MYCOPLASMA PNEUMONIAE INFECTION IN PATIENTS WITH CHRONIC ASTHMA

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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. OBJECTIVE: A bacterium, Mycoplasma pneumoniae, has been shown to occur frequently in the airways of patients with chronic asthma and during acute attacks of asthma. Treatment of this bacterium has also been shown to improve the lung function of thse asthmatics. Our research group at UTHSCSA (University of Texas Health Science Center at San Antonio) has discovered these bacteria produce a toxin that may injure the airway. Detection of the body's response to this toxin or measurement of this toxin in either blood or airway secretions may allow us to better understand the role that Mycoplasma plays in the development of asthma or the progression of the disease. Additionally, our preliminary data suggest that detections of the body's response to this toxin (called the CARDS Toxin) appears to be a much better way to detect Mycoplasma in the airways than the current "Gold" standard (called PCR to P1-adhesin). The purpose of this study is to determine the frequency of Mycoplasma (using the "Gold" standard assay and our newly discovered assay) in three populations of asthmatics: chronic, moderately severe asthmatics, asthmatics presenting with an asthma attack, and patients with refractory asthma. Further, we believe that the development and use of CARDS TX-based serological, antigen capture, and PCR assays will be a marked improvement in linking M. pneumoniae to asthma and other related airway dysfunctions. RESEARCH PLAN: We plan to serially study sputum, throat swabs, nasal lavage, and serum from asthmatic patients to determine the role of Mycoplasma in acute and chronic asthma. Additionally, we plan to compare the standard test for Mycoplasma to our newly developed assay. METHODS: Nasal lavage, throat swab and serum will be collected from all subjects at the beginning of the study and one year later. Any patient who is positive for Mycoplasma by PCR wil have repeat sampels every 8-12 weeks until two samples are negative. Stable asthmatics will have sputum induction performed if they are unable to provide 1 cc of sputum for analysis. CLINICAL RELEVANCE: Mycoplasma pneumoniae is a potential pathogen that may cause exacerbations of asthma or persistent chronic asthma. Persistent infection may be associated with refractory asthma. This study will enable us to better understand the relationship between Mycoplasma and acute and chronic asthma.