Acute exacerbations of asthma in adults: role of Chlamydia pneumoniae infection

Allegra, L.; Blasi, Francesco; Centanni, Stefano; Cosentini, Roberto; Denti, F.; Raccanelli, Rita; Tarsia, Paolo; Valenti, Vincenzo

doi:10.1183/09031936.94.07122165

Cited by 115 publications

(53 citation statements)

References 7 publications

(15 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…C. pneumoniae was identified in 18.5% of the patients with community-acquired pneumonia, 9% of the asthmatic patients and 5% of the patients with acute exacerbations of COPD. These results are similar to those found in previous studies [5,11,13,[22][23][24][25][26]. However, poor correlation was found between PCR-EIA and rELISA serology.…”

Section: Discussionsupporting

confidence: 81%

Comparison of two serological methods and a polymerase chain reaction-enzyme immunoassay for the diagnosis of acute respiratory infections with Chlamydia pneumoniae in adults

Petitjean

Vincent

Fretigny

et al. 1998

Journal of Medical Microbiology

View full text Add to dashboard Cite

Chlamydia pneumoniae is a common respiratory tract pathogen. Serological methods currently used for the diagnosis of C. pneumoniae infection lack specificity, give ambiguous results from a single serum sample and often provide only a retrospective diagnosis. A prospective study was undertaken to assess whether PCR could be a useful addition to the serological techniques routinely practised for diagnosis. This study investigated 68 adult patients with a diagnosis of acute respiratory infection. Acute and convalescent serological determination of antibodies to C. pneumoniae were performed by means of an rELISA test and a micro-immunofluorescence (MIF) test. Nasopharyngeal aspirates or bronchoalveolar lavage specimens and bronchial aspirates obtained from the 68 patients were evaluated by PCR-enzyme immunoassay (PCR-EIA) for the presence of C. pneumoniae and by immunofluorescence assay and cell culture for virus identification. Mycoplasma pneumoniae serology was also performed. Eight patients (11.8%) were positive by either rELISA or PCR-EIA, or both, with an infection rate of 5 (18.5%) of 27 in patients with community-acquired pneumonia, 2 (9%) of 22 in asthmatic patients and 1 (5%) of 19 in patients with an exacerbation of chronic obstructive pulmonary disease. Serological evidence of acute infection was found in four of these patients with the rELISA test and in three others with the MIF test. PCR-EIA detected C. pneumoniae DNA in four specimens, but there were concordant results with both rELISA and PCR-EIA in only one patient. A positive PCR-EIA was also obtained in a patient who did not show an antibody response in acute serum. The discrepancy between serological and PCR-EIA results reflects the difficulties in routine laboratory diagnosis of C. pneumoniae infection and the necessity for further studies with optimised techniques.

show abstract

Section: Discussionsupporting

confidence: 81%

Comparison of two serological methods and a polymerase chain reaction-enzyme immunoassay for the diagnosis of acute respiratory infections with Chlamydia pneumoniae in adults

Petitjean

Vincent

Fretigny

et al. 1998

Journal of Medical Microbiology

View full text Add to dashboard Cite

show abstract

“…In one study of adults with asthma, infection with C. pneumoniae was responsible for 10% of all acute exacerbations [106], similar to rates reported in children aged 5-16 yrs experiencing an acute episode of wheezing [101]. The higher prevalence rates of C. pneumoniae among adults with asthma, as compared to age-matched controls, have also been linked to acute exacerbations [107].…”

Section: Exacerbationsmentioning

confidence: 49%

Atypical pathogens and respiratory tract infections

Blasi¹

2004

European Respiratory Journal

Self Cite

109

View full text Add to dashboard Cite

The atypical respiratory pathogens Chlamydia pneumoniae, Mycoplasma pneumoniae and Legionella pneumophila are now recognised as a significant cause of acute respiratory-tract infections, implicated in community-acquired pneumonia, acute exacerbations of chronic bronchitis, asthma, and less frequently, upper respiratory-tract infections.Chronic infection with C. pneumoniae is common among patients with chronic obstructive pulmonary disease and may also play a role in the natural history of asthma, including exacerbations. The lack of a gold standard for diagnosis of these pathogens still handicaps the current understanding of their true prevalence and role in the pathogenesis of acute and chronic respiratory infections.While molecular diagnostic techniques, such as polymerase chain reaction, offer improvements in sensitivity, specificity and rapidity over culture and serology, the need remains for a consistent and reproducible diagnostic technique, available to all microbiology laboratories.Current treatment guidelines for community-acquired pneumonia recognise the importance of atypical respiratory pathogens in its aetiology, for which macrolides are considered suitable first-line agents. The value of atypical coverage in antibiotic therapy for acute exacerbations of chronic bronchitis and exacerbations of asthma is less clear, while there is no evidence to suggest that atypical pathogens should be covered in antibiotic treatment of upper respiratory-tract infections. The term "atypical pathogen" most commonly refers to Chlamydia pneumoniae, Mycoplasma pneumoniae and Legionella pneumophila. Once believed to be of little clinical significance, a wealth of data accumulated over the past decade suggests that these are important respiratory pathogens in a wide range of respiratory-tract infections (RTIs) and are capable of causing severe, as well as mild-to-moderate, illness.Although the role of atypical pathogens [1], and of C. pneumoniae in particular [2], has been reviewed previously, there has been little focus on appropriate coverage of these pathogens in treatment decisions for patients with RTIs. In addressing this issue, this review examines the role of atypical pathogens in the aetiology of upper and lower RTIs, in both adults and children, and discusses the value of appropriate coverage of these pathogens in empirical antibiotic prescribing.

show abstract

“…For example, patients with allergic asthma are more prone to rhinovirus infections than nonatopic individuals (34,35). In addition, they exhibit increased rates of atypical bacterial infections caused by Chlamydia pneumoniae and Mycoplasma pneumoniae (36-38), which are known to exacerbate the course of disease (39,40) and to increase airway hyperresponsiveness (AHR) and lung inflammation in a murine model of asthma (41). Patients with allergic rhinitis commonly exhibit S. aureus colonization of the nasal mucosa, which has been demonstrated to aggravate disease severity (42,43).…”

Section: High Prevalence Of Microbial Infections In Allergic Diseasesmentioning

confidence: 99%

Does allergy impair innate immunity? Leads and lessons from atopic dermatitis

Mrabet-Dahbi

Maurer

2010

Allergy

View full text Add to dashboard Cite

To cite this article: Mrabet‐Dahbi S, Maurer M. Does allergy impair innate immunity? Leads and lessons from atopic dermatitis. Allergy 2010; 65: 1351–1356.AbstractHost defence responses against invading pathogens are well‐balanced, inflammatory processes of the innate and adaptive immune system. Impaired development or abnormal function of either system can result in failure to control pathogens and to clear infections. Infections have been claimed to modulate the onset and course of allergic diseases. This so‐called hygiene hypothesis is still an active area of research. In contrast, the effects of allergies on infections and pathogen‐directed immune responses are less well understood. Here, we have reviewed the existing evidence that allergies result in impaired innate immunity and we discuss recent observations that may explain why and how innate immunity is dysfunctional in allergic patients. With a focus on atopic dermatitis as a model of allergic disease, we speculate that one of the key features of allergic conditions, namely Th2 polarization, leads to several independent inhibitory effects on host defence and consequently to a higher risk of infections in allergic patients. A better understanding of impaired host defence and its mechanisms in allergic subjects will help to improve the management of these diseases.

show abstract

Acute exacerbations of asthma in adults: role of Chlamydia pneumoniae infection

Cited by 115 publications

References 7 publications

Comparison of two serological methods and a polymerase chain reaction-enzyme immunoassay for the diagnosis of acute respiratory infections with Chlamydia pneumoniae in adults

Comparison of two serological methods and a polymerase chain reaction-enzyme immunoassay for the diagnosis of acute respiratory infections with Chlamydia pneumoniae in adults

Atypical pathogens and respiratory tract infections

Does allergy impair innate immunity? Leads and lessons from atopic dermatitis

Contact Info

Product

Resources

About