Serological evidence of infection with Chlamydia pneumoniae is related to the severity of asthma

There is evidence that infection with Chlamydia pneumoniae is associated with asthma of recent onset and that it can influence the severity of asthma. This has led to the suggestion that macrolide antibiotics may be useful in the treatment of asthma in subjects infected with C. pneumoniae. This study examined the association between immunoglobulin (Ig)G and IgA titres to C. pneumoniae and the severity of asthma. IgG and IgA antibodies to C. pneumoniae were measured in 619 subjects with asthma (18-60 yrs), using the microimmunofluoresence method. Subjects were asked about their use of asthma medicines, symptoms, previous hospitalization for asthma, smoking status and age of onset of asthma. In subjects with IgG titres of > or =1:64 and/or IgA titres > or =1:16 (n=212), spirometry was performed and peak expiratory flow rate (PEFR) and symptoms were recorded twice daily for 4 weeks on a diary card. The use of high dose inhaled steroids was associated with an increase of 74.1% in the titre of IgG antibodies (p=0.04) and an increase of 70.6% in the titre of IgA antibodies (p=0.0001) when compared with the use of low dose inhaled steroids. There was an inverse association between IgG antibodies and forced expiratory volume in one second (FEV1) as a percentage of predicted in those subjects with elevated IgG and/or IgA (p=0.04). In this group IgA antibodies were also associated with a higher daytime symptom score (p=0.04). Higher titres of antibodies to Chlamydia pneumoniae appears to be associated with markers of asthma severity. This raises the possibility that chronic infection with Chlamydia pneumoniae leads to an increase in the severity of asthma. Studies aimed at eradicating chronic infection with Chlamydia pneumoniae are necessary to determine whether or not this is the case.

This article has been cited by other articles:

				W. C. Webley, Y. Tilahun, K. Lay, K. Patel, E. S. Stuart, C. Andrzejewski, and P. S. Salva Occurrence of Chlamydia trachomatis and Chlamydia pneumoniae in paediatric respiratory infections Eur. Respir. J., February 1, 2009; 33(2): 360 - 367. [Abstract] [Full Text] [PDF]

				H. Yamaguchi, S. Kamiya, T. Uruma, T. Osaki, H. Taguchi, T. Hanawa, M. Fukuda, H. Kawakami, H. Goto, H. Friedman, et al. Chlamydia pneumoniae Growth Inhibition in Cells by the Steroid Receptor Antagonist RU486 (Mifepristone) Antimicrob. Agents Chemother., June 1, 2008; 52(6): 1991 - 1998. [Abstract] [Full Text] [PDF]

				G. E. Kaiko, S. Phipps, D. K. Hickey, C. E. Lam, P. M. Hansbro, P. S. Foster, and K. W. Beagley Chlamydia muridarum Infection Subverts Dendritic Cell Function to Promote Th2 Immunity and Airways Hyperreactivity J. Immunol., February 15, 2008; 180(4): 2225 - 2232. [Abstract] [Full Text] [PDF]

				D. Droemann, J. Rupp, T. Goldmann, U. Uhlig, D. Branscheid, E. Vollmer, P. Kujath, P. Zabel, and K. Dalhoff Disparate Innate Immune Responses to Persistent and Acute Chlamydia pneumoniae Infection in Chronic Obstructive Pulmonary Disease Am. J. Respir. Crit. Care Med., April 15, 2007; 175(8): 791 - 797. [Abstract] [Full Text] [PDF]

				T H Harju, M Leinonen, J Nokso-Koivisto, T Korhonen, R Raty, Q He, T Hovi, J Mertsola, A Bloigu, P Rytila, et al. Pathogenic bacteria and viruses in induced sputum or pharyngeal secretions of adults with stable asthma Thorax, July 1, 2006; 61(7): 579 - 584. [Abstract] [Full Text] [PDF]

				S. L. Johnston and R. J. Martin Chlamydophila pneumoniae and Mycoplasma pneumoniae: A Role in Asthma Pathogenesis? Am. J. Respir. Crit. Care Med., November 1, 2005; 172(9): 1078 - 1089. [Abstract] [Full Text] [PDF]

				D. Caronzolo, V. Lucini, M. Pannacci, S. Grosso, F. Colleoni, F. Fraschini, and F. Scaglione Glucocorticoids Increase In Vitro and In Vivo Activities of Antibiotics against Chlamydophila pneumoniae Antimicrob. Agents Chemother., December 1, 2004; 48(12): 4878 - 4881. [Abstract] [Full Text] [PDF]

				G.L. Biscione, J. Corne, A.J. Chauhan, and S.L. Johnston Increased frequency of detection of Chlamydophila pneumoniae in asthma Eur. Respir. J., November 1, 2004; 24(5): 745 - 749. [Abstract] [Full Text] [PDF]

				F. Blasi Atypical pathogens and respiratory tract infections Eur. Respir. J., July 1, 2004; 24(1): 171 - 182. [Abstract] [Full Text] [PDF]

				M. H. Gotfried Macrolides for the Treatment of Chronic Sinusitis, Asthma, and COPD Chest, February 1, 2004; 125(2_suppl): 52S - 61S. [Abstract] [Full Text] [PDF]

				R. F. Lemanske Jr. Is Asthma an Infectious Disease?: Thomas A. Neff Lecture Chest, March 1, 2003; 123(2007): 385S - 390S. [Abstract] [Full Text] [PDF]

				G. Falck, J. Gnarpe, L.-O. Hansson, K. Svardsudd, and H. Gnarpe Comparison of Individuals With and Without Specific IgA Antibodies to Chlamydia pneumoniae: Respiratory Morbidity and the Metabolic Syndrome Chest, November 1, 2002; 122(5): 1587 - 1593. [Abstract] [Full Text] [PDF]

				P.A.B. Wark, S.L. Johnston, J.L. Simpson, M.J. Hensley, and P.G. Gibson Chlamydia pneumoniae immunoglobulin A reactivation and airway inflammation in acute asthma Eur. Respir. J., October 1, 2002; 20(4): 834 - 840. [Abstract] [Full Text] [PDF]

				L.C. von Hertzen Role of persistent infection in the control and severity of asthma: focus on Chlamydia pneumoniae Eur. Respir. J., March 1, 2002; 19(3): 546 - 556. [Abstract] [Full Text] [PDF]

				K-;H. Carlsen and P.J. Sterk Infection: friend or foe to the development of asthma? Eur. Respir. J., November 1, 2001; 18(5): 744 - 747. [Full Text] [PDF]

				C. Kroegel, J. Rodel, B. Mock, K. W. Garey, and I. Rubinstein Chlamydia pneumoniae, Clarithromycin, and Severe Asthma Chest, September 1, 2001; 120(3): 1035 - 1036. [Full Text] [PDF]

				S. L. Johnston Is Chlamydia pneumoniae Important in Asthma? . The First Controlled Trial of Therapy Leaves the Question Unanswered Am. J. Respir. Crit. Care Med., August 15, 2001; 164(4): 513 - 514. [Full Text] [PDF]

				P. N. BLACK, F. BLASI, C. R. JENKINS, R. SCICCHITANO, G. D. MILLS, A. R. RUBINFELD, R. E. RUFFIN, P. R. MULLINS, J. DANGAIN, B. C. COOPER, et al. Trial of Roxithromycin in Subjects with Asthma and Serological Evidence of Infection with Chlamydia pneumoniae Am. J. Respir. Crit. Care Med., August 15, 2001; 164(4): 536 - 541. [Abstract] [Full Text] [PDF]

				S. Chinn Statistics for the European Respiratory Journal Eur. Respir. J., August 1, 2001; 18(2): 393 - 401. [Abstract] [Full Text] [PDF]

				M. GENCAY, J. J. RÜDIGER, M. TAMM, M. SOLÉR, A. P. PERRUCHOUD, and M. ROTH Increased Frequency of Chlamydia pneumoniae Antibodies in Patients with Asthma Am. J. Respir. Crit. Care Med., April 1, 2001; 163(5): 1097 - 1100. [Abstract] [Full Text]