The role of bacterial infections in asthma

Area of Science:

• Microbiology
• Pulmonology
• Immunology

Background:

• Bacterial infections are increasingly recognized as significant contributors to asthma exacerbations.
• Viruses have historically received more attention than bacteria in asthma exacerbations.
• Specific bacteria such as Streptococcus pneumoniae, Hemophilus influenzae, and Moraxella catarrhalis are linked to asthma, especially with concurrent sinusitis.

Purpose of the Study:

• To highlight the clinical relevance of bacterial organisms in asthma exacerbations.
• To emphasize the need for increased attention to atypical bacteria, specifically Chlamydia pneumoniae and Mycoplasma pneumoniae, in asthma.
• To review current data and suggest future research directions for bacterial involvement in asthma pathogenesis.

Main Methods:

• Review of existing data linking specific bacterial pathogens to asthma exacerbations.
• Discussion of diagnostic modalities including culture, serology, and PCR.
• Exploration of the potential role of atypical bacteria in asthma development and pathogenesis.

Main Results:

• Streptococcus pneumoniae, Hemophilus influenzae, and Moraxella catarrhalis are associated with asthma exacerbations, particularly when sinusitis is present.
• Chlamydia pneumoniae and Mycoplasma pneumoniae show suggestive links to asthma exacerbation and potential causation.
• Current data are not conclusive but warrant further investigation into atypical bacteria's role in asthma.

Conclusions:

• Bacterial infections, including common and atypical pathogens, are clinically relevant in asthma exacerbations and potentially in asthma development.
• Treatment strategies for suspected bacterial asthma exacerbations should target relevant organisms.
• Further research, including the development of animal models and comprehensive host response evaluations, is crucial to elucidate the role of bacteria in asthma pathogenesis.