Varshney Avanish K, Chaudhry Rama, Saharan Sunil, Kabra Sushil Kumar, Dhawan Benu, Dar Lalit, Malhotra Pawan
Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
FEMS Immunol Med Microbiol. 2009 Jun;56(1):25-31. doi: 10.1111/j.1574-695X.2009.00543.x. Epub 2009 Feb 23.
The role of Mycoplasma pneumoniae infection as a trigger for asthma exacerbations is well supported in previous studies. This study was designed to investigate the role of M. pneumoniae infection in acute exacerbation of asthma in children. A total of 150 patients (110 males, 40 females) were studied and immunoglobulin M (IgM) antibodies to M. pneumoniae were detected by enzyme-linked immunosorbent assay (ELISA), and PCR amplification was performed for the P1 gene to associate M. pneumoniae infection with asthma. As compared with 33 children with asthma, only two of the control subjects had positive IgM titers for M. pneumoniae, which was statistically significant (P=0.002). A total of 15 children with asthma were positive by PCR for the P1 gene while none of the controls had a positive PCR. Of these positive cases, 24 cases were positive only by ELISA, six were positive only by PCR and nine patients were found to be positive by both ELISA and PCR. All the clinical characteristics of the patients at baseline were comparable between the moderate and the severe group of patients statistically, except for the peak expiratory flow rate. Mycoplasma pneumoniae infection was found to have a significant association with acute exacerbation in the moderate group of asthma patients by PCR (P=0.01). These data suggest that M. pneumoniae infection may contribute to asthma exacerbation.
肺炎支原体感染作为哮喘急性加重诱因的作用在以往研究中得到了充分支持。本研究旨在探讨肺炎支原体感染在儿童哮喘急性加重中的作用。共研究了150例患者(男110例,女40例),采用酶联免疫吸附测定(ELISA)检测肺炎支原体免疫球蛋白M(IgM)抗体,并对P1基因进行聚合酶链反应(PCR)扩增,以确定肺炎支原体感染与哮喘的关系。与33例哮喘儿童相比,对照组中仅2例肺炎支原体IgM滴度呈阳性,差异有统计学意义(P=0.002)。15例哮喘儿童PCR检测P1基因呈阳性,而对照组均为阴性。在这些阳性病例中,24例仅ELISA检测呈阳性,6例仅PCR检测呈阳性,9例ELISA和PCR检测均呈阳性。除呼气峰值流速外,中度和重度患者组基线时患者的所有临床特征在统计学上具有可比性。通过PCR检测发现,肺炎支原体感染与中度哮喘患者的急性加重显著相关(P=0.01)。这些数据表明,肺炎支原体感染可能导致哮喘急性加重。