Martin R J, Kraft M, Chu H W, Berns E A, Cassell G H
Department of Medicine, National Jewish Medical and Research Center and The Pulmonary and Critical Care Division, University of Colorado Health Sciences Center, 1400 Jackson St., Denver, CO 80206, USA.
J Allergy Clin Immunol. 2001 Apr;107(4):595-601. doi: 10.1067/mai.2001.113563.
Asthma is a prevalent disease with marked effects on quality of life and economic societal burden. However, the cause of asthma and its pathophysiology are not completely defined. Recently, the possibility that chronic infection may play a role has been suggested.
We sought to define the association between Mycoplasma and Chlamydia species and chronic asthma.
We performed a comparison study of asthmatic patients and normal control subjects. Fifty-five patients with chronic stable asthma were compared with 11 normal control subjects by using PCR, culture, and serology for Mycoplasma species, Chlamydia species, and viruses from the nasopharynx, lung, and blood. Bronchoalveolar lavage cell count and differential, as well as tissue morphometry, were also evaluated. Computer-generated scoring for the degree of chronic sinusitis in asthmatic patients was additionally evaluated.
Thirty-one of 55 asthmatic patients had positive PCR results for Mycoplasma (n = 25) or Chlamydia species (n = 6), which were mainly found on lung biopsy specimens or in lavage fluid. Only 1 of 11 normal control subjects had positive PCR results for Mycoplasma species. The distinguishing phenotype between asthmatic patients with positive and negative PCR results was the significantly greater number of tissue mast cells in the group with positive results.
A significant number of patients with chronic stable asthma demonstrate the presence of Mycoplasma species, Chlamydia species, or both in their airways, with the distinguishing feature of increased mast cell number. These findings need further delineation but may help us to understand the pathophysiology of asthma and new treatment options.
哮喘是一种常见疾病，对生活质量和社会经济负担有显著影响。然而，哮喘的病因及其病理生理学尚未完全明确。最近，有人提出慢性感染可能起作用。
我们试图确定支原体和衣原体与慢性哮喘之间的关联。
我们对哮喘患者和正常对照者进行了一项比较研究。通过聚合酶链反应（PCR）、培养以及针对来自鼻咽、肺和血液的支原体、衣原体和病毒的血清学检测，将55例慢性稳定型哮喘患者与11例正常对照者进行比较。还评估了支气管肺泡灌洗细胞计数及分类，以及组织形态计量学。另外评估了哮喘患者慢性鼻窦炎程度的计算机生成评分。
55例哮喘患者中有31例PCR检测支原体（n = 25）或衣原体（n = 6）呈阳性，主要在肺活检标本或灌洗液中发现。11例正常对照者中只有1例支原体PCR检测呈阳性。PCR检测结果阳性和阴性的哮喘患者之间的区别表型是阳性组组织肥大细胞数量明显更多。
相当数量的慢性稳定型哮喘患者气道中存在支原体、衣原体或两者皆有，其显著特征是肥大细胞数量增加。这些发现需要进一步阐明，但可能有助于我们理解哮喘的病理生理学和新的治疗选择。
