肺炎衣原体与成人哮喘急性加重
Chlamydia pneumoniae and exacerbations of asthma in adults.
作者信息
Miyashita N, Kubota Y, Nakajima M, Niki Y, Kawane H, Matsushima T
机构信息
Department of Medicine, Kawasaki Medical School, Kurashiki City, Okayama, Japan.
出版信息
Ann Allergy Asthma Immunol. 1998 May;80(5):405-9. doi: 10.1016/S1081-1206(10)62992-4.
BACKGROUND
Chlamydia pneumoniae is a frequent causative agent of acute respiratory disease and has been recently reported as a possible cause of asthma.
OBJECTIVE
We assessed the prevalence of C. pneumoniae infections in adult patients with acute exacerbations of asthma.
METHODS
One hundred sixty-eight adult patients with acute exacerbations of asthma and 108 control subjects matched for age, sex, and smoking status were studied. Nasopharyngeal swab specimens were obtained from all subjects and analyzed by isolation in cell culture and polymerase chain reaction (PCR) test for C. pneumoniae. Serum samples were also obtained and tested for C. pneumoniae-specific antibodies by the microimmunofluorescence test.
RESULTS
C. pneumoniae was isolated from two (1.2%) asthma patients and none from controls and detected by PCR from nine (5.4%) cases and one (0.9%) control. Both culture positive specimens were also positive in PCR. Further, serologic evidence of acute C. pneumoniae infection was present in 15 (8.9%) of asthma patients and in three (2.8%) of controls (P = .048). The prevalence of C. pneumoniae-specific IgG and IgA was significantly higher in asthma cases than in controls (IgG > or = 1:16: 85.1% versus 67.6%, P = .001; IgA > or = 1:16: 47.6% versus 16.7%, P < .001). Mean titer of IgG and IgA was also significantly greater in asthma cases than in controls (IgG: 38.8 versus 18.1, P = .0001; IgA: 17.2 versus 6.1, P = .0001).
CONCLUSIONS
Our data suggest that C. pneumoniae infection may trigger acute exacerbations of adult asthma.
背景
肺炎衣原体是急性呼吸道疾病的常见病原体，最近有报道称它可能是哮喘的病因之一。
目的
我们评估了成年哮喘急性加重患者中肺炎衣原体感染的患病率。
方法
研究了168例成年哮喘急性加重患者以及108例年龄、性别和吸烟状况相匹配的对照者。从所有受试者采集鼻咽拭子标本，通过细胞培养分离和肺炎衣原体聚合酶链反应（PCR）检测进行分析。还采集血清样本，通过微量免疫荧光试验检测肺炎衣原体特异性抗体。
结果
从2例（1.2%）哮喘患者中分离出肺炎衣原体，对照组未分离出；通过PCR在9例（5.4%）病例和1例（0.9%）对照中检测到。两个培养阳性标本的PCR检测也呈阳性。此外，15例（8.9%）哮喘患者和3例（2.8%）对照者有急性肺炎衣原体感染的血清学证据（P = 0.048）。哮喘病例中肺炎衣原体特异性IgG和IgA的患病率显著高于对照组（IgG≥1:16：85.1%对67.6%，P = 0.001；IgA≥1:16：47.6%对16.7%，P<0.001）。哮喘病例中IgG和IgA的平均滴度也显著高于对照组（IgG：38.8对18.1，P = 0.0001；IgA：17.2对6.1，P = 0.0001）。
结论
我们的数据表明，肺炎衣原体感染可能引发成年哮喘的急性加重。
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