Chlamydia pneumoniae and asthma
- aDepartment of Respiratory Medicine, City Hospital, Dudley Road, Birmingham, UK, bDepartment of Respiratory Medicine, Birmingham Heartlands Hospital, Birmingham, UK, cDepartment of Microbiology, City Hospital, Dudley Road, Birmingham, UK, dSchool of Mathematics and Statistics, University of Birmingham, Birmingham, UK
- Dr P J Cook, Department of Respiratory Medicine, Birmingham Heartlands Hospital, Bordesley Green, Birmingham B9 5SS, UK.
- Received 3 February 1997
- Revision requested 4 April 1997
- Revised 1 December 1997
- Accepted 16 December 1997
Abstract
BACKGROUND This study was designed to test the association of Chlamydia pneumoniae infection with asthma in a multiracial population, after adjustments for several potential confounding variables.
METHODS Antibodies to C pneumoniaewere measured by microimmunofluorescence in 123 patients with acute asthma, 1518 control subjects admitted to the same hospital with various non-cardiovascular, non-pulmonary disorders, and 46 patients with severe chronic asthma, including some with “brittle” asthma. Acute infection or reinfection was defined by titres of IgG of ≥512 or IgM ≥8 or a fourfold rise in IgG, and previous infection by IgG 64–256 or IgA ≥8. Logistic regression was used to control for likely confounders, including ethnic origin, age, sex, smoking habit, steroid medication, diabetes mellitus and social deprivation, on antibody levels.
RESULTS Antibody titres consistent with acuteC pneumoniae infection were found in 5.7% of patients with acute asthma and 5.7% of control patients, while 14.6% of patients with acute asthma and 12.7% of control patients had titres suggesting previous infection. These two groups did not differ significantly. However, titres suggesting previous infection were found in 34.8% of patients with severe chronic asthma: the difference between this group and the control group was statistically significant with an adjusted odds ratio of 3.99 (95% confidence interval 1.60 to 9.97).
CONCLUSIONS These data raise important questions about the previously demonstrated association of C pneumoniae infection with asthma, and suggest that future studies of this association should give particular attention to the presence or absence of a history of severe chronic asthma.
