MACROLIDES IN ASTHMA (MIA)

这个子项目是众多研究子项目之一

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Asthma is a prevalent chronic lung disease. While the etiology of this syndrome is at present incompletely defined, a number of host and environmental factors likely interact to cause the asthma clinical syndrome. Respiratory tract infections, both viral and bacterial, have been postulated to play a role in modulating asthma onset and severity. Chronic airway infections with either Mycoplasma pneumoniae or Chlamydia pneumoniae have been implicated as an important cofactor in asthma. Martin and colleagues reported on the relationship between airway infection with mycoplasma or chlamydia and asthma in 55 chronic stable asthmatic subjects. Thirty-one of these 55 asthmatic patients (56.4%) had positive polymerase chain reaction (PCR) results for mycoplasma (n=25) or chlamydia species (n=7), primarily in endobronchial biopsy specimens or bronchoalveolar lavage fluid. By comparison, only 1 of 11 healthy control subjects had positive PCR results for mycoplasma species. Seroprevalence of these organisms did not differ significantly between asthmatics and controls. To evaluate, in an exploratory clinical trial, whether chronic airway infection with Mycoplasma pneumoniae or Chlamydia pneumoniae is a determinant of clinical response to clarithromycin in patients with asthma. Specific Aim 1a: to evaluate the effect on asthma control of 16 weeks of randomly allocated clarithromycin or placebo added to fluticasone in subjects with suboptimally controlled asthma and M. pneumoniae or C. pneumoniae airway infection. Specific Aim 1b: to evaluate the effect on asthma control of 16 weeks of randomly allocated clarithromycin or placebo added to fluticasone in uninfected, suboptimally controlled asthmatics.