Evidence for Chlamydia pneumoniae Infection in Steroid-Dependent Asthma

Hahn, David L.; Bukstein, Don A.; Luskin, Allan T.; Zeitz, H

doi:10.1016/s1081-1206(10)62938-9

Cited by 71 publications

(40 citation statements)

References 19 publications

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“…Similar observations have also been madein previous reports (3)(4)(5). Recently, long-term macrolide therapy trials have been undertaken for eradication of C. pneumoniae from deep tissues, secondary prevention of cardiovascular diseases or improvement or prevention of asthma symptoms (13)(14)(15)(16)(17). In our cases, we tried long-term macrolide therapy, a six-week course of clarithromycin or azithromycin.…”

Section: Discussionsupporting

confidence: 84%

Recurrent Pneumonia due to Persistent Chlamydia Pneumoniae Infection.

et al. 2002

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Twocases of recurrent pneumoniadue to Chlamydia pneumoniae are described. C. pneumoniae was continuously detected from the nasopharynx in both patients by the polymerase chain reaction and/or culture even with appropriate antibiotic therapy during the first episode. After eradication of C. pneumoniae with long-term macrolide therapy, the respiratory symptoms of both patients completely disappeared and no relapse was observed. These data indicate that newtreatment strategies maybe necessary to eradicate the organism in patients prone to persistent infection. (Internal Medicine 41 : 30-33, 2002)

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Section: Discussionsupporting

confidence: 84%

Recurrent Pneumonia due to Persistent Chlamydia Pneumoniae Infection.

et al. 2002

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“…Although antibiotic therapy is not routinely advocated in the management of acute asthma, there is evidence to suggest that in adult patients with uncontrolled steroid-dependent asthma and recent infection with C. pneumoniae, treatment with macrolides (clarithromycin or azithromycin) can greatly improve symptoms and reduce dependence on steroids [112]. In addition to their antimicrobial activity against atypical pathogens, macrolides may also improve symptoms and pulmonary function in patients with asthma by virtue of their anti-inflammatory activities [113].…”

Section: Therapymentioning

confidence: 99%

Atypical pathogens and respiratory tract infections

Blasi¹

2004

European Respiratory Journal

109

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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.

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“…An association between C. pneumoniae infection and disease has been suggested in participants with steroiddependent asthma [11,22]. For this reason, an association between the use of inhaled steroids and the presence of one or more C. pneumoniae infection was only examined in asthmatic participants.…”

Section: Relationship Between Chlamydophila Pneumoniae and Inhaled Stmentioning

confidence: 99%

Increased frequency of detection of Chlamydophila pneumoniae in asthma

Biscione

Corne²,

Chauhan³

et al. 2004

European Respiratory Journal

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Previous studies have suggested that chronic Chlamydophila pneumoniae infection may play a role in the pathogenesis of asthma. However, most studies have been based on serology and have been unable to differentiate acute from chronic infection.The present authors assessed the presence of acute and chronic C. pneumoniae infection in 74 spouse pairs, each consisting of one atopic asthmatic and one nonatopic nonasthmatic. Nasal secretions were sampled every 2 weeks from October to December and actively replicating C. pneumoniae infection was detected by specific RT-PCR.C. pneumoniae was detected in 31 out of 709 samples analysed, 23 (6.4%) were positive in 362 samples from asthmatic participants and in eight out of 347 (2.3%) samples from their normal spouses (with a significant difference in infection rates, 95% confidence interval: 4.2%, 1.2-7.2%). A total of 16 (22%) asthmatic and seven (9%) normal participants were positive at least once during the study.These data confirm that Chlamydophila pneumoniae infection is detected more frequently among asthmatic participants than normal control participants. Further studies are required to confirm whether infections are also present in the lower airway and whether Chlamydophila pneumoniae infection plays a role in disease pathogenesis. Eur Respir J 2004; 24: 745-749.

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Evidence for Chlamydia pneumoniae Infection in Steroid-Dependent Asthma

Cited by 71 publications

References 19 publications

Recurrent Pneumonia due to Persistent Chlamydia Pneumoniae Infection.

Recurrent Pneumonia due to Persistent Chlamydia Pneumoniae Infection.

Atypical pathogens and respiratory tract infections

Increased frequency of detection of Chlamydophila pneumoniae in asthma

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