Hahn D L, Peeling R W, Dillon E, McDonald R, Saikku P
Dean Medical Center, Madison, Wisconsin, USA.
Ann Allergy Asthma Immunol. 2000 Feb;84(2):227-33. doi: 10.1016/S1081-1206(10)62760-3.
Chlamydia pneumoniae infection has been reported as a possible etiologic agent in asthma, which in primary care settings often appears to be initiated by acute respiratory infections.
To determine if serologic markers for C. pneumoniae are associated with adult asthma that first became symptomatic after an acute respiratory illness (asthma associated with infection: AAWI).
Serum samples from 164 primary care outpatients, mean age 44 years, (68 with AAWI; 36 with atopic, occupational or exercise-induced asthma (non-AAWI); 16 nonasthmatic patients with acute bronchitis; and 44 asymptomatic nonasthmatic controls) were tested for the presence of C. pneumoniae-specific IgG and IgA antibodies. Levels of chlamydial heat shock protein 60 (CHSP60) antibody were also measured. Those positive for CHSP60 were tested for C. pneumoniae-specific IgE antibodies by immunoblotting.
Statistically significant differences in IgG and IgA seroreactivity were noted between groups: acute bronchitis and AAWI had the highest levels (93% to 94% IgG seroreactivity, 69% to 75% IgA seroreactivity) whereas non-AAWI and asymptomatic controls had the lowest levels (61% to 84% IgG seroreactivity, 31% to 43% IgA seroreactivity, P < .02 after adjustment for age, sex and smoking). CHSP60 antibodies were significantly more prevalent in AAWI than in non-AAWI (19% versus 3%, P = .02). IgE antibodies against C. pneumoniae 60, 62, and/or 70 kD antigens were detected in 5 of 13 CHSP60 positive AAWI patients. Persistent IgG, IgA, and CHSP60 seroreactivities were noted in all seropositive asthma patients with serial serum samples.
Serologic markers of C. pneumoniae infection were associated with acute bronchitis and with asthma that first became symptomatic following respiratory illness. Serologic responses to C. pneumoniae may be useful in the classification and diagnosis of asthma.
据报道，肺炎衣原体感染可能是哮喘的病因之一，在基层医疗环境中，哮喘似乎常由急性呼吸道感染引发。
确定肺炎衣原体的血清学标志物是否与急性呼吸道疾病后首次出现症状的成人哮喘（与感染相关的哮喘：AAWI）有关。
检测了164名基层医疗门诊患者的血清样本，这些患者平均年龄44岁（68例AAWI患者；36例患有特应性、职业性或运动诱发性哮喘（非AAWI）；16例患有急性支气管炎的非哮喘患者；44例无症状非哮喘对照），以检测肺炎衣原体特异性IgG和IgA抗体的存在。还测量了衣原体热休克蛋白60（CHSP60）抗体水平。对CHSP60呈阳性的患者通过免疫印迹法检测肺炎衣原体特异性IgE抗体。
各研究组之间在IgG和IgA血清反应性方面存在统计学显著差异：急性支气管炎组和AAWI组的水平最高（IgG血清反应性为93%至94%，IgA血清反应性为69%至75%），而非AAWI组和无症状对照组的水平最低（IgG血清反应性为61%至84%，IgA血清反应性为31%至43%，在对年龄、性别和吸烟进行调整后P <.02）。CHSP60抗体在AAWI组中的流行率显著高于非AAWI组（分别为19%和3%，P =.02）。在13例CHSP60阳性的AAWI患者中有5例检测到针对肺炎衣原体60、62和/或70 kD抗原的IgE抗体。在所有血清阳性的哮喘患者的系列血清样本中均观察到持续的IgG、IgA和CHSP60血清反应性。
肺炎衣原体感染的血清学标志物与急性支气管炎以及呼吸道疾病后首次出现症状的哮喘有关。对肺炎衣原体的血清学反应可能有助于哮喘的分类和诊断。
