Miller - Commun Dis Public Health 2000 abstract / PubMed
Frequency of serologic evidence of Bordetella infections and mixed infections with other respiratory pathogens in university students with cough illnesses. LA Jackson, JD Cherry, SP Wang, JT Grayston. Clin Infect Dis 2000 Jul;31(1):3-6. "Our findings indicate that bordetella infections are common in young adults with cough illnesses (incidence, 9%), and a surprising number of these are mixed infections with other respiratory pathogens."Jackson - Clin Infect Dis 2000 abstract / PubMed
Costs of illness due to Bordetella pertussis in families. LH Lee, ME
Pichichero. Arch Fam Med 2000 Nov-Dec;9(10):989-996. Sixty-nine
families (87 individuals). "A family member required an average of 1.6
visits before (range, 0-7 visits) and after (range, 0-9 visits)
pertussis was diagnosed; children younger than 1 year needed 2.5 and 2
visits, respectively. Symptomatic improvement occurred after a mean of
31 days (range, 4-134 days) after pertussis diagnosis and full recovery
after a mean of 66 days (range, 5-383 days). Adults experienced the
longest recovery time (median, 93 days) compared with other age groups.
The average medical costs for an infant, child, adolescent, and adult
were $2822, $308, $254, and $181, respectively. Parents lost an average
of 6 workdays (range, 1-35 days) to care for an ill child; for these
parents, costs associated with work loss averaged $767 per family. An
average of 1.7 and 0.7 lost workdays accrued to bring an ill child to a
physician's office and the emergency department, respectively. A
majority (58%) of parents working while family members were ill with
pertussis reported decreased work productivity ranging from 25% to 99%.
Work-related costs contributed more than 60% of the overall costs of
pertussis." The average cost was $2115 per family.
Pertussis is a frequent cause of prolonged cough illness in adults and adolescents. LD Senzilet, SA Halperin, JS Spika, M Alagaratnam, A Morris, B Smith. Clin Infect Dis 2001 Jun 15;32(12):1691-1697. 48/442 patients (19.9%) with prolongued cough illness had laboratory-confirmed or laboratory evidence of pertussis involvement.Senzilet - Clin Infect Dis 2001 abstract / PubMed
Changes in genetic diversity of the Bordetella pertussis population
in the United Kingdom between 1920 and 2006 reflect vaccination
coverage and emergence of a single dominant clonal type. DJ Litt, SE
Neal, NK Fry. J Clin Microbiol 2009 Mar;47(3):680-688. "genetic
diversity of the bacterial population decreased during periods of high
vaccine coverage. However, it was elevated between 1977 and 1986, when
vaccine coverage in the United Kingdom was low and epidemics occurred.
A high proportion of MLVA types during this epidemic period were novel,
and the prnA(2) and prnA(3) alleles were seen for the first time in the
United Kingdom. MLVA-27 appeared in 1982, was codominant during the
1998-to-2001 period, and comprised approximately 70% of isolates during
both the 2002-to-2004 and the 2005-to-2006 periods."