Yano T, Ichikawa Y, Komatu S, Arai S, Oizumi K
First Department of Internal Medicine, Kurume University School of Medicine, Japan.
Am J Respir Crit Care Med. 1994 May;149(5):1348-53. doi: 10.1164/ajrccm.149.5.8173777.
Although mycoplasmal airway infection frequently exacerbates bronchial asthma, the cause of the initial onset of asthma remains unclear at present. In this report, we describe a patient in whom a previous acute mycoplasmal respiratory infection led to an initial onset of bronchial asthma. One month after the onset of the illness, cough and wheezing appeared. Pulmonary function studies revealed an airway obstructive dysfunction. Oral administration of bronchodilators resulted in a marked improvement of the asthmatic symptoms. An airway hyperresponsiveness to methacholine was demonstrated even 2 yrs after the initial onset of the illness, and IgE antibody specific to Mycoplasma pneumoniae was detected in the serum by use of enzyme-linked immunosorbent assay. An immediate skin test for M. pneumoniae was positive in addition to multiple positive skin tests. A bronchial inhalation challenge test with M. pneumoniae antigen also yielded a positive result. We conclude that the effects of mycoplasmal respiratory infections on the airway are multifactorial and involve a complex interplay of airway inflammation and IgE-mediated hypersensitivity.
虽然支原体气道感染常使支气管哮喘加重，但目前哮喘初始发病的原因仍不清楚。在本报告中，我们描述了一名患者，其先前的急性支原体呼吸道感染导致了支气管哮喘的初次发作。发病1个月后，出现咳嗽和喘息。肺功能研究显示气道阻塞性功能障碍。口服支气管扩张剂使哮喘症状明显改善。即使在发病初始2年后，仍显示对乙酰甲胆碱的气道高反应性，并且通过酶联免疫吸附测定在血清中检测到针对肺炎支原体的IgE抗体。除多项皮肤试验阳性外，肺炎支原体的即刻皮肤试验也呈阳性。用肺炎支原体抗原进行支气管吸入激发试验也产生了阳性结果。我们得出结论，支原体呼吸道感染对气道的影响是多因素的，涉及气道炎症和IgE介导的超敏反应的复杂相互作用。
