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Chronic Chlamydia pneumoniae infection and asthma exacerbations in children

A F Cunningham1, S L Johnston, S A Julious

  • 1Molecular Microbiology, Southampton University Medical School, Southampton General Hospital, UK.

The European Respiratory Journal
|April 29, 1998
PubMed

Insights

Chronic Chlamydia pneumoniae infection is common in school-aged children and linked to more frequent asthma attacks. Immune responses to this bacteria correlate with increased asthma exacerbations, suggesting a potential interaction with allergic inflammation.

Area of Science:

  • Pediatric respiratory health
  • Infectious disease immunology
  • Asthma research

Background:

  • Chlamydia pneumoniae and Mycoplasma pneumoniae infections are suspected triggers for asthma.
  • The association between these infections and asthma exacerbations requires further investigation, particularly in children.

Purpose of the Study:

  • To investigate the link between Chlamydia pneumoniae and Mycoplasma pneumoniae infections and asthma symptoms in children.
  • To determine if chronic infections or immune responses correlate with asthma severity and frequency of exacerbations.

Main Methods:

  • A 13-month longitudinal study of 108 children (9-11 years) with asthma symptoms.
  • Daily symptom and peak flow diaries, with nasal aspirates collected during symptomatic episodes and from asymptomatic children.
  • Polymerase chain reaction (PCR) and enzyme immunoassay (amplified secretory IgA) used to detect C. pneumoniae and M. pneumoniae infections and immune responses.

Main Results:

  • Chlamydia pneumoniae was detected in similar proportions of symptomatic (23%) and asymptomatic (28%) episodes.
  • Children with multiple asthma exacerbations were more likely to test PCR positive for C. pneumoniae, indicating chronic infection (p<0.02).
  • Significantly higher levels of C. pneumoniae-specific secretory IgA were found in children with four or more exacerbations compared to those with one (p<0.02).
  • Mycoplasma pneumoniae was rarely detected and not considered significant in this cohort.

Conclusions:

  • Chronic Chlamydia pneumoniae infection is prevalent in school-aged children with asthma.
  • Immune responses to C. pneumoniae are positively associated with the frequency of asthma exacerbations.
  • The immune response to chronic C. pneumoniae infection may exacerbate asthma symptoms by interacting with allergic inflammation.

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