MACROLIDES IN ASTHMA (MIA)

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 哮喘是一种常见的慢性肺部疾病。虽然这种综合征的病因目前尚未完全确定，但许多宿主和环境因素可能相互作用导致哮喘临床综合征。呼吸道感染，无论是病毒性的还是细菌性的，都被认为在调节哮喘发作和严重程度中起作用。 肺炎支原体或肺炎衣原体的慢性气道感染被认为是哮喘的重要辅助因素。Martin及其同事报道了55例慢性稳定型哮喘患者的气道支原体或衣原体感染与哮喘的关系。其中31个 55例哮喘患者（56.4%）的支原体（n=25）或衣原体（n=7）聚合酶链反应（PCR）结果呈阳性，主要在支气管内活检标本或支气管肺泡灌洗液中。相比之下，11名健康对照受试者中只有1名支原体PCR结果阳性。血清阳性 在哮喘患者和对照组之间，这些微生物的数量没有显著差异。 在一项探索性临床试验中，评价慢性气道肺炎支原体或肺炎衣原体感染是否是哮喘患者对克拉霉素临床应答的决定因素。 具体目标1a：评价随机分配的克拉霉素或安慰剂加氟替卡松治疗16周对哮喘控制不佳和M. pneumoniae或C.肺炎气道感染。 具体目标1b：评价在未感染、控制不佳的哮喘患者中随机分配克拉霉素或安慰剂加氟替卡松治疗16周对哮喘控制的效果。

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.