Blanchard E, Raherison C
Service des maladies respiratoires, CHU de Bordeaux, université Bordeaux-2 Victor-Segalen, Bordeaux, France.
Rev Mal Respir. 2010 Oct;27(8):890-7. doi: 10.1016/j.rmr.2010.04.002. Epub 2010 May 20.
A growing body of basic and clinical science implicates Mycoplasma pneumonia in asthma, but its exact contribution to asthma development, exacerbation and persistence is as yet unclear.
M. pneumoniae infection, with the induction of bronchial hyperresponsiveness, seems to be a precipitating factor for asthma development in predisposed subjects. M. pneumoniae has been seen both in acute exacerbation (18-20%) and in chronically infected adults with stable asthma, where it may be enhancing chronic airway inflammation.
If M. pneumoniae plays a role in the development or progression of asthma, its eradication might influence the clinical course of the disease and improve symptoms. Macrolide treatment, with antimicrobial and anti-inflammatory properties, could have a place in the management of asthma, especially steroid-dependent asthma.
M. pneumoniae infection seems to be important in asthma pathogenesis and the clinical course of the disease. Difficulty in detecting the pathogen complicates investigations. Ongoing research will further determine the place of macrolide antibiotics in asthma management.
越来越多的基础和临床科学研究表明肺炎支原体与哮喘有关,但其对哮喘发生、加重和持续存在的确切作用尚不清楚。
肺炎支原体感染可诱发支气管高反应性,似乎是易感人群哮喘发生的一个诱发因素。在急性加重期(18%-20%)以及患有稳定型哮喘的慢性感染成人中均发现了肺炎支原体,它可能会加剧慢性气道炎症。
如果肺炎支原体在哮喘的发生或进展中起作用,根除它可能会影响疾病的临床进程并改善症状。具有抗菌和抗炎特性的大环内酯类药物治疗在哮喘管理中可能占有一席之地,尤其是对激素依赖型哮喘。
肺炎支原体感染在哮喘发病机制和疾病临床进程中似乎很重要。病原体检测困难使研究变得复杂。正在进行的研究将进一步确定大环内酯类抗生素在哮喘管理中的地位。