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Respiratory Research
Published in: Respiratory Research 1/2017

Open Access 01-12-2017 | Review

Infection-mediated asthma: etiology, mechanisms and treatment options, with focus on Chlamydia pneumoniae and macrolides

Authors: Wilmore C. Webley, David L. Hahn

Published in: Respiratory Research | Issue 1/2017

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Abstract

Asthma is a chronic respiratory disease characterized by reversible airway obstruction and airway hyperresponsiveness to non-specific bronchoconstriction agonists as the primary underlying pathophysiology. The worldwide incidence of asthma has increased dramatically in the last 40 years. According to World Health Organization (WHO) estimates, over 300 million children and adults worldwide currently suffer from this incurable disease and 255,000 die from the disease each year. It is now well accepted that asthma is a heterogeneous syndrome and many clinical subtypes have been described. Viral infections such as respiratory syncytial virus (RSV) and human rhinovirus (hRV) have been implicated in asthma exacerbation in children because of their ability to cause severe airway inflammation and wheezing. Infections with atypical bacteria also appear to play a role in the induction and exacerbation of asthma in both children and adults. Recent studies confirm the existence of an infectious asthma etiology mediated by Chlamydia pneumoniae (CP) and possibly by other viral, bacterial and fungal microbes. It is also likely that early-life infections with microbes such as CP could lead to alterations in the lung microbiome that significantly affect asthma risk and treatment outcomes. These infectious microbes may exacerbate the symptoms of established chronic asthma and may even contribute to the initial development of the clinical onset of the disease. It is now becoming more widely accepted that patterns of airway inflammation differ based on the trigger responsible for asthma initiation and exacerbation. Therefore, a better understanding of asthma subtypes is now being explored more aggressively, not only to decipher pathophysiologic mechanisms but also to select treatment and guide prognoses. This review will explore infection-mediated asthma with special emphasis on the protean manifestations of CP lung infection, clinical characteristics of infection-mediated asthma, mechanisms involved and antibiotic treatment outcomes.
Literature
1.
Burrows B. The natural history of asthma. J Allergy Clin Immunol. 1987;80:375S–7.CrossRef
2.
Hahn DL, Starkey MR, Horvat JC, Kim RY, Hansbro PM. Chlamydial infection and asthma: Is early allergic sensitization the only mechanism? J Allergy Clin Immunol. 2010;125:1414–5.CrossRefPubMed
3.
Smith DH, Malone DC, Lawson KA, Okamoto LJ, Battista C, Saunders WB. A national estimate of the economic cost of asthma. Am J Resp Crit Care Med. 1997;156:787–93.CrossRefPubMed
4.
Demoly P, Gueron B, Annunziata K, Adamek L, Walters RD. Update on asthma control in five European countries: results of a 2008 survey. Eur Respir Rev. 2008;2010(19):150–7.
5.
Schatz M, Zeiger RS, Drane A, Harden K, Cibildak A, Oosterman JE, Kosinski M. Reliability and predictive validity of the Asthma Control Test administered by telephone calls using speech recognition technology. J Allergy Clin Immunol. 2007;119(2):336–43.CrossRefPubMed
6.
McIvor RA, Boulet LP, FitzGerald JM, Zimmerman S, Chapman KR. Asthma control in Canada: no improvement since we last looked in 1999. Can Fam Physician. 2007;53(4):672–7.PubMedPubMedCentral
7.
Webley WC, Salva PS, Andrzejewski C, Cirino F, West CA, Tilahun Y, Stuart ES. The bronchial lavage of pediatric patients with asthma contains infectious Chlamydia. Am J Respir Crit Care Med. 2005;171(10):1083–8.CrossRefPubMed
8.
Lemanske Jr RF, Jackson DJ, Gangnon RE, Evans MD, Li Z, Shult PA, Kirk CJ, Reisdorf E, Roberg KA, Anderson EL, et al. Rhinovirus illnesses during infancy predict subsequent childhood wheezing. J Allergy Clin Immunol. 2005;116:571–7.CrossRefPubMed
9.
Wood PR, Hill VL, Burks ML, Peters JI, Singh H, Kannan TR, Vale S, Cagle MP, Principe MF, Baseman JB, et al. Mycoplasma pneumoniae in children with acute and refractory asthma. Ann Allergy Asthma Immunol. 2013;110(5):328–34. e321.CrossRefPubMedPubMedCentral
10.
Denning DW, O'Driscoll BR, Hogaboam CM, Bowyer P, Niven RM. The link between fungi and severe asthmma. Eur Respir J. 2006;27:615–26.CrossRefPubMed
11.
von Hertzen LC. Role of persistent infection in the control and severity of asthma: focus on Chlamydia pneumoniae. Eur Respir J. 2002;19:546–56.CrossRef
12.
von Hertzen L, Vasankari T, Liippo K, Wahlström E, Puolakkainen M. Chlamydia pneumoniae and severity of asthma. Scand J Infect Dis. 2002;34:22–7.CrossRef
13.
Cho Y, Kim T, Lee T, Moon K, Lee J, Kim Y, Lee K, Moon H. Chlamydia pneumoniae infection enhances cellular proliferation and reduces steroid responsiveness of human peripheral blood mononuclear cells via a tumor necrosis factor-alpha-dependent pathway. Clinical & Experimental Allergy. 2005;35:1625–31.CrossRef
14.
15.
Thomsen SF, van der Sluis S, Kyvik KO, Backer V. A study of asthma severity in adult twins. Clin Respir J. 2011.
16.
17.
18.
Brooks C, Pearce N, Douwes J. The hygiene hypothesis in allergy and asthma: an update. Curr Opin Allergy Clin Immunol. 2013;13(1):70–7.CrossRefPubMed
19.
20.
Webley WC, Hahn DL. Respiratory Chlamydophyla pneumoniae resides primarily in the lower airway. Eur Respir J. 2011;38(4):994–5.CrossRefPubMed
21.
Wu L, Skinner SJM, Lambie N, Vuletic JC, Blasi F, Black PN. Immunohistochemical staining for Chlamydia pneumoniae is increased in lung tissue from subjects with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2000;162:1148–51.CrossRefPubMed
22.
Hilty M, Burke C, Pedro H, Cardenas P, Bush A, Bossley C, Davies J, Ervine A, Poulter L, Pachter L, et al. Disordered microbial communities in asthmatic airways. PLoS One. 2010;5(1), e8578.CrossRefPubMedPubMedCentral
23.
Huang YJ, Nelson CE, Brodie EL, Desantis TZ, Baek MS, Liu J, Woyke T, Allgaier M, Bristow J, Wiener-Kronish JP, et al. Airway microbiota and bronchial hyperresponsiveness in patients with suboptimally controlled asthma. J Allergy Clin Immunol. 2011;127(2):372–81. e371-373.CrossRefPubMed
24.
Good Jr JT, Rollins DR, Martin RJ. Macrolides in the treatment of asthma. Curr Opin Pulm Med. 2012;18(1):76–84.CrossRefPubMed
25.
26.
Webley WC, Aldridge KL. Infectious asthma triggers: time to revise the hygiene hypothesis? Trends Microbiol. 2015;23(7):389–91.CrossRefPubMed
27.
Teo SM, Mok D, Pham K, Kusel M, Serralha M, Troy N, Holt BJ, Hales BJ, Walker ML, Hollams E, et al. The infant nasopharyngeal microbiome impacts severity of lower respiratory infection and risk of asthma development. Cell Host Microbe. 2015;17(5):704–15.CrossRefPubMedPubMedCentral
28.
Shima K, Coopmeiners J, Graspeuntner S, Dalhoff K, Rupp J. Impact of micro-environmental changes on respiratory tract infections with intracellular bacteria. FEBS Lett. 2016;590(21):3887–904.CrossRefPubMed
29.
Piacentini GL, Peroni DG, Blasi F, Pescollderungg L, Goller P, Gallmetzer L, Drago L. Bodini A. Atypical bacteria in adenoids and tonsils of children requiring adenotonsillectomy. Acta Oto-laryngologica: Boner AL; 2009.
30.
Normann E, Gnarpe J, Nääs J, Gnarpe H, Karlsson MG, Wettergren B. Chlamydia pneumoniae in children undergoing adenoidectomy. Acta Pediatr. 2001;90:126–9.CrossRef
31.
Hansbro NG, Horvat JC, Wark PA, Hansbro PM. Understanding the mechanisms of viral induced asthma: new therapeutic directions. Pharmacol Ther. 2008;117(3):313–53.CrossRefPubMed
32.
Johnston SL, Pattemore PK, Sanderson G, Smith S, Lampe F, Josephs L, Symington P, O'Toole S, Myint SH, Tyrrell DA, et al. Community study of role of viral infections in exacerbations of asthma in 9–11 year old children. BMJ. 1995;310(6989):1225–9.CrossRefPubMedPubMedCentral
33.
Grissell TV, Powell H, Shafren DR, Boyle MJ, Hensley MJ, Jones PD, Whitehead BF, Gibson PG. Interleukin-10 gene expression in acute virus-induced asthma. Am J Respir Crit Care Med. 2005;172(4):433–9.CrossRefPubMed
34.
Cunningham AF, Johnston SL, Julious SA, Lampe FC, Ward ME. Chronic Chlamydia pneumoniae infection and asthma exacerbations in children. Eur Resp J. 1998;11:345–9.CrossRef
35.
Hahn DL, McDonald R. Can acute Chlamydia pneumoniae infection initiate chronic asthma? Ann Allergy Asthma Immunol. 1998;81:339–44.CrossRefPubMed
36.
Hahn DL, Peeling RW, Dillon E, McDonald R, Saikku P. Serologic markers for Chlamydia pneumoniae in asthma. Ann Allergy Asthma Immunol. 2000;84:227–33.CrossRefPubMed
37.
Hahn DL. Acute asthmatic bronchitis: A new twist to an old problem. J Fam Pract. 1994;39:431–5.PubMed
38.
Hahn DL. Infectious asthma: a reemerging clinical entity? J Fam Pract. 1995;41:153–7.PubMed
39.
40.
Hahn DL, Dodge R, Golubjatnikov R. Association of Chlamydia pneumoniae (strain TWAR) infection with wheezing, asthmatic bronchitis and adult-onset asthma. JAMA. 1991;266:225–30.CrossRefPubMed
41.
Hahn DL. Chlamydia pneumoniae, asthma and COPD: what is the evidence? Ann Allergy Asthma Immunol. 1999;83:271–92.CrossRefPubMed
42.
43.
44.
Hahn DL, Grasmick M, Hetzel S, Yale S. Azithromycin for bronchial asthma in adults: an effectiveness trial. J Am Board Fam Med. 2012;25(4):442–59.CrossRefPubMed
45.
Hahn DL. Role of Chlamydia pneumoniae as an inducer of asthma. In: Friedman H, Yamamoto Y, Bendinelli M, editors. Chlamydia pneumoniae Infection and Disease. New York: Kluwer Academic/Plenum Publishers; 2004. p. 239–62.
46.
Thomson NC, Chaudhuri R, Livingston E. Asthma and cigarette smoking. Eur Respir J. 2004;24:822–33.CrossRefPubMed
47.
Shemer-Avni Y, Lieberman D. Chlamydia pneumoniae-induced ciliostasis in ciliated bronchial epithelial cells. J Infect Dis. 1995;171:1274–8.CrossRefPubMed
48.
Hahn DL. Chlamydia/Mycoplasma: Do they cause new-onset asthma in adults? In: Johnston SL, Papadopoulos NG, editors. Respiratory Infections in Allergy and Asthma, vol. 178. New York: Marcel Dekker, Inc; 2003. p. 645–62.
49.
Patel KK, Anderson EA, Salva PS, Webley WC. The prevalence and identity of Chlamydia-specific IgE in children with asthma and other chronic respiratory symptoms. Respir Res. 2012;13(1):32.CrossRefPubMedPubMedCentral
50.
Emre U, Sokolovskaya N, Roblin P, Schacter J, Hammerschlag M. Detection of Chlamydia pneumoniae-IgE in children with reactive airway disease. J Infect Dis. 1995;172:265–7.CrossRefPubMed
51.
Yang X, HayGlass KT, Brunham RC. Genetically determined differences in IL-10 and IFN-gamma responses correlate with clearance of Chlamydia trachomatis mouse pneumonitis infection. J Immunol. 1996;156(11):4338–44.PubMed
52.
Yang X, Gartner J, Zhu L, Wang S, Brunham RC. IL-10 gene knockout mice show enhanced Th1-like protective immunity and absent granuloma formation following Chlamydia trachomatis lung infection. J Immunol. 1999;162(2):1010–7.PubMed
53.
Penttila JM, Anttila M, Puolakkainen M, Laurila A, Varkila K, Sarvas M, Makela PH, Rautonen N. Local immune responses to Chlamydia pneumoniae in the lungs of BALB/c mice during primary infection and reinfection. Infect Immun. 1998;66(11):5113–8.PubMedPubMedCentral
54.
Stephens RS. The cellular paradigm of chlamydial pathogenesis. Trends Microbiol. 2003;11(1):44–51.CrossRefPubMed
55.
Prescott SL, Macaubas C, Holt BJ, Smallacombe TB, Loh R, Sly PD, Holt PG. Transplacental priming of the human immune system to environmental allergens: universal skewing of initial T cell responses toward the Th2 cytokine profile. J Immunol. 1998;160(10):4730–7.PubMed
56.
Hansbro PM, Beagley KW, Horvat JC, Gibson PG. Role of atypical bacterial infection of the lung in predisposition/protection of asthma. Pharmacol Ther. 2004;101(3):193–210.CrossRefPubMed
57.
Horvat JC, Beagley KW, Wade MA, Preston JA, Hansbro NG, Hickey DK, Kaiko GE, Gibson PG, Foster PS, Hansbro PM. Neonatal chlamydial infection induces mixed T-cell responses that drive allergic airway disease. Am J Respir Crit Care Med. 2007;176(6):556–64.CrossRefPubMed
58.
Horvat JC, Starkey MR, Kim RY, Phipps S, Gibson PG, Beagley KW, Foster PS, Hansbro PM. Early-life chlamydial lung infection enhances allergic airways disease through age-dependent differences in immunopathology. J Allergy Clin Immunol. 2010;125(3):617–25. 625 e611-625 e616.CrossRefPubMed
59.
Patel KK, Webley WC. Evidence of infectious asthma phenotype: Chlamydia-induced allergy and pathogen-specific IgE in a neonatal mouse model. PLoS One. 2013;8(12), e83453.CrossRefPubMedPubMedCentral
60.
Starkey MR, Kim RY, Beckett EL, Schilter HC, Shim D, Essilfie AT, Nguyen DH, Beagley KW, Mattes J, Mackay CR, et al. Chlamydia muridarum lung infection in infants alters hematopoietic cells to promote allergic airway disease in mice. PLoS One. 2012;7(8), e42588.CrossRefPubMedPubMedCentral
61.
Kaiko GE, Phipps S, Hickey DK, Lam CE, Hansbro PM, Foster PS, Beagley KW. Chlamydia muridarum infection subverts dendritic cell function to promote Th2 immunity and airways hyperreactivity. J Immunol. 2008;180(4):2225–32.CrossRefPubMed
62.
Schröder NWJ, Crother TM, Naiki Y, Chen S, Wong MH, Yilmaz A, Slepenkin A, Schulte D, Alsabeh R, Doherty TM, et al. Innate immune responses during respiratory tract infection with a bacterial pathogen induce allergic airway sensitization. J Allergy Clin Immunol. 2008;122:595–602.CrossRefPubMedPubMedCentral
63.
64.
Campbell LA, Rosenfeld ME. Persistent C. pneumoniae infection in atherosclerotic lesions: rethinking the clinical trials. Front Cell Infect Microbiol. 2014;4:34.CrossRefPubMedPubMedCentral
65.
Park CS, Lee YS, Kwon HS, Lee T, Kim TB, Moon KA, Yoo B, Moon HB, Cho YS. Chlamydophila pneumoniae inhibits corticosteroid-induced suppression of metalloproteinase-9 and tissue inhibitor metalloproteinase-1 secretion by human peripheral blood mononuclear cells. J Med Microbiol. 2012;61(Pt 5):705–11.CrossRefPubMed
66.
McGrath KW, Icitovic N, Boushey HA, Lazarus SC, Sutherland ER, Chinchilli VM, Fahy JV. A large subgroup of mild-to-moderate asthma is persistently noneosinophilic. Am J Respir Crit Care Med. 2012;185(6):612–9.CrossRefPubMedPubMedCentral
67.
C-c K. Pathologic manifestations of chlamydial infection. Am Heart J. 1999;138:S496–9.CrossRef
68.
Burrows B, Martinez F, Halonen M, Barbee RA, Cline MG. Association of asthma with serum IgE levels and skin-test reactivity to allergens. New Engl J Med. 1989;320:271–7.CrossRefPubMed
69.
Hahn DL. A Cure for Asthma? What Your Doctor Isn't Telling You, and Why. Durham, North Carolina: Peoples Pharmacy Press; 2013.
70.
71.
Simpson JL, Powell H, Boyle MJ, Scott RJ, Gibson PG. Clarithromycin targets neutrophilic airway inflammation in refractory asthma. Am J Respir Crit Care Med. 2008;177:148–55.CrossRefPubMed
72.
Expert Panel Report 3. Guidelines for the diagnosis and management of asthma, US Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute. 2007. p. 417.
73.
Moore WC, Bleecker ER, Curran-Everett D, Erzurum SC, Ameredes BT, Bacharier L, Calhoun WJ, Castro M, Chung KF, Clark MP, et al. Characterization of the severe asthma phenotype by the National Heart, Lung, and Blood Institute's Severe Asthma Research Program. J Allergy Clin Immunol. 2007;119:405–13.CrossRefPubMedPubMedCentral
74.
Zeiger RS, Schatz M, Chen W, Li Q, Khatry DB, Tran TN. Adherent uncontrolled adult persistent asthma: characteristics and asthma outcomes. J Allergy Clin Immunol Pract. 2015;3(6):986–90. e982.CrossRefPubMed
75.
Zeiger RS, Schatz M, Li Q, Chen W, Khatry DB, Tran TN. Characteristics and outcomes of HEDIS-defined asthma patients with COPD Diagnostic Coding. J Allergy Clin Immunol Pract. 2016;4(2):273–83. e275.CrossRefPubMed
76.
Banh HL. Unconventional treatment options in severe asthma: an overivew. J Pharm Pharm Sci. 2011;14(3):387–99.CrossRefPubMed
77.
Reiter J, Demirel N, Mendy A, Gasana J, Vieira ER, Colin AA, Quizon A, Forno E. Macrolides for the long-term management of asthma - a meta-analysis of randomized clinical trials. Allergy. 2013;68(8):1040–9.CrossRefPubMed
78.
79.
Chung KF, Wenzel SE, Brozek JL, Bush A, Castro M, Sterk PJ, Adcock IM, Bateman ED, Bel EH, Bleecker ER, et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J. 2014;43(2):343–73.CrossRefPubMed
80.
81.
Travers J, Marsh S, Williams M, Weatherall M, Caldwell B, Shirtcliffe P, Aldington S, Beasley R. External validity of randomised controlled trials in asthma: to whom do the results of the trials apply? Thorax. 2007;62:219–23.CrossRefPubMed
82.
Herland K, Akselsen J-P, Skjønsberg OH, Bjermer L. How representative are clinical study patients with asthma or COPD for a larger "real life" population of patients with obstructive lung disease? Respir Med. 2005;99:11–9.CrossRefPubMed
83.
Johnston SL, Szigeti M, Cross M, Brightling C, Chaudhuri R, Harrison T, Mansur A, Robison L, Sattar Z, Jackson D, et al. Azithromycin for acute exacerbations of asthma: The AZALEA randomized clinical trial. JAMA Intern Med. 2016;176(11):1630–7.CrossRefPubMed
84.
Brusselle GG, Van Braeckel E. AZALEA trial highlights antibiotic overuse in acute asthma attacks. JAMA Intern Med. 2016;176(11):1637–8.CrossRefPubMed
85.
86.
Cook PJ, Honeybourne D, Miles JF, Ayres JG, Tunnicliffe W, Phipps JM, Treharne JD, Wise R. Chlamydia pneumoniae infection is not associated with unselected cases of acute asthma, but may be associated with chronic type 1 "brittle" asthma. Resp Crit Care Med. 1996;153(part 2 of 2 parts):A860. abstract.
87.
88.
Grayston JT, Kronmal RA, Jackson LA, Parisis AF, Muhlestein JB, Cohen JD, Rogers WJ, Crouse JR, Borrowdale SR, Schron E, et al. Azithromycin for the secondary prevention of coronary events. N Engl J Med. 2005;352:1637–45.CrossRefPubMed
89.
O'Connor CM, Dunne MW, Pfeffer MA, Muhlestein JP, Yao L, Gupta S, Benner RJ, Fisher MR, Cook TD. Azithomycin for the secondary prevention of coronary heart disease events. The WIZARD Study: a randomized controlled trial. JAMA. 2003;290(11):1459–66.CrossRefPubMed
90.
Albert RK, Connett J, Bailey WC, Casaburi R, Cooper Jr JA, Criner GJ, Curtis JL, Dransfield MT, Han MK, Lazarus SC, et al. Azithromycin for prevention of exacerbations of COPD. N Engl J Med. 2011;365(8):689–98.CrossRefPubMedPubMedCentral
91.
92.
Svanstrom H, Pasternak B, Hviid A. Use of azithromycin and death from cardiovascular causes. N Engl J Med. 2013;368(18):1704–12.CrossRefPubMed
93.
Khosropour CM, Capizzi JD, Schafer SD, Kent JB, Dombrowski JC, Golden MR. Lack of association between azithromycin and death from cardiovascular causes. N Engl J Med. 2014;370(20):1961–2.CrossRefPubMedPubMedCentral
94.
Wenzel RP, Fowler 3rd AA, Edmond MB. Antibiotic prevention of acute exacerbations of COPD. N Engl J Med. 2012;367(4):340–7.CrossRefPubMed
95.
Segal LN, Clemente JC, Wu BG, Wikoff WR, Gao Z, Li Y, Ko JP, Rom WN, Blaser MJ, Weiden MD. Randomised, double-blind, placebo-controlled trial with azithromycin selects for anti-inflammatory microbial metabolites in the emphysematous lung. Thorax. 2017;72(1):13–22.CrossRefPubMed
96.
Slater M, Rivett DW, Williams L, Martin M, Harrison T, Sayers I, Bruce KD, Shaw D. The impact of azithromycin therapy on the airway microbiota in asthma. Thorax. 2014;69(7):673–4.CrossRefPubMed
97.
Carr TF, Kraft M. Chronic infection and severe asthma. Immunol Allergy Clin North Am. 2016;36(3):483–502.CrossRefPubMed
98.
Loudon K, Treweek S, Sullivan F, Donnan P, Thorpe KE, Zwarenstein M. The PRECIS-2 tool: designing trials that are fit for purpose. BMJ. 2015;350:h2147.CrossRefPubMed
99.
Wong EH, Porter JD, Edwards MR, Johnston SL. The role of macrolides in asthma: current evidence and future directions. Lancet Respir Med. 2014;2(8):657–70.CrossRefPubMed
100.
Juniper EF, Guyatt GH, Ferrie PJ, Griffith LE. Measuring quality of life in asthma. Am Rev Respir Dis. 1993;147(4):832–8.CrossRefPubMed
101.
Suresh Babu K. Kastelik J. Role of long term antibiotics in chronic respiratory diseases. Respir Med: Morjaria JB; 2013.
102.
Spagnolo P, Fabbri LM, Bush A. Long-term macrolide treatment for chronic respiratory disease. Eur Respir J. 2013;42(1):239–51.CrossRefPubMed
103.
104.
Rollins DR, Good Jr JT, Martin RJ. The role of atypical infections and macrolide therapy in patients with asthma. J Allergy Clin Immunol Pract. 2014;2(5):511–7.CrossRefPubMed
Metadata
Title
Infection-mediated asthma: etiology, mechanisms and treatment options, with focus on Chlamydia pneumoniae and macrolides
Authors
Wilmore C. Webley
David L. Hahn
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Respiratory Research / Issue 1/2017
Electronic ISSN: 1465-993X
DOI
https://doi.org/10.1186/s12931-017-0584-z

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