Skip to main content
SpringerLink
Log in

Chlamydia pneumoniae Infections in Asthma

Clinical Implications

  • Leading Article
  • Published:
American Journal of Respiratory Medicine

Abstract

Chlamydia pneumoniae is an intracellular pathogen that has been suggested to play a role in the pathology of asthma. However, so far none of the studies have provided clear evidence for a causative role of C. pneumoniae infections in asthma, although there is little doubt that chronic C. pneumoniae infection does aggravate asthma and should be treated.

The diagnosis of C. pneumoniae infection is still a matter of concern for it is dependent on trained skilled personnel and can vary significantly between different diagnostic laboratories. This fact is also one of the major problems encountered when comparing epidemiological studies investigating the possible role of C. pneumoniae infections and their impact on the pathogenesis of other diseases.

With regard to therapy, long-term treatment with macrolides is the best available method to eradicate C. pneumoniae. Successful therapy for C. pneumoniae, however, can also be complicated by the high possibility of de novo infection as epidemiological studies have shown that the prevalence of antibodies to C. pneumoniae increases with age in all populations studied. In the northern hemisphere the prevalence of C. pneumoniae is also affected by seasonal conditions. It is too early to draw any conclusions from the equatorial belt countries. The available data on C. pneumoniae in tropical countries indicate a much faster infection rate during early adulthood with 100% serological prevalence at an age greater than 25 years. This data, if confirmed, would argue against C. pneumoniae causing asthma since the asthma prevalence in those countries does not increase in a parallel pattern.

An alternative interpretation of most studies could be that the increased rate of C. pneumoniae infections in patients with asthma results from a modified susceptibility towards the microorganism, due to yet unknown changes of the host cell’s physiology. It should be kept in mind that increased prevalence of C. pneumoniae infection is not restricted to asthma.

Further studies are needed to understand the role of C. pneumoniae, especially of chronic infection, in the pathogenesis of inflammatory diseases with a specific focus on the effect that the microorganism triggers in the infected host cell. Only when we understand what C. pneumoniae does to its host cell will we be able to judge its impact on the overall status of an affected patient, and this knowledge will help us to develop a successful therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Table I
Table II

Similar content being viewed by others

References

  1. Laitinen LA, Laitinen L, Altraja A, et al. Bronchial biopsy findings in intermittent or “early” asthma. J Allergy Clin Immunol 1996; 98: S3–6

    Article  PubMed  CAS  Google Scholar 

  2. Vignola AM, Chanez P, Campbell AM, et al. Airway inflammation in mild intermittent and in persistent asthma. Am J Respir Crit Care Med 1998; 157: 403–9

    PubMed  CAS  Google Scholar 

  3. Mauad T, Xavier ACG, Saldiva PHN, et al. Elastosis and fragmentation of fibers of the elastic system in fatal asthma. Am J Respir Crit Care Med 1999; 160: 968–75

    PubMed  CAS  Google Scholar 

  4. Daser A, Daheshia M, De Sanctis GT. Genetics of allergen-induced asthma. J Allergy Clin Immunol 2001; 108: 167–74

    Article  PubMed  CAS  Google Scholar 

  5. Chapman MD, Tsay A, Vailes LD. Home allergen monitoring and control: improving clinical practice and patient benefits. Allergy 2001; 56: 604–10

    Article  PubMed  CAS  Google Scholar 

  6. Bornehag CG, Blomquist G, Gyntelberg F, et al. Dampness in buildings and health: Nordic interdisciplinary review of the scientific evidence on associations between exposure to “dampness” in buildings and health effects (NORDDAMP). Indoor Air 2001; 11: 72–86

    Article  PubMed  CAS  Google Scholar 

  7. Settipane RA, Lieberman P. Update on nonallergic rhinitis. Ann Allergy Asthma Immunol 2001; 86: 494–507

    Article  PubMed  CAS  Google Scholar 

  8. Martin RJ, Kraft M, Chu HW, et al. A link between chronic asthma and chronic infection. J Allergy Clin Immunol 2001; 107: 595–601

    Article  PubMed  CAS  Google Scholar 

  9. Esposito S, Blasi F, Arosio C, et al. Importance of acute Mycoplasma pneumoniae and Chlamydia pneumoniae infections in children with wheezing. Eur Respir J 2000; 16: 1142–6

    Article  PubMed  CAS  Google Scholar 

  10. Daian CM, Wolff AH, Bielory L. The role of atypical organisms in asthma. Allergy Asthma Proc 2000; 21: 107–11

    Article  PubMed  CAS  Google Scholar 

  11. Freymuth F, Vabret A, Brouard J, et al. Detection of viral, Chlamydia pneumoniae and Mycoplasma pneumoniae infections in exacerbations of asthma in children. J Clin Virol 1999; 13: 131–9

    Article  PubMed  CAS  Google Scholar 

  12. Micillo E, Bianco A, D’Auria D, et al. Respiratory infections and asthma. Allergy 2000; 55Suppl. 61:42–5

    PubMed  Google Scholar 

  13. Teichtahl H, Buckmaster N, Pertnikovs E. The incidence of respiratory tract infection in adults requiring hospitalisation for asthma. Chest 1997; 112: 591–6

    Article  PubMed  CAS  Google Scholar 

  14. Principi N, Esposito S. Emerging role of Mycoplasma pneumoniae and Chlamydia pneumoniae in paediatric respiratory-tract infections. Lancet Infect Dis 2001; 1: 334–44

    Article  PubMed  CAS  Google Scholar 

  15. Mygind N. The common cold as a trigger of asthma. Monaldi Arch Chest Dis 2000; 55: 478–83

    PubMed  CAS  Google Scholar 

  16. Marin J, Jeler-Kacar D, Levstek V, et al. Persistence of viruses in upper respiratory tract of children with asthma. J Infect 2000; 41: 69–72

    Article  PubMed  CAS  Google Scholar 

  17. Grayston JT, Kuo CC, Wang SP, et al. A new Chlamydia psittaci strain, TWAR, isolated in acute respiratory tract infections. N Engl J Med 1986; 315: 161–8

    Article  PubMed  CAS  Google Scholar 

  18. Hahn DL, Azenabor AA, Beatty WL, et al. Chlamydia pneumoniae as a respiratory pathogen. Front Biosci 2002; 7: E66–76

    Article  PubMed  CAS  Google Scholar 

  19. Schachter J. Chlamydial infections (part I). N Engl J Med 1978; 298: 428–35

    Article  PubMed  CAS  Google Scholar 

  20. Zhang JP, Stephens RS. Mechanism of C. trachomatis attachment to eukaryotic host cells. Cell 1992; 69: 861–9

    Article  PubMed  CAS  Google Scholar 

  21. Chen JC, Stephens RS. Trachoma and LGV biovars of Chlamydia trachomatis share the same glycosaminoglycan-dependent mechanism for infection of eukaryotic cells. Mol Microbiol 1994; 11: 501–7

    Article  PubMed  CAS  Google Scholar 

  22. Eckman MR, Leinonen M, Syrjälä H, et al. Evaluation of serological methods in the diagnosis of C. pneumoniae during an epidemic in Finland. Eur J Clin Microbiol 1993; 12: 756–60

    Article  Google Scholar 

  23. Saikku P. Chlamydial serology in respiratory tract infections. In: Stary A, editor. Proceedings, third meeting of the European Society for Chlamydia Research. Bologna: Società Editrice Esculapio, 1996: 353

    Google Scholar 

  24. Hindiyeh M, Carroll KC. Laboratory diagnosis of atypical pneumonia. Semin Respir Infect 2000; 15: 101–13

    Article  PubMed  CAS  Google Scholar 

  25. Verkooyen RP, Hazenberg MA, van Haaswn GH, et al. Age related interferences with Chlamydia pneumoniae microimmunofluorescence serology due to circulating rheumatoid factor. J Clin Microbiol 1992; 30: 1289–90

    Google Scholar 

  26. Grayston JT, Aldous MB, Easton A, et al. Evidence that C. pneumoniae causes pneumonia and bronchitis. J Infect Dis 1993; 168: 1231–5

    Article  PubMed  CAS  Google Scholar 

  27. File TM, Bartlett JG, Cassell GH, et al. The importance of Chlamydia pneumoniae as a pathogen: the 1996 consensus conference on C. pneumoniae infections. Infect Dis Clin Pract 1997; 6Suppl. 2: S28–31

    Article  Google Scholar 

  28. Lorenz J. Clinical efficacy of new antibacterial therapies in at risk populations (review). J Infect 2002; 44Suppl. A: 25–30

    PubMed  Google Scholar 

  29. Gaydos CA, Roblin PM, Hammerschlag MR, et al. Diagnostic utility of PCR-enzyme immunoassay, culture, and serology for detection of C. pneumoniae in symptomatic and asymptomatic patients. J Clin Microbiol 1994; 32: 903–5

    PubMed  CAS  Google Scholar 

  30. Ramirez JA, Ahkee S, Tolentino A, et al. Diagnosis of Legionella pneumophilia, Mycoplasma pneumoniae, or Chlamydia pneumoniae lower respiratory infection using the polymerase chain reaction on a single throat swab specimen. Diagn Microbiol Infect Dis 1996; 24: 7–14

    Article  PubMed  CAS  Google Scholar 

  31. Petitjean J, Vincent F, Fretigny M, et al. Comparison of two serological methods and a polymerase chain reaction-enzyme immunoassay for the diagnosis of acute respiratory infections with Chlamydia pneumoniae in adults. J Med Microbiol 1998; 47: 615–21

    Article  PubMed  CAS  Google Scholar 

  32. Dowell SF, Peeling RW, Boman J, et al. Standardizing Chlamydia pneumoniae assays: recommendations from the Centers for Disease Control and Prevention (USA) and the Laboratory Centre for Disease Control (Canada). Clin Infect Dis 2001; 33: 492–503

    Article  PubMed  CAS  Google Scholar 

  33. Hammerschlag MR. Chlamydia pneumoniae and the lung. Eur Respir J 2000; 16: 1001–7

    Article  PubMed  CAS  Google Scholar 

  34. Zawadzke L, Thanassi J, Pucci M, et al. 100th American society for microbiology annual meeting. Expert Opin Investig Drugs 2000; 9: 1907–22

    Article  PubMed  CAS  Google Scholar 

  35. Vincent F, Petitjean J, Filmont JE, et al. Acute respiratory Chlamydia pneumoniae infections in adults: value of direct gene amplification diagnosis. Rev Mal Respir 1999; 16: 1131–7

    PubMed  CAS  Google Scholar 

  36. Saikku P, Leinonen M, Mattila M, et al. Serological evidence of an association of a novel Chlamydia, TWAR, with coronary heart disease and acute myocardial infarction. Lancet 1988; II: 983–6

    Article  Google Scholar 

  37. Katsenis C, Kouskouni E, Kolokotronis L, et al. The significance of Chlamydia pneumoniae in symptomatic carotid stenosis. Angiology 2001; 52: 615–9

    Article  PubMed  CAS  Google Scholar 

  38. Vink A, Pasterkamp G, Poppen M, et al. The adventitia of atherosclerotic coronary arteries frequently contains Chlamydia pneumoniae. Atherosclerosis 2001; 157: 117–22

    Article  PubMed  CAS  Google Scholar 

  39. Boman J, Hammerschlag MR. Chlamydia pneumoniae and atherosclerosis: critical assessment of diagnostic methods and relevance to treatment studies. Clin Microbiol Rev 2002; 15: 1–20

    Article  PubMed  CAS  Google Scholar 

  40. Meijer A, Roholl PJ, Gielis-Proper SK, et al. Chlamydia pneumoniae antigens, rather than viable bacteria, persist in atherosclerotic lesions. J Clin Pathol 2000; 53: 911–6

    Article  PubMed  CAS  Google Scholar 

  41. Koskiniemi M, Gencay M, Salonen O, et al. Chlamydia pneumoniae associated with central nervous system infections. Eur Neurol 1996; 36: 160–3

    Article  PubMed  CAS  Google Scholar 

  42. Koyi H, Branden E, Gnarpe J, et al. Chlamydia pneumoniae may be associated with lung cancer: preliminary report on a seroepidemiological study. APMIS 1999; 107: 828–32

    Article  PubMed  CAS  Google Scholar 

  43. Jackson LA, Wang SP, Nazar-Stewart V, et al. Association of Chlamydia pneumoniae immunoglobulin A seropositivity and risk of lung cancer. Cancer Epidemiol Biomarkers Prev 2000; 9: 1263–6

    PubMed  CAS  Google Scholar 

  44. Koyi H, Branden E, Gnarpe J, et al. An association between chronic infection with Chlamydia pneumoniae and lung cancer: a prospective 2-year study. APMIS 2001; 109: 572–80

    Article  PubMed  CAS  Google Scholar 

  45. Saikku P. The epidemiology and significance of Chlamydia pneumoniae. J Infect 1992; 25: 27–34

    Article  PubMed  Google Scholar 

  46. Laurila AL, Von Hertzen L, Saikku P. Chlamydia pneumoniae and chronic lung diseases. Scand J Infect Dis 1997; 104: 34–6

    CAS  Google Scholar 

  47. Einarsson S, Sigurdsson HK, Magnusdomir SD, et al. Age specific prevalence of antibodies against Chlamydia pneumoniae in Iceland. Scand J Infect Dis 1994; 26: 393–7

    Article  PubMed  CAS  Google Scholar 

  48. Karvonen M, Tuomilehto J, Naukkarinen A, et al. The prevalence and regional distribution of antibodies against Chlamydia pneumoniae (strain TWAR) in Finland in 1958. Int J Epidemiol 1992; 21: 391–8

    Article  PubMed  CAS  Google Scholar 

  49. Karvonen M, Tuomioletho J, Pitkaniemi J, et al. Chlamydia pneumoniae antibody prevalence in South-Western and Eastern Finland in 1983 and 1987. Int J Epidemiol 1994; 23: 176–83

    Article  PubMed  CAS  Google Scholar 

  50. Birkbaek NJ, Jensen JS, Seefeldt T, et al. Chlamydia pneumoniae infection in adults with chronic cough compared with healthy blood donors. Eur Respir J 2000; 16: 108–11

    Article  Google Scholar 

  51. Freidank HM, Brauer D. Prevalence of antibodies to Chlamydia pneumoniae TWAR in a group of German medical students. J Infect 1993; 27: 89–93

    Article  PubMed  CAS  Google Scholar 

  52. Van der Abeele AM, Van Renterghem L, Willems K, et al. Prevalence of antibodies to Chlamydia pneumoniae in a Belgian population. J Infect Dis 1992; 25Suppl. 1: 87–90

    Google Scholar 

  53. Gencay M, Rüdiger JJ, Tamm M, et al. Increased frequency of Chlamydia pneumoniae antibodies in patients with asthma. Am J Respir Crit Care Med 2001; 163: 1097–100

    PubMed  CAS  Google Scholar 

  54. Marton A, Karoly A, Szalka A. Prevalence of Chlamydia pneumoniae antibodies in Hungary. Eur J Clin Microbiol Infect 1992; 11: 139–42

    Article  CAS  Google Scholar 

  55. Gencay M, Dereli D, Ertem E, et al. Prevalence of Chlamydia pneumoniae specific antibodies in different clinical situations and health subjects in Izmir, Turkey. Eur J Epidemiol 1998; 14: 505–9

    Article  PubMed  CAS  Google Scholar 

  56. Miyashita N, Niki Y, Nakajama M, et al. Prevalence of asymptomatic infection with Chlamydia pneumoniae in subjectively healthy adults. Chest 2001; 119: 1416–9

    Article  PubMed  CAS  Google Scholar 

  57. Wang SP, Liu YC, Cheng DL, et al. Seroprevalence of Chlamydia pneumoniae in Taiwan. Scand J Infect Dis 1993; 25: 565–8

    Article  PubMed  CAS  Google Scholar 

  58. Suttithawil W, Wangroongsarb P, Naigowit P, et al. Chlamydophila (Chlamydia) pneumoniae as a cause of community-acquired pneumonia in Thailand. J Med Assoc Thai 2001; 84: 430–7

    PubMed  CAS  Google Scholar 

  59. San Joaquin VH, Herrin JR, Hautala JM. Chlamydial pneumonia of infancy: further clinical observations. Clin Pediatr (Phila) 1980; 19: 109–12

    Article  CAS  Google Scholar 

  60. Roldaan AC, Masural N. Viral respiratory infections in asthmatic children staying in a mountain resort. Eur J Respir Dis 1982; 63: 140–50

    PubMed  CAS  Google Scholar 

  61. Weiss SG, Newcomb RW, Beem MO. Pulmonary assessment of children after chlamydial pneumonia of infancy. J Pediatr 1986; 108: 659–64

    Article  PubMed  CAS  Google Scholar 

  62. Hammerschlag MR. Atypical pneumonias in children. Adv Pediatr Infect Dis 1995; 10: 1–39

    PubMed  CAS  Google Scholar 

  63. Emre U, Roblin PM, Gelling M, et al. The association of Chlamydia pneumoniae infection and reactive airway disease in children. Arch Pediatr Adolesc Med 1994; 148: 727–32

    Article  PubMed  CAS  Google Scholar 

  64. Emre U, Sokolovskaya N, Roblin PM, et al. Detection of anti-Chlamydia pneumoniae IgE in children with reactive airway disease. J Infect Dis 1995; 172: 265–7

    Article  PubMed  CAS  Google Scholar 

  65. Cunningham AF, Johnston SL, Julious SA, et al. Chronic Chlamydia pneumoniae infection and asthma exacerbations in children. Eur Respir J 1998; 11: 345–9

    Article  PubMed  CAS  Google Scholar 

  66. Martinez Tagle M, Kogan R, Rojas P, et al. Diagnosis of Chlamydia pneumoniae in community-acquired pneumonia in children in Chile. Acta Paediatr 2000; 89: 650–3

    Article  PubMed  CAS  Google Scholar 

  67. Esposito S, Principi N. Asthma in children: are chlamydia or mycoplasma involved? Paediatr Drugs 2001; 3: 159–68

    Article  PubMed  CAS  Google Scholar 

  68. Shamssain MH, Shamsian N. Prevalence and severity of asthma, rhinitis, and atopic eczema in 13–14 year-old schoolchildren from the northeast of England. Ann Allergy Asthma Immunol 2001; 86: 428–32

    Article  PubMed  CAS  Google Scholar 

  69. Weiland SK, von Mutius E, Hirsch T, et al. Prevalence of respiratory and atopic disorders among children in the east and west of Germany five years after unification. Eur Respir J 1999; 14: 862–70

    Article  PubMed  CAS  Google Scholar 

  70. Lee SI, Shin MH, Lee HB, et al. Prevalence of symptoms of asthma and other allergic diseases in Korean children: a nationwide questionnaire. J Korean Med Sci 2001; 16: 155–64

    PubMed  CAS  Google Scholar 

  71. Trabukultivakorn M. Prevalence of asthma, rhinitis, and eczema in northern Thai children from Chiang Mai (International Study of Asthma and Allergies in Childhood, ISAAC). Asian Pac J Allergy Immunol 1999; 17: 243–8

    Google Scholar 

  72. Asher MI, Barry D, Clayton T, et al. The burden of symptoms of asthma, allergic rhinoconjunctivitis and atopic eczema in children and adolescents in six New Zealand centres: ISAAC phase one. N Z Med J 2001; 114: 114–20

    PubMed  CAS  Google Scholar 

  73. Behbehani NA, Abal A, Syabbalo NC, et al. Prevalence of asthma, allergic rhinitis, and eczema in 13- to 14 year old children in Kuwait: an ISAAC study. Ann Allergy Asthma Immunol. 2000; 85: 58–63

    Article  PubMed  CAS  Google Scholar 

  74. Mallol J, Solé D, Asher I, et al. Prevalence of asthma symptoms in Latin America: the international study of asthma and allergies in childhood (ISAAC). Pediatr Pulmonol 2000; 30: 439–44

    Article  PubMed  CAS  Google Scholar 

  75. Mills GD, Lindeman JA, Fawcett JP, et al. Chlamydia pneumoniae serological status is not associated with asthma in children or young adults. Int J Epidemiol 2000; 29: 280–4

    Article  PubMed  CAS  Google Scholar 

  76. Hahn DL, Dodge RW, Golubjatnikov R. Association of Chlamydia pneumoniae (strain TWAR) infection with wheezing, asthmatic bronchitis, and adult-onset asthma. JAMA 1991; 266: 225–30

    Article  PubMed  CAS  Google Scholar 

  77. Hahn DL. Chlamydia pneumoniae infection and asthma. Lancet 1992; 339: 1173–4

    Article  PubMed  CAS  Google Scholar 

  78. Puolakkainen M, Ukkonen P, Saikku P. The seroepidemiology of Chlamydia in Finland over the period 1971–1987. Epidemiol Infect 1989; 102: 287–95

    Article  PubMed  CAS  Google Scholar 

  79. Klaukka T, Peura S, Martikainen J. Why has the utilisation of antiasthmatics increased in Finland? J Clin Epidemiol 1991; 44: 859–63

    Article  PubMed  CAS  Google Scholar 

  80. Grayston JT, Campbell LA, Kuo C-C, et al. A new respiratory tract pathogen: Chlamydia pneumoniae strain TWAR. J Infect Dis 1990; 161: 618–25

    Article  PubMed  CAS  Google Scholar 

  81. Grayston JT. Infections caused by Chlamydia pneumoniae strain TWAR. Clin Infect Dis 1992; 15: 757–61

    Article  PubMed  CAS  Google Scholar 

  82. Nicholson KG, Kent J, Ireland DC. Respiratory viruses and exacerbations of asthma in adults. BMJ 1993; 307: 982–6

    Article  PubMed  CAS  Google Scholar 

  83. Pietrzak MP. Aviators have been grounded due to the development of asthma [letter]. Aviat Space Environ Med 1993; 64: 254

    PubMed  CAS  Google Scholar 

  84. Hahn DL, Golubjatnikov R. Asthma and chlamydial infection: a case series. J Fam Pract 1994; 38: 589–95

    PubMed  CAS  Google Scholar 

  85. Hahn DL. Infection as a cause of asthma [letter]. Ann Allergy 1994; 73: 276

    PubMed  CAS  Google Scholar 

  86. Hahn DL. Treatment of Chlamydia pneumoniae infection in adult asthma: a before-after trial. J Fam Pract 1995; 41: 345–51

    PubMed  CAS  Google Scholar 

  87. Hahn DL, Anttila T, Saikku P. Association of Chlamydia pneumoniae IgA antibodies with recently symptomatic asthma. Epidemiol Infect 1996; 117: 513–7

    Article  PubMed  CAS  Google Scholar 

  88. Hahn DL, Bukstein D, Luskin A, et al. Evidence for Chlamydia pneumoniae infection in steroid-dependent asthma. Ann Allergy Asthma Immunol 1998; 80: 45–9

    Article  PubMed  CAS  Google Scholar 

  89. Hahn DL, McDonald R. Can acute Chlamydia pneumoniae respiratory tract infection initiate chronic asthma? Ann Allergy Asthma Immunol 1998; 81: 339–44

    Article  PubMed  CAS  Google Scholar 

  90. Hahn DL. Chlamydia pneumoniae antibodies and adult-onset asthma [letter]. J Allergy Clin Immunol 2000; 106: 404

    Article  PubMed  CAS  Google Scholar 

  91. Hahn DL, Peeling RW, Dillon E, et al. Serologic markers for Chlamydia pneumoniae in asthma. Ann Allergy Asthma Immunol 2000; 84: 227–33

    Article  PubMed  CAS  Google Scholar 

  92. Bjornsson E, Hjelm E, Janson C, et al. Serology of chlamydia in relation to asthma and bronchial hyperresponsiveness. Scand J Infect Dis 1996; 28: 63–9

    Article  PubMed  CAS  Google Scholar 

  93. Von Hertzen L, Toyryla M, Gimishanov A, et al. Asthma, atopy and Chlamydia pneumoniae antibodies in adults. Clin Exp Allergy 1999; 29: 522–8

    Article  Google Scholar 

  94. Miyashita N, Kubota Y, Nakaijama M, et al. Chlamydia pneumoniae and exacerbations of asthma in adults. Ann Allergy Asthma Immunol 1998; 80: 405–9

    Article  PubMed  CAS  Google Scholar 

  95. Cook PJ, Davies P, Tunnicliffe W, et al. Chlamydia pneumoniae and asthma. Thorax 1998; 53: 254–9

    Article  PubMed  CAS  Google Scholar 

  96. Black PN, Scicchitano R, Jenkins CR, et al. Serological evidence of infection with Chlamydia pneumoniae is related to the severity of asthma. Eur Respir J 2000; 15: 254–9

    Article  PubMed  CAS  Google Scholar 

  97. ten Brinke A, van Dissel JT, Sterk PJ, et al. Persistent airflow limitation in adult-onset nonatopic asthma is associated with serologic evidence of Chlamydia pneumoniae infection. J Allergy Clin Immunol 2001; 107: 449–54

    Article  PubMed  Google Scholar 

  98. Von HL, Vasankari T, Liioppo K, et al. Chlamydia pneumoniae and severity of asthma. Scand J Infect Dis 2002; 34: 22–7

    Article  PubMed  Google Scholar 

  99. Von HL. Role of persistent infection in the control and severity of asthma focus on Chlamydia pneumoniae. Eur Respir J 2002; 19: 546–56

    Article  PubMed  Google Scholar 

  100. Kol A, Lichtman AH, Finberg RW, et al. Cutting edge: heat shock protein (HSP) 60 activates the innate immune response: CD14 is an essential receptor for HSP60 activation of mononuclear cells. J Immunol 2000; 164: 13–7

    PubMed  CAS  Google Scholar 

  101. Huittinen T, Hahn D, Anttila T, et al. Host immune response to Chlamydia pneumoniae heat shock protein 60 is associated with asthma. Eur Respir J 2001; 17: 1078–82

    Article  PubMed  CAS  Google Scholar 

  102. Larsen FO, Norn S, Mordhorst CH, et al. Chlamydia pneumoniae and possible relationship to asthma: serum immunoglobulins and histamine release in patients and controls. APMIS 1998; 106: 928–34

    Article  PubMed  CAS  Google Scholar 

  103. Routes JM, Nelson HS, Noda JA, et al. Lack of correlation between Chlamydia pneumoniae antibody titers and adult-onset asthma. J Allergy Clin Immunol 2000; 105: 391–2

    Article  PubMed  CAS  Google Scholar 

  104. Blasi F, Legnani D, Lombardo VM, et al. Chlamydia pneumoniae infection in acute exacerbations of COPD. Eur Respir J 1993; 6: 19–22

    PubMed  CAS  Google Scholar 

  105. Blasi F, Consentini R, Legnais D, et al. Incidence of community-acquired pneumonia caused by Chlamydia pneumoniae in Italian patients. Eur J Clin Microbiol Infect Dis 1993; 12: 696–9

    Article  PubMed  CAS  Google Scholar 

  106. Block S, Hedrick J, Hammerschlag MR, et al. Comparative safety and efficacy of clarithromycin and erythromycin ethylsuccinate suspension in the treatment of children with community-acquired pneumonia. Pediatr Infect Dis 1995; 14: 471–7

    Article  CAS  Google Scholar 

  107. Hammerschlag MR, Chirgwin K, Roblin PM, et al. Persistent infection with Chlamydia pneumoniae following acute respiratory illness. Clin Infest Dis 1992; 14: 178–82

    Article  CAS  Google Scholar 

  108. File TM, Segeti J, Dunbar L, et al. A multicenter randomized study comparing the efficacy and safety of intravenous and/or oral levofloxacin verses ceftriaxone and/or cefuroxime axetil in the treatment of adults with community acquired pneumonia. Antimicrob Agents Chemother 1997; 41: 1965–72

    PubMed  CAS  Google Scholar 

  109. Schönwald S, Kuzman I, Oreskovic K, et al. Azithromycin: single 1.5 g dose in the treatment of patients with atypical pneumonia syndrome: a randomized study. Infection 1999; 27: 198–202

    Article  PubMed  Google Scholar 

  110. Vergis EN, Indorf A, File TM, et al. Azithromycin vs cefuroxime plus erythromycin for empirical treatment of community acquired pneumonia in hospitalized patients: a prospective, randomized, multicenter trial. Arch Intern Med 2000; 160: 1294–300

    Article  PubMed  CAS  Google Scholar 

  111. Hammerschlag MR, Roblin PM. Microbiologie efficacy of moxifloxacin for the treatment of community acquired pneumonia due to Chlamydia pneumoniae. Int J Antimicrob Agents 2000; 15: 149–52

    Article  PubMed  CAS  Google Scholar 

  112. Numazaki K, Sakamoto Y, Umetsu M, et al. Therapeutic effect of clarithromycin for respiratory-tract infections in children caused by Chlamydia pneumoniae. Int J Antimicrob Agents 2000; 13: 219–22

    Article  PubMed  CAS  Google Scholar 

  113. Gray GC, Witucki PJ, Gould MT, et al. Randomized, placebo-controlled clinical trial of oral azithromycin prophylaxis against respiratory infections in a high-risk, young adult population. Clin Infect Dis 2001; 33: 983–9

    Article  PubMed  CAS  Google Scholar 

  114. Johnston SL. Is Chlamydia pneumoniae important in asthma?: the first controlled trial of therapy leaves the question unanswered. Am J Respir Crit Care Med 2001; 164: 513–4

    PubMed  CAS  Google Scholar 

  115. Richeldi L, Ferrara G, Fabbri LM, et al. Macrolides for chronic asthma (Cochrane Review). Available in The Cochrane Library [database on disk and CD ROM]. Updated quarterly. The Cochrane Collaboration; issue 4. Oxford: Update Software, 2002: CD002997

    Google Scholar 

  116. Black PN, Blasi F, Jenkins CR, et al. Trial of roxithromycin in subjects with asthma and serological evidence of infection with Chlamydia pneumoniae. Am J Respir Crit Care Med 2001; 164: 536–41

    PubMed  CAS  Google Scholar 

  117. Kroegel C, Rodel J, Mock B. Chlamydia pneumoniae, clarithromycin, and severe asthma. Chest 2001; 120: 1035–6

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

This study was supported by a donation from Mr C. Jacquet, Basel, Switzerland. The authors have no conflicts of interest directly relevant to the content of this review.

Author information

Authors and Affiliations

  1. Department of Research, Pulmonary Cell Research, University Hospitals Basel, Hebelstrasse 20, CH-4031, Basel, Switzerland

    Mesut Gencay & Michael Roth

  2. The Woolcock Institute for Medical Research, Department of Pharmacology, University of Sydney, Sydney, Australia

    Mesut Gencay & Michael Roth

Authors
  1. Mesut Gencay
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael Roth
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mesut Gencay.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gencay, M., Roth, M. Chlamydia pneumoniae Infections in Asthma. Am J Respir Med 2, 31–38 (2003). https://doi.org/10.1007/BF03256637

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03256637

Keywords

Search

Navigation