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1 Respiratory Cell and Molecular Biology, Research Division, Southampton General Hospital, Southampton, and 2 Dept of Respiratory Medicine, National Heart and Lung Institute at St Mary's, Imperial College School of Medicine, London, UK. 3 Airways Research Centre, John Hunter Hospital, and 4 Faculty of Medicine, The University of Newcastle, Newcastle, Australia
CORRESPONDENCE: P.G. Gibson, Dept of Respiratory and Sleep Medicine, John Hunter Hospital, Locked Bag 1, Hunter Region Mail Centre, NSW 2310, Australia. Fax: 61 2 49213469. E-mail: mdpgg@mail.newcastle.edu.au
Keywords: asthma, Chlamydia pneumoniae, induced sputum, inflammation
Received: January 15, 2002
Accepted May 2, 2002
This study was supported by the National Health and Medical Research Council, Canberra, New South Wales, Australia.
Infection with Chlamydia pneumoniae can trigger acute asthma and is associated with severe chronic asthma. The aim of the present study was to examine the relationship between airway inflammation and serological response to C. pneumoniae in acute severe asthma.
Subjects (n=54) were recruited within 4 h of presentation to the emergency department with an acute exacerbation of asthma. Clinical history taking, sputum induction (0.9% saline), spirometry and acute and convalescent serology for C. pneumoniae immunoglobulins A and G were performed.
At presentation, 47% of subjects had antibodies directed against C. pneumoniae, and 38% (20) demonstrated an increase in C. pneumoniae antibody levels, with 15 demonstrating a rise in immunoglobulin A concentration. C. pneumoniae responders exhibited significantly higher sputum neutrophil levels (4.6x106 cells·mL–1) compared to nonresponders (1.2x106 cells·mL–1, p=0.02) and elevated sputum eosinophil cationic protein concentration (3,981 versus 1,122 ng·mL–1, p=0.02).
An acute antibody response to Chlamydia pneumoniae is common in exacerbations of asthma. The serological features suggest that Chlamydia pneumoniae reactivation may trigger neutrophilic airway inflammation in acute asthma.
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