Asthma, Rhinitis, Other Respiratory Diseases
The development of asthma in children infected with Chlamydia pneumoniae is dependent on the modifying effect of mannose-binding lectin

https://doi.org/10.1016/S0091-6749(03)02010-4Get rights and content

Abstract

Background

Although several studies found associations between infection with Chlamydia pneumoniae and asthma, these were mainly restricted to the exacerbation of the symptoms in adults with known asthma. Data about the role of C pneumoniae in the initiation and development of asthma in children are controversial.

Objective

We investigated the role of C pneumoniae infection in 139 children with asthma, comparing them with 174 healthy control subjects. Furthermore, we studied the modifying effect of mannose-binding lectin (MBL) variant alleles on the susceptibility to asthma in children infected with C pneumoniae.

Methods

C pneumoniae–specific antibodies were measured by means of ELISA, and MBL genotypes were determined by means of PCR-RFLP.

Results

There were no significant differences in the percentage of children with positive results for C pneumoniae–specific antibodies between patients and control subjects. Among asthmatic children carrying variant MBL alleles, there were significantly more patients with positive results for C pneumoniae–specific IgG than among control children with variant MBL genotypes (63.7% vs 40.7% of asthmatic vs control children, respectively; odds ratio adjusted for age and sex, 2.21; 95% CI, 1.10-4.41; P = .02). Infected children with variant MBL alleles were found to have a higher risk of asthma development than infected children with normal MBL genotype. This risk was especially high in children with chronic or recurrent infection (positive results for both IgA and IgG; adjusted odds ratio, 5.38; 95% CI, 1.75-14.36; P = .01), but no increased risk was seen in children with current C pneumoniae infection (positive results for IgM).

Conclusion

This study indicates the important role of variant MBL alleles in the susceptibility to asthma in children infected with C pneumoniae. (J Allergy Clin Immunol 2003;112:729-34.)

Section snippets

Subjects

One hundred thirty-nine asthmatic children (79 boys and 60 girls; age range, 3-18 years; mean age, 10.5 years [SD 4.1]) and 174 healthy children (95 boys and 79 girls; age range, 3-18 years; mean age, 11.5 years [SD 3.9]) were enrolled in the study. All patients were from Budapest.

The asthmatic children attended the Allergic Outpatient Consultation of the Budai Children's Hospital. All the asthmatic children had specialist-diagnosed asthma with the following characteristics: (1) recurrent

Results

Table II shows the number and percentage of children with positive results for C pneumoniae–specific antibodies in the 2 groups. There were no significant differences in the proportion of patients with positive results for any C pneumoniae–specific antibodies between asthmatic and control children. Furthermore, there were no differences between sexes in the infection status in any groups of children (data not shown).

By definition, IgG positivity indicates that the probands have had C pneumoniae

Discussion

This study supports the association between C pneumoniae infection and asthma; however, the association was dependent on variation in the MBL gene. Significantly increased risk for development of asthma was seen in infected children who carried at least one variant MBL allele. However, this association was restricted to children with past C pneumoniae infection (positive for IgG). Furthermore, infected children with variant MBL alleles were found to have considerably higher risk of development

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    Supported by OTKA (National Scientific Research Fund): T032349 and T031887; Hungarian Ministry of Welfare: ETT 134/2001 and 300/2000; and a János Bolyai Research Grant.

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