Abstract
Background: The factors that cause the allergic sensitization and inflammation in asthma still remain to be clarified. A role for Chlamydia pneumoniae has been suggested although serological studies have produced conflicting findings. This study aims to clarify the relationship between asthmatic variables and C. pneumoniae serological status.
Methods: A case-control study was undertaken on an asthma-enriched subset from a longitudinal birth cohort. In all, 198 subjects (96 with self-reported asthma) had C. pneumoniae serology (microimmunofluorescence [MIF] IgG, IgA) undertaken at age 11 and age 21 and assessment made in relation to a number of asthma variables.
Results The only statistically significant finding was in subjects self-reporting asthma at age 21 who had evidence of lower IgG titres (P = 0.046), a finding in the opposite direction to that expected from the hypothesis. Subjects with high IgG titres (> or =128) were less likely to have reported ever having asthma; odds ratio (OR) = 0.29, (95% CI: 0.10-0.87). No association existed between symptoms suggestive of asthma in the previous 12 months and either IgG (P = 0.127) or IgA (P = 0.189) antibody titres at age 21. Likewise, no association was found between symptoms suggestive of asthma in the previous two years and C. pneumoniae IgG antibody titre (P = 0.81) at age 11. There was no evidence of an association with any of the other variables examined at either age 11 or age 21. These included use of inhaled steroids, serum IgE levels, airway responsiveness, skin test evidence of atopy, or smoking status.
Conclusion: The results of this study suggest that C. pneumoniae infection when diagnosed by MIF serology is not a major risk factor for the development of asthma in children and young adults. The study has not, however, addressed the role this organism may play in specific asthmatic subsets or asthma exacerbations.