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哮喘患儿存在特异性抗肺炎支原体 IgM 升高,但与呼吸道感染史无关的 IgG 或 IgE 值不受影响。

Asthmatic children have increased specific anti-Mycoplasma pneumoniae IgM but not IgG or IgE-values independent of history of respiratory tract infection.

机构信息

Department of Pediatrics, Center for Allergy and Asthma Research, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA.

出版信息

Pediatr Infect Dis J. 2013 Jun;32(6):599-603. doi: 10.1097/INF.0b013e3182862ea8.

Abstract

BACKGROUND

Bronchial asthma is exacerbated by Mycoplasma pneumoniae-induced upper respiratory tract infections (URTIs) in children. Specific IgM and IgG isotypes are involved in the immune response to M. pneumoniae, but little is known about the role of specific IgE antibodies against M. pneumoniae in asthma.

OBJECTIVE

To investigate the role of IgM-, IgG- and IgE-specific antibody responses to M. pneumoniae in children with persistent asthma in relationship to history of URTI within the past 6 months.

METHODS

Total or specific anti-M. pneumoniae IgM, IgG and IgE antibody responses were studied in stable asthmatic pediatric patients (M. pneumoniae positive and negative) without current exacerbation and nonasthmatic controls (N = 23 and 13, respectively) (UniCAP total IgE Fluoroenzymeimmunoassay, enzyme-linked immunosorbent assay).

RESULTS

Values of specific IgM correlated with specific IgG (Spearman correlation, rho = 0.61, P < 0.0001) but not with specific IgE anti-M. pneumoniae antibodies (AMA) in asthmatic subjects compared with nonasthmatic controls. However, concentrations of specific IgG correlated with specific IgE AMA (rho = 0.49, P = 0.0017). Asthmatic subjects had higher levels of specific IgM AMA levels compared with nonasthmatics (median [interquartile range]: 0.57 [1.00] versus 0.21 [0.19]; Kruskal-Wallis test, P = 0.0008). In addition, IgM positivity was significantly higher in asthmatic compared with nonasthmatic subjects (39.1% versus 0.0%; Fisher's exact test, P = 0.01). These results were independent of URTI history in the past 6 months, which was not associated with higher IgM, IgG or IgE AMA levels compared with no URTI history (P = 0.25-0.64).

CONCLUSIONS

Increased specific IgM anti-M. pneumoniae responses may indicate an important role for M. pneumoniae infection in asthma.

摘要

背景

肺炎支原体引起的上呼吸道感染(URTIs)会加重儿童的支气管哮喘。特异性 IgM 和 IgG 同种型参与了对肺炎支原体的免疫反应,但对于肺炎支原体特异性 IgE 抗体在哮喘中的作用知之甚少。

目的

研究肺炎支原体持续存在的儿童哮喘中 IgM、IgG 和 IgE 特异性抗体反应的作用,以及过去 6 个月内 URTI 史的关系。

方法

对稳定期哮喘患儿(肺炎支原体阳性和阴性)(无当前加重且无哮喘对照)(UniCAP 总 IgE 荧光酶免疫测定、酶联免疫吸附试验)进行总或特异性抗肺炎支原体 IgM、IgG 和 IgE 抗体反应研究。

结果

与非哮喘对照组相比,哮喘组的特异性 IgM 与特异性 IgG 相关(Spearman 相关,rho = 0.61,P < 0.0001),但与肺炎支原体特异性 IgE 抗体(AMA)无关。然而,特异性 IgG 与特异性 IgE AMA 相关(rho = 0.49,P = 0.0017)。与非哮喘组相比,哮喘组的特异性 IgM AMA 水平更高(中位数[四分位间距]:0.57[1.00]与 0.21[0.19];Kruskal-Wallis 检验,P = 0.0008)。此外,与非哮喘组相比,哮喘组 IgM 阳性率显著升高(39.1%与 0.0%;Fisher 确切检验,P = 0.01)。这些结果与过去 6 个月内的 URTI 史无关,与无 URTI 史相比,URTI 史与更高的 IgM、IgG 或 IgE AMA 水平无关(P = 0.25-0.64)。

结论

增加的肺炎支原体特异性 IgM 反应可能表明肺炎支原体感染在哮喘中起重要作用。

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