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A link between chronic asthma and chronic infection
1Department of Medicine, National Jewish Medical and Research Center and The Pulmonary and Critical Care Division, University of Colorado Health Sciences Center, 1400 Jackson St., Denver, CO 80206, USA.
Background:
Asthma is a prevalent disease with marked effects on quality of life and economic societal burden. However, the cause of asthma and its pathophysiology are not completely defined. Recently, the possibility that chronic infection may play a role has been suggested.
Objective:
We sought to define the association between Mycoplasma and Chlamydia species and chronic asthma.
Methods:
We performed a comparison study of asthmatic patients and normal control subjects. Fifty-five patients with chronic stable asthma were compared with 11 normal control subjects by using PCR, culture, and serology for Mycoplasma species, Chlamydia species, and viruses from the nasopharynx, lung, and blood. Bronchoalveolar lavage cell count and differential, as well as tissue morphometry, were also evaluated. Computer-generated scoring for the degree of chronic sinusitis in asthmatic patients was additionally evaluated.
Results:
Thirty-one of 55 asthmatic patients had positive PCR results for Mycoplasma (n = 25) or Chlamydia species (n = 6), which were mainly found on lung biopsy specimens or in lavage fluid. Only 1 of 11 normal control subjects had positive PCR results for Mycoplasma species. The distinguishing phenotype between asthmatic patients with positive and negative PCR results was the significantly greater number of tissue mast cells in the group with positive results.
Conclusion:
A significant number of patients with chronic stable asthma demonstrate the presence of Mycoplasma species, Chlamydia species, or both in their airways, with the distinguishing feature of increased mast cell number. These findings need further delineation but may help us to understand the pathophysiology of asthma and new treatment options.
Insights
Chronic asthma may be linked to infections from Mycoplasma and Chlamydia species. Asthmatic patients showed higher mast cell counts, suggesting a role in disease pathophysiology and potential new treatments.
Area of Science:
- Respiratory Medicine
- Infectious Diseases
- Immunology
Background:
- Asthma significantly impacts quality of life and incurs economic costs.
- The precise causes and pathophysiology of asthma remain incompletely understood.
- Chronic infections are increasingly suspected as contributing factors to asthma.
Purpose of the Study:
- To investigate the association between Mycoplasma and Chlamydia species and chronic asthma.
- To compare the prevalence of these microbial species in asthmatic patients versus healthy controls.
Main Methods:
- A comparative study involving 55 chronic stable asthma patients and 11 healthy controls.
- Utilized PCR, culture, and serology to detect Mycoplasma, Chlamydia, and viruses in respiratory samples and blood.
- Assessed bronchoalveolar lavage cell counts, tissue morphometry, and chronic sinusitis severity.
Main Results:
- PCR detected Mycoplasma or Chlamydia in 31 of 55 asthmatic patients, primarily in lung biopsies and lavage fluid.
- Only one control subject tested positive for Mycoplasma.
- Asthmatic patients with positive PCR results exhibited significantly higher tissue mast cell counts.
Conclusions:
- A substantial proportion of chronic stable asthma patients harbor Mycoplasma or Chlamydia species in their airways.
- Increased mast cell presence is a key distinguishing feature in these patients.
- These findings may offer insights into asthma pathophysiology and inform novel therapeutic strategies.
Related Concept Videos
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:29Asthma-I: Introduction
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:28Asthma I: Introduction
01:24Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features