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Asthma in children: are chlamydia or mycoplasma involved?
1Paediatric Department I, University of Milan, Italy. sufersus@mailserver.unimi.it
Abstract:
Asthma aetiology is complex, involving interactions between genetic susceptibility, allergen exposure and external aggravating factors such as air pollution, smoking and respiratory tract infections. Available evidence supports a role for acute Chlaymdia pneumoniae or Mycoplasma pneumoniae respiratory tract infection as a trigger for 5 to 30% of wheezing episodes and asthma exacerbations. It also appears that acute infections with C. pneumoniae and M. pneumoniae can initiate asthma in some previously asymptomatic patients; however, the quantitative role for these atypical bacteria as asthma initiators is unknown at the present time. Whether chronic infections with these agents play an important role in persistent asthma symptoms and/or to asthma severity is unclear and additional information should be acquired before definite conclusions can be reached. Improvement in asthma symptoms after antimicrobial therapy active against C. pneumoniae and M. pneumoniae has been observed. In some studies C. pneumoniae seems to be more important for asthma pathogenesis and exacerbations than M. pneumoniae; in other reports the role of M. pneumoniae appears to be more significant. However, a number of questions remain unanswered. Carefully controlled randomised trials are clearly warranted to determine whether infection with atypical bacteria is really associated with asthma and to define the appropriate role of antimicrobial treatment.
Insights
Acute respiratory infections by Chlamydia pneumoniae and Mycoplasma pneumoniae may trigger asthma exacerbations and potentially initiate asthma. Further research is needed to clarify their role and the effectiveness of antimicrobial treatment.
Area of Science:
- Pulmonology
- Infectious Diseases
- Microbiology
Background:
- Asthma's complex etiology involves genetic, environmental, and infectious factors.
- Atypical bacteria, Chlamydia pneumoniae (C. pneumoniae) and Mycoplasma pneumoniae (M. pneumoniae), are implicated in respiratory infections.
- Evidence suggests these infections may trigger asthma symptoms and exacerbations.
Purpose of the Study:
- To investigate the role of C. pneumoniae and M. pneumoniae in asthma pathogenesis.
- To determine if these atypical bacterial infections can initiate asthma in susceptible individuals.
- To evaluate the impact of chronic infections and the efficacy of antimicrobial therapy in asthma.
Main Methods:
- Review of existing evidence on atypical bacterial infections and asthma.
- Analysis of studies examining C. pneumoniae and M. pneumoniae as triggers for wheezing and exacerbations.
- Observation of symptom improvement following antimicrobial treatment.
Main Results:
- Acute C. pneumoniae or M. pneumoniae infections trigger 5-30% of wheezing episodes and asthma exacerbations.
- These infections may initiate asthma in some previously healthy individuals, though the quantitative role is unknown.
- Symptom improvement observed after antimicrobial therapy suggests a potential link.
Conclusions:
- The precise role of C. pneumoniae and M. pneumoniae in asthma initiation and persistence requires further investigation.
- The relative importance of C. pneumoniae versus M. pneumoniae in asthma pathogenesis remains debated.
- Randomized controlled trials are essential to confirm the association between atypical bacterial infections and asthma, and to define optimal antimicrobial treatment strategies.