MYCOPLASMA PNEUMONIAE INFECTION IN PATIENTS WITH CHRONIC ASTHMA

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 目的：肺炎支原体是一种常见的肺炎支原体，常见于慢性哮喘和哮喘急性发作期患者的呼吸道。这种细菌的治疗也被证明能改善哮喘患者的肺功能。我们在UTHSCSA(德克萨斯大学圣安东尼奥健康科学中心)的研究小组发现，这些细菌产生一种可能损害呼吸道的毒素。检测人体对这种毒素的反应，或测量血液或呼吸道分泌物中的这种毒素，可能会让我们更好地了解支原体在哮喘发生发展或疾病进展中所起的作用。此外，我们的初步数据表明，检测人体对这种毒素(称为卡片毒素)的反应似乎是检测呼吸道中支原体的一种比目前的“金”标准(称为PCR对P1-粘附素)好得多的方法。 本研究的目的是确定支原体在三类哮喘患者中的频率(使用“金”标准和我们新发现的方法)：慢性、中重度哮喘患者、哮喘发作患者和难治性哮喘患者。此外，我们相信，基于TX的血清学、抗原捕获和聚合酶链式反应检测方法的开发和使用将显著改善肺炎支原体与哮喘和其他相关的呼吸道功能障碍之间的联系。 研究计划：我们计划对哮喘患者的痰、咽拭子、鼻腔冲洗和血清进行系列研究，以确定支原体在急性和慢性哮喘中的作用。此外，我们计划将支原体的标准检测方法与我们新开发的检测方法进行比较。 方法：在研究开始时和一年后收集所有受试者的鼻腔冲洗、咽拭子和血清。任何支原体聚合酶链式反应阳性的患者将每8-12周重复取样一次，直到有两个样本为阴性。缓解期哮喘患者如果不能提供1毫升的痰进行分析，就会进行诱导取痰。 临床意义：肺炎支原体是一种潜在的病原体，可能导致哮喘加重或持续性慢性哮喘。持续感染可能与难治性哮喘有关。这项研究将使我们更好地了解支原体与急、慢性哮喘的关系。

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.