CHLAMYDIA-PNEUMONIAE AND EXACERBATIONS OF ASTHMA IN ADULTS

Background: Chlamydia pneumoniae is a frequent causative agent of acut e respiratory disease and has been recently reported as a possible cau se of asthma. Objective: We assessed the prevalence of C. pneumoniae i nfections in adult patients with acute exacerbations of asthma. Method s: One hundred sixty-eight adult patients with acute exacerbations of asthma and 108 control subjects matched for age, sex, and smoking stat us were studied. Nasopharyngeal swab specimens were obtained from all subjects and analyzed by isolation in cell culture and polymerase chai n reaction (PCR) test for C. pneumoniae. Serum samples were also obtai ned and tested for C. pneumoniae-specific antibodies by the microimmun ofluorescence test. Results: C. pneumoniae was isolated from two (1.2% ) asthma patients and none from controls and detected by PCR from nine (5.4%) cases and one (0.9%) control. Both culture positive specimens were also positive in PCR. Further, serologic evidence of acute C. pne umoniae infection was present in 15 (8.9%) of asthma patients and in t hree (2.8%) of controls (P = .048). The prevalence of C. pneumoniae-sp ecific IgG and IgA was significantly higher in asthma cases than in co ntrols (IgG greater than or equal to 1:16: 85.1% versus 67.6%, P = .00 1; IgA greater than or equal to 1:16: 47.6% versus 16.7%, P < .001). M ean titer of Ige and IgA was also significantly greater in asthma case s than in controls (IgG: 38.8 versus 18.1, P = .0001; IgA: 17.2 versus 6.1, P = .0001). Conclusions: Our data suggest that C. pneumoniae inf ection may trigger acute exacerbations of adult asthma.