Persistent airflow limitation in adult-onset nonatopic asthma is associated with serologic evidence of Chlamydia pneumoniae infection

被引:108
作者
ten Brinke, A
van Dissel, JT
Sterk, PJ
Zwinderman, AH
Rabe, KF
Bel, EH
机构
[1] Leiden Univ, Med Ctr, Dept Pulm Dis, NL-2300 RC Leiden, Netherlands
[2] Leiden Univ, Med Ctr, Dept Infect Dis, NL-2300 RC Leiden, Netherlands
[3] Leiden Univ, Med Ctr, Dept Med Stat, NL-2300 RC Leiden, Netherlands
关键词
asthma; severity of illness index; airway obstruction; prognosis; chronic disease; phenotype; Chlamydia pneumoniae; infection; immunology; human;
D O I
10.1067/mai.2001.113047
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Background: Persistent airflow limitation may develop in patients with asthma, particularly in adults with nonatopic (intrinsic) disease. Although the underlying mechanisms are still unknown, respiratory infections might be involved. Objective: We investigated the annual loss of lung function in relation to seropositivity to Chlamydia pneumoniae in different subgroups of patients with severe asthma according to age at onset of asthma and atopic status. Methods: One hundred one nonsmoking outpatients with a pulmonologist's diagnosis of severe asthma (32 men and 69 women; mean age, 46.0 years; range, 18-75 years) were included in a cross-sectional study. C pneumoniae-specific serum IgG and IgA were measured by means of ELISA. The estimated decline in lung function was calculated from the relationship between postbronchodilator FEV1/vital capacity (percent predicted) and the duration of asthma and expressed as the slope of the regression line. Results: Patients with adult-onset nonatopic asthma and positive IgG antibodies to C pneumoniae had a significantly steeper slope of the regression line compared with the other subgroups of asthmatic patients (P = .001), being indicative of a 4-fold greater estimated decline in postbronchodilator FEV1/vital capacity (2.3% vs 0.5% predicted per year of asthma duration). Conclusion: These results suggest that C pneumoniae infection might promote the development of persistent airflow limitation in patients with nonatopic adult-onset asthma. It remains to be established whether viable pathogens that are accessible for therapeutic intervention are still present in the lower airways.
引用
收藏
页码:449 / 454
页数:6
相关论文
共 33 条
  • [1] Difficult asthma
    Barnes, PJ
    Woolcock, AJ
    [J]. EUROPEAN RESPIRATORY JOURNAL, 1998, 12 (05) : 1209 - 1218
  • [2] Serological evidence of infection with Chlamydia pneumoniae is related to the severity of asthma
    Black, PN
    Scicchitano, R
    Jenkins, CR
    Blasi, F
    Allegra, L
    Wlodarczyk, J
    Cooper, BC
    [J]. EUROPEAN RESPIRATORY JOURNAL, 2000, 15 (02) : 254 - 259
  • [3] ASTHMA AND IRREVERSIBLE AIR-FLOW OBSTRUCTION
    BROWN, PJ
    GREVILLE, HW
    FINUCANE, KE
    [J]. THORAX, 1984, 39 (02) : 131 - 136
  • [4] Chlamydia pneumoniae and asthma
    Cook, PJ
    Davies, P
    Tunnicliffe, W
    Ayres, JG
    Honeybourne, D
    Wise, R
    [J]. THORAX, 1998, 53 (04) : 254 - 259
  • [5] Chronic Chlamydia pneumoniae infection and asthma exacerbations in children
    Cunningham, AF
    Johnston, SL
    Julious, SA
    Lampe, FC
    Ward, ME
    [J]. EUROPEAN RESPIRATORY JOURNAL, 1998, 11 (02) : 345 - 349
  • [6] Association of Chlamydia pneumoniae IgA antibodies with recently symptomatic asthma
    Hahn, DL
    Anttila, T
    Saikku, P
    [J]. EPIDEMIOLOGY AND INFECTION, 1996, 117 (03) : 513 - 517
  • [7] ASSOCIATION OF CHLAMYDIA-PNEUMONIAE (STRAIN TWAR) INFECTION WITH WHEEZING, ASTHMATIC BRONCHITIS, AND ADULT-ONSET ASTHMA
    HAHN, DL
    DODGE, RW
    GOLUBJATNIKOV, R
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1991, 266 (02): : 225 - 230
  • [8] Reversible and irreversible airflow obstruction as predictor of overall mortality in asthma and chronic obstructive pulmonary disease
    Hansen, EF
    Phanareth, K
    Laursen, LC
    Kok-Jensen, A
    Dirksen, A
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1999, 159 (04) : 1267 - 1271
  • [9] The immunopathology of extrinsic (atopic) and intrinsic (non-atopic) asthma: more similarities than differences
    Humbert, M
    Menz, G
    Ying, S
    Corrigan, CJ
    Robinson, DS
    Durham, SR
    Kay, AB
    [J]. IMMUNOLOGY TODAY, 1999, 20 (11): : 528 - 533
  • [10] IL-4 and IL-5 mRNA and protein in bronchial biopsies from patients with atopic and nonatopic asthma: Evidence against ''intrinsic'' asthma being a distinct immunopathologic entity
    Humbert, M
    Durham, SR
    Ying, S
    Kimmitt, P
    Barkans, J
    Assoufi, B
    Pfister, R
    Menz, G
    Robinson, DS
    Kay, AB
    Corrigan, CJ
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1996, 154 (05) : 1497 - 1504