Abstract
Mycoplasmas represent the smallest self-replicating organisms. They are unique among bacteria in that they lack a cell wall and require sterols for growth. The limited metabolic and biosynthetic activities of mycoplasmas have complicated development of accurate means for laboratory detection and hampered understanding of their roles as human pathogens. Mycoplasma pneumoniae was first identified and characterized in the 1960s and shown to be a common cause of upper and lower respiratory disease in children and adults. Serious infections requiring hospitalization, while rare, occur in persons of all age groups, and may affect multiple organ systems. Severity of disease appears to be related to the degree to which the host immune response reacts to the infection. Extrapulmonary complications involving all of the major organ systems can occur in association with M. pneumoniae infection as a result of direct invasion and/or autoimmune response. Evidence is accumulating for this organism’s contributory role in chronic lung conditions such as asthma. Serology has been the most common means for laboratory detection of M. pneumoniae infection due to the slow growth that makes culture impractical. Newer diagnostic methods utilizing nucleic acid amplification offer the advantages for rapid detection and are likely to become increasingly important in the future, but these techniques have not achieved widespread utilization thus far due to the lack of commercially sold products and non-standardized methodology. Management of M. pneumoniae infections can usually be achieved with macrolides, ketolides, tetracyclines, or fluoroquinolones. As more is learned about pathogenesis and immune response elicited by M. pneumoniae, improved methods for diagnosis and prevention of disease due to this organism are anticipated.
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References
Himmelreich R, Hilbert H, Plagens H, Pirkl E, Li BC, Herrmann R (1996) Complete sequence analysis of the genome of the bacterium Mycoplasma pneumoniae. Nucleic Acids Res 24: 4420–4449
Miyata M (2002) Gliding motility of mycoplasma-a mechanism cannot be explained by today’s biology. Nippon Saikingaku Zasshi 57: 581–595
Foy HM (1993) Infections caused by Mycoplasma pneumoniae and possible carrier state in different populations of patients. Clin Infect Dis 17 (Suppl 1): S37–46
Lind K, Benzon MW, Jensen JS, Clyde WA, Jr (1997) A seroepidemiological study of Mycoplasma pneumoniae infections in Denmark over the 50-year period 1946-1995. Eur J Epidemiol 13: 581–586
Block S, Hedrick J, Hammerschlag MR, Cassell GH, Craft JC (1995) Mycoplasma pneumoniae and Chlamydia pneumoniae in pediatric community-acquired pneumonia: comparative efficacy and safety of clarithromycin vs. erythromycin ethylsuccinate. Pediatr Infect Dis J 14: 471–477
Layani-Milon MP, Gras I, Valette M, Luciani J, Stagnara J, Aymard M, Lina B (1999) Incidence of upper respiratory tract Mycoplasma pneumoniae infections among outpatients in Rhone-Alpes, France, during five successive winter periods. J Clin Microbiol 37: 1721–1726
Marston BJ, Plouffe JF, File TM Jr, Hackman BA, Salstrom SJ, Lipman HB, Kolczak MS, Breiman RF (1997) Incidence of community-acquired pneumonia requiring hospitalization. Results of a population-based active surveillance Study in Ohio. The Community-Based Pneumonia Incidence Study Group. Arch Intern Med 157: 1709–1718
Cousin-Allery A, Charron A, de Barbeyrac B, Fremy G, Skov Jensen J, Renaudin H, Bebear C (2000) Molecular typing of Mycoplasma pneumoniae strains by PCR-based methods and pulsed-field gel electrophoresis. Application to French and Danish isolates. Epidemiol Infect 124: 103–111
Dumke R, Catrein I, Pirkil E, Herrmann R, Jacobs E (2003) Subtyping of Mycoplasma pneumoniae isolates based on extended genome sequencing and on expression profiles. Int J Med Microbiol 292: 513–525
Chmura K, Lutz RD, Chiba H, Numata MS, Choi HJ, Fantuzzi G, Voelker DR, Chan ED (2003) Mycoplasma pneumoniae antigens stimulate interleukin-8. Chest 123: 425S
Yang J, Hooper WC, Phillips DJ, Talkington DF (2002) Regulation of proinflammatory cytokines in human lung epithelial cells infected with Mycoplasma pneumoniae. Infect Immun 70: 3649–3655
Roberts DD, Olson LD, Barile MF, Ginsburg V, Krivan HC (1989) Sialic acid dependent adhesion of Mycoplasma pneumoniae to purified glycoproteins. J Biol Chem 264: 9289–9293
Dallo SF, Kannan TR, Blaylock MW, Baseman JB (2002) Elongation factor Tu and E1 beta subunit of pyruvate dehydrogenase complex act as fibronectin binding proteins in Mycoplasma pneumoniae. Mol Microbiol 46: 1041–1051
Dallo SF, Baseman JB (2000) Intracellular DNA replication and long-term survival of pathogenic mycoplasmas. Microb Pathog 29: 301–309
Waites KB, Talkington DF (2004) Mycoplasma pneumoniae and its role as a human pathogen. Clin Microbiol Rev 17: 697–728
Bredt W, Kist M, Jacobs E (1981) Phagocytosis and complement action. Isr J Med Sci 17: 637–640
Loos M, Brunner H (1979) Complement components (C1, C2, C3, C4) in bronchial secretions after intranasal infection of guinea pigs with Mycoplasma pneumoniae: dissociation of unspecific and specific defense mechanisms. Infect Immun 25: 583–585
Hamvas RM, Johnson M, Vlieger AM, Ling C, Sherriff A, Wade A, Klein NJ, Turner MW, Webster AD (2005) Role for mannose binding lectin in the prevention of mycoplasma infection. Infect Immun 73: 5238–5240
Phiboonpocanum S, Chiba H, Mitsuzawa H, Martin W, Murphy RC, Harbeck RJ, Voelker RB (2005) Surfactant protein A binds Mycoplasma pneumoniae with high affinity and attenuates its growth by recognition of desaturated phosphatidylglycerols. J Biol Chem 280: 9–17
Hoek KL, Cassell GH, Duffy LB, Atkinson TP (2002) Mycoplasma pneumoniae-induced activation and cytokine production in rodent mast cells. J Allergy Clin Immunol 109: 470–476
Hoek KL, Duffy LB, Cassell GH, Atkinson TP (2005) A role for the Mycoplasma pneumoniae adhesin P1 in Interleukin (IL)-4 synthesis and release from rodent mast cells. Microb Pathog 39: 149–158
Into T, Nodasaka Y, Hasebe A, Okuzawa T, Nakamura J, Ohata N, Shibata K (2002) Mycoplasmal lipoproteins induce toll-like receptor 2-and caspasesmediated cell death in lymphocytes and monocytes. Microbiol Immunol 46: 265–276
Takeuchi O, Kaufmann A, Grote K, Kawai T, Hoshino K, Morr M, Muhlradt PF, Akira S (2000) Cutting edge: preferentially the R-stereoisomer of the mycoplasmal lipopeptide macrophage-activating lipopeptide-2 activates immune cells through a toll-like receptor 2-and MyD88-dependent signaling pathway. J Immunol 164: 554–557
Taylor-Robinson D, Webster AD, Furr PM, Asherson GL (1980) Prolonged persistence of Mycoplasma pneumoniae in a patient with hypogammaglobulinaemia. J Infect 2: 171–175
Johnston CL, Webster AD, Taylor-Robinson D, Rapaport G, Hughes GR (1983) Primary late-onset hypogammaglobulinaemia associated with inflammatory polyarthritis and septic arthritis due to Mycoplasma pneumoniae. Ann RheumDis 42: 108–110
Hayakawa M, Taguchi H, Kamiya S, Fujioka Y, Watanabe H, Kawai S, Kobayashi H (2002) Animal model of Mycoplasma pneumoniae infection using germfree mice. Clin Diagn Lab Immunol 9: 669–676
Tanaka H, Narita M, Teramoto S, Saikai T, Oashi K, Igarashi T, Abe S (2002) Role of interleukin-18 and T-helper type 1 cytokines in the development of Mycoplasma pneumoniae pneumonia in adults. Chest 121: 1493–1497
Opitz O, Pietsch K, Ehlers S, Jacobs E (1996) Cytokine gene expression in immune mice reinfected with Mycoplasma pneumoniae: the role of T cell subsets in aggravating the inflammatory response. Immunobiology 196: 575–587
Taylor G, Taylor-Robinson D, Fernald GW (1974) Reduction in the severity of Mycoplasma pneumoniae-induced pneumonia in hamsters by immunosuppressive treatment with antithymocyte sera. J Med Microbiol 7: 343–348
Cartner SC, Lindsey JR, Gibbs-Erwin J, Cassell GH, Simecka JW (1998) Roles of innate and adaptive immunity in respiratory mycoplasmosis. Infect Immun 66: 3485–3491
Jones H, Tabor L, Sun X, Woolard M, Simecka JW (2002) Depletion of CD8+ T cells exacerbates CD4+ Th cell asociated inflammatory lesions during murine respiratory disease. J Immunol 168: 3493–3501
Kraft M, Cassell GH, Henson JE, Watson H, Williamson J, Marmion BP, Gaydos CA, Martin RJ (1998) Detection of Mycoplasma pneumoniae in the airways of adults with chronic asthma. Am J Respir Crit Care Med 158: 998–1001
Gil JC, Cedillo RL, Mayagoitia BG, Paz MD (1993) Isolation of Mycoplasma pneumoniae from asthmatic patients. Ann Allergy 70: 23–25
Seggev JS, Lis I, Siman-Tov R, Gutman R, Abu-Samara H, Schey G, Naot Y (1986) Mycoplasma pneumoniae is a frequent cause of exacerbation of bronchial asthma in adults. Ann Allergy 57: 263–265
Kraft M, Cassell GH, Pak J, Martin RJ (2002) Mycoplasma pneumoniae and Chlamydia pneumoniae in asthma: effect of clarithromycin. Chest 121: 1782–1788
Martin RJ, Chu HW, Honour JM, Harbeck RJ (2001) Airway inflammation and bronchial hyperresponsiveness after Mycoplasma pneumoniae infection in a murine model. Am J Respir Cell Mol Biol 24: 577–582
Koh YY, Park Y, Lee HJ, Kim CK (2001) Levels of interleukin-2, interferongamma, and interleukin-4 in bronchoalveolar lavage fluid from patients with Mycoplasma pneumonia: implication of tendency toward increased immunoglobulin E production. Pediatrics 107: E39
Gump DW, Phillips CA, Forsyth BR, McIntosh K, Lamborn KR, Stouch WH (1976) Role of infection in chronic bronchitis. Am Rev Respir Dis 113: 465–474
Talkington DF, Shott S, Fallon MT, Schwartz SB, Thacker WL (2004) Analysis of eight commercial enzyme immunoassay tests for detection of antibodies to Mycoplasma pneumoniae in human serum. Clin Diagn Lab Immunol 11: 862–867
Morozumi M, Hasegawa K, Kobayashi R, Inoue N, Iwata S, Kuroki H, Kawamura N, Nakayama E, Tajima T, Shimizu K et al (2005) Emergence of macrolide-resistant Mycoplasma pneumoniae with a 23S rRNA gene mutation. Antimicrob Agents Chemother 49: 2302–2306
Carpenter TC (2002) Corticosteroids in the treatment of etriatal encephalitis complicating Mycoplasma pneumoniae pneumonia: possible benefit of intravenous immunoglobulin. Pediatr Infect Dis J 20: 534–545
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Waites, K.B., Simecka, J.W., Talkington, D.F., Atkinson, T.P. (2007). Pathogenesis of Mycoplasma pneumoniae infections:adaptive immunity, innate immunity, cell biology, and virulence factors. In: Community-Acquired Pneumonia. Birkhäuser Advances in Infectious Diseases. Birkhäuser Basel. https://doi.org/10.1007/978-3-7643-7563-8_9
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DOI: https://doi.org/10.1007/978-3-7643-7563-8_9
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