Chlamydia pneumoniae Infections in Asthma

Abstract

Chlamydia pneumoniae is an intracellular pathogen that has been suggested to play a role in the pathology of asthma. However, so far none of the studies have provided clear evidence for a causative role of C. pneumoniae infections in asthma, although there is little doubt that chronic C. pneumoniae infection does aggravate asthma and should be treated. The diagnosis of C. pneumoniae infection is still a matter of concern for it is dependent on trained skilled personnel and can vary significantly between different diagnostic laboratories. This fact is also one of the major problems encountered when comparing epidemiological studies investigating the possible role of C. pneumoniae infections and their impact on the pathogenesis of other diseases. With regard to therapy, long-term treatment with macrolides is the best available method to eradicate C. pneumoniae. Successful therapy for C. pneumoniae, however, can also be complicated by the high possibility of de novo infection as epidemiological studies have shown that the prevalence of antibodies to C. pneumoniae increases with age in all populations studied. In the northern hemisphere the prevalence of C. pneumoniae is also affected by seasonal conditions. It is too early to draw any conclusions from the equatorial belt countries. The available data on C. pneumoniae in tropical countries indicate a much faster infection rate during early adulthood with 100% serological prevalence at an age greater than 25 years. This data, if confirmed, would argue against C. pneumoniae causing asthma since the asthma prevalence in those countries does not increase in a parallel pattern. An alternative interpretation of most studies could be that the increased rate of C. pneumoniae infections in patients with asthma results from a modified susceptibility towards the microorganism, due to yet unknown changes of the host cell's physiology. It should be kept in mind that increased prevalence of C. pneumoniae infection is not restricted to asthma. Further studies are needed to understand the role of C. pneumoniae, especially of chronic infection, in the pathogenesis of inflammatory diseases with a specific focus on the effect that the microorganism triggers in the infected host cell. Only when we understand what C. pneumoniae does to its host cell will we be able to judge its impact on the overall status of an affected patient, and this knowledge will help us to develop a successful therapy.

Antichlamydia IgG Antibody in Adult Asthmatics in Al-Najaf

“…The study demonstrated seropositivity of antichlamydial IgG in 34.4% of asthmatics patients versus 13.8% in the control group, the difference was significant (P=0.041, OR=3.2) and this result is consistent with that of many investigators, in Biscione et al, 22% asthmatic versus 9% normal participants had a positive antichlamydial IgG (12), Specjalski and Jassem reported more than 60% of asthmatics were seropositive for antichlamydial IgG (13) however Gencay & Roth reported lower figures of seropositivity in asthmatics but still with a significant difference from the control (18.2% versus 3.0%, P<0.01) (14).…”

Chlamydophila pneumoniae and Mycoplasma pneumoniae

“…Unlike culture, PCR testing can detect both organisms rendered nonviable during transport and organisms that are noncultivable in persistent infection; however, this attribute also limits the clinical utility of PCR, as it cannot distinguish between viable and nonviable organisms after antibacterial treatment (18). It may be possible to overcome this by using reverse transcriptase-PCR, which can identify metabolic activity via the detection of messenger RNA (21); however, this new method is not yet well validated.…”

“…However, it should be noted that the quality of commercially available MIF kits varies and interpretation of results is subjective, making comparisons across laboratories and studies problematic. Although a number of alternative serologic assays for detection of C. pneumoniae have been described in the literature, their use is not currently recommended because of a lack of commercial availability and/or peer-reviewed evaluation of specificity (17,18).…”

Antimicrobial Therapy in Childhood Asthma and Wheezing

“…Acute infection is accompanied by lymphocyte pneumoniae is that it does not distinguish between viable and proliferation and the release of tumor necrosis factor (TNF)-α, nonviable bacteria, for example after antibacterial chemothera-IFNγ, and various interleukins (IL2, IL4, IL5, IL6, IL8, IL10, and py. [92] Thus, at least one other method is recommended for the IL18). [21] laboratory diagnosis of both infections.…”