Persistent airflow limitation in adult-onset nonatopic asthma is associated with serologic evidence of Chlamydia pneumoniae infection
Persistent airflow limitation in adult-onset nonatopic asthma is associated with serologic evidence of Chlamydia pneumoniae infection
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DOI：
10.1067/mai.2001.113047
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发表时间：
2001-03-01
影响因子：
14.2
通讯作者：
Bel, EH
中科院分区：
文献类型：
--
作者：
ten Brinke, A;van Dissel, JT;Bel, EH
背景：持续性气流受限可能发生在哮喘患者，特别是患有非特应性(内源性)疾病的成年人。虽然发病机制尚不清楚，但可能与呼吸道感染有关。目的：我们根据哮喘发病年龄和特应性状态，调查不同亚组重症哮喘患者每年肺功能丧失与肺炎衣原体抗体阳性率的关系。方法：101例经肺科医生诊断为重症哮喘的不吸烟门诊患者(男性32例，女性69例；平均年龄46.0岁；年龄18-75岁)纳入横断面研究。采用双抗体夹心法检测C肺炎特异性血清免疫球蛋白Ig G和Ig A。结果：成人起病的非特应性哮喘患者和肺炎衣原体抗体阳性的患者与其他哮喘患者相比，肺功能下降的回归直线斜率显著增加(P=.001)。哮喘持续时间预测为每年2.3%比0.5%。结论：肺炎衣原体感染可能促进非特应性成人哮喘患者持续气流受限的发展。可用于治疗干预的可存活病原体是否仍存在于下呼吸道仍有待确定。
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.