Isotype-specific antibody responses to acute Mycoplasma pneumoniae infection

Background: Mycoplasma pneumoniae-induced respiratory infections affect millions of patients and have been implicated in exacerbation of bronchial asthma. IgE may be involved in such exacerbations. While specific IgG and IgM responses to Mycoplasma pneumoniae are well described, the response of other isotypes is less known. Purpose: To determine whether specific IgE and what subclasses of IgG are formed in response to Mycoplasma pneumoniae infection. Methods: We studied 20 patients with acute Mycoplasma pneumoniae infection, in whom the diagnosis was confirmed by a 16-fold increase in complement fixation titer between acute and convalescent serum samples. We developed an enzyme-linked immunosorbent assay (ELISA) for the determination of IgG, IgA, and IgM antibodies specific for Mycoplasma pneumoniae protein antigens. We used Western blotting to confirm the results of the ELISA and to detect Mycoplasma-specific IgG subclasses and IgE. Results: Changes in Mycoplasma pneumoniae-specific IgG, IgA, and IgM were significant. Western blots of Mycoplasma pneumoniae antigens in 13 convalescent sera showed specific IgG in all, IgM in 11, IgA in 6, and IgE in 10. The IgG response consisted mainly of IgG1 and IgG3, and to a lesser degree of IgG2 and IgG4. Conclusions: We conclude that Mycoplasma pneumoniae infection is associated with a significant specific IgA and IgE response, in addition to the well-known responses of IgG and IgM. As IgE is involved in allergic reactions, the production of Mycoplasma pneumoniae-specific IgE may have a role in exacerbation of bronchial asthma.