Mycoplasma pneumoniae Infection in Patients with Chronic Asthma

慢性哮喘患者肺炎支原体感染

• 批准号: 7686480
• 负责人: JAY PETERS
• 金额: $ 15.87万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7686480
• 关键词: Acute; Adult; American; Antibiotic Therapy; Antibodies; Antibody Formation; Antigens; Area; Asthma; Bacterial Adhesins; Bacterial Infections; Biological Assay; Child; Chronic; Chronic Disease; Clinical; Community Acquired Respiratory Distress Syndrome Toxin; Complex; Daily; Data; Development; Diagnostic tests; Disease; Disease Progression; Disease susceptibility; Economics; Environmental Risk Factor; Etiology; Evaluation; Functional disorder; Genes; Genetic Predisposition to Disease; Goals; Gold; IgE; Immune; Infection; Inflammatory; Interleukin-4; Interleukin-5; Irrigation; Link; Lung; Measurement; Measures; Mediator of activation protein; Morbidity - disease rate; Mycoplasma; Mycoplasma pneumonia infection; Mycoplasma pneumoniae; Nose; Numbers; Pathogenesis; Pathology; Patients; Pharmaceutical Preparations; Play; Pneumonia; Polymerase Chain Reaction; Population; Population Control; Precipitating Factors; Prevalence; Proteins; Pulmonary function tests; Quality of life; Randomized; Refractory; Research; Research Personnel; Resolution; Respiratory System; Respiratory Tract Infections; Role; Sampling; Serological; Serum; Sputum; Standards of Weights and Measures; Symptoms; Testing; Toxin; United States; Week; Work; abstracting; asthmatic patient; base; cytokine; design; experience; immunogenic; improved; mortality; response

Asthma is a complex disease since it involves genetic predisposition, environmental factors, and an interaction with the immune status in the development and progression of the disease. Over 15 million Americans are afflicted with this disease and despite the use of potent medications, between 16-17% of patients experience continuous daily and frequent nocturnal symptoms. One underappreciated and controversial factor in the etiology of asthma is the role that atypical bacterial infections, such as those caused by Mycoplasma pneumoniae, play in initiating, exacerbating and prolonging airway-related symptoms and pathologies. Multiple lines of evidence directly link M. pneumoniae to the pathogenesis of asthma beyond its role as a precipitating factor in acute exacerbation of asthma. In children, M. pneumoniae infections have been shown to induce chronic lung damage for prolonged periods after the resolution of respiratory tract symptoms. Studies have demonstrated abnormal pulmonary function tests in up to 50% of children and abnormalities of the lung in 37% of children months to years after an episode of M. pneumoniae respiratory infection. Mycoplasma pneumoniae is also known to induce a number of inflammatory mediators implicated in the pathogenesis of asthma. IgE, IL-4, and IL-5 have been shown to be significantly elevated in children with M. pneumoniae infections, suggesting that M. pneumoniae can induce a TH-2 like cytokine response. In adults, M. pneumoniae has been detected in a large percentage of patients with stable moderately severe chronic asthma. The significance of this finding was supported by a randomized, doubleblind study that demonstrated only PCR positive asthmatics improved their pulmonary function test when treated with antibiotic therapy directed against mycoplasmas. Recently, Drs. Baseman and Kannan discovered an ADP-ribosylating, vacuolating toxin of M. pneumoniae designated the Community Acquired Respiratory Distress Syndrome Toxin (CARDS TX). CARDS TX appears to be much more immunogenic than the P1 adhesin molecule in patients with both acute and chronic asthma, and cards fxgene PCR assays also appear to be a marked improvement over existing M. pneumoniae PCR assays in detecting M. pneumoniae in patient samples. This project is designed to evaluate the prevalence of antibodies to CARDS TX and detect cards tx DMA by PCR in nasal lavage, sputum, and serum in various groups of patients with acute and chronic asthma. Specifically, we will evaluate chronic stable asthmatics, patients with acute exacerbation of asthma, and a group of asthmatics with refractory asthma. We plan to compare the sensitivity of CARDS TX to the "gold" standard P1 assay for M. pneumoniae and to evaluate the cellular and cytokine response in these groups of asthmatic patients.

哮喘是一种复杂的疾病，因为它涉及遗传易感性、环境因素和免疫系统。 在疾病的发展和进展中与免疫状态的相互作用。超过1500万 美国人患有这种疾病，尽管使用强效药物，但仍有16-17%的人患有这种疾病。 患者经历连续的每日症状和频繁的夜间症状。一个被低估的人， 哮喘病因学中的一个有争议的因素是非典型细菌感染的作用，例如 肺炎支原体引起的，在启动、加重和延长气道相关 症状和病理。多条证据直接将M.肺炎的发病机制 哮喘超出其作为哮喘急性加重的促发因素的作用。在儿童中，M。肺炎 感染已经显示在解决后的长时间内诱导慢性肺损伤。 呼吸道症状。研究表明，高达50%的肺功能检查异常， 儿童和肺部异常的37%的儿童数月至数年后发作的M。肺炎 呼吸道感染肺炎支原体也是已知的诱导炎症介质的数量 与哮喘的发病机制有关。IgE、IL-4和IL-5已被证明是显著升高的， 儿童M。pneumoniae感染，提示M.肺炎克雷伯菌可诱导TH-2样细胞因子 反应成年人，M。在大部分稳定性肺炎患者中检测到肺炎， 中重度慢性哮喘这一发现的意义得到了一项随机、双盲、 一项研究表明，只有PCR阳性的哮喘患者在 用针对支原体的抗生素治疗。 最近，Baseman博士和Kannan博士发现了一种ADP核糖基化、空泡化的M。肺炎 被命名为社区获得性呼吸窘迫综合征毒素（Community Acquired Respiratory Distress Syndrome Toxin，简称CITTX）。CARDS TX 在急性和慢性淋巴细胞白血病患者中， 慢性哮喘，卡fxgene PCR检测也似乎是一个显着的改善，现有的M。 pneumoniae M.患者样品中的肺炎。该项目旨在 评估鼻灌洗液中抗cardTX抗体的流行率并通过PCR检测cardTX DMA， 急性和慢性哮喘患者的痰液和血清。具体来说，我们将 评估慢性稳定型哮喘患者、哮喘急性发作患者和一组哮喘患者 难治性哮喘我们计划比较P1 TX与“金”标准P1检测的灵敏度， M.并评估这些哮喘患者组中的细胞和细胞因子应答。