High exposure to NO2 in the week before the start of a respiratory viral infection, and at levels within current air quality standards, is associated with an increase in the severity of a resulting asthma exacerbation.

Previous studies have suggested that chronic Chlamydophila pneumoniae infection may play a role in the pathogenesis of asthma. However, most studies have been based on serology and have been unable to differentiate acute from chronic infection.The present authors assessed the presence of acute and chronic C. pneumoniae infection in 74 spouse pairs, each consisting of one atopic asthmatic and one nonatopic nonasthmatic. Nasal secretions were sampled every 2 weeks from October to December and actively replicating C. pneumoniae infection was detected by specific RT-PCR.C. pneumoniae was detected in 31 out of 709 samples analysed, 23 (6.4%) were positive in 362 samples from asthmatic participants and in eight out of 347 (2.3%) samples from their normal spouses (with a significant difference in infection rates, 95% confidence interval: 4.2%, 1.2-7.2%). A total of 16 (22%) asthmatic and seven (9%) normal participants were positive at least once during the study.These data confirm that Chlamydophila pneumoniae infection is detected more frequently among asthmatic participants than normal control participants. Further studies are required to confirm whether infections are also present in the lower airway and whether Chlamydophila pneumoniae infection plays a role in disease pathogenesis. Eur Respir J 2004; 24: 745-749.

Preterm labour continues to complicate a substantial number of pregnancies, and preterm delivery accounts for most early neonatal deaths not due to congenital abnormalities.' Ritodrine hydrochloride, a 13 sympathomimetic agent with predominant effects on 0 receptors such as those of the uterus,2 is effective in suppressing premature uterine contractions.2 We describe six pregnant women given ritodrine hydrochloride who developed swelling of the salivary glands with hypersecretion of amylase. Patients and resultsFrom May 1990 to October 1991 we treated 150 pregnant women with premature uterine contractions with ritodrine hydrochloride. The drug was administered intravenously in a solution containing 50 mg of ritodrine hydrochloride in 500 ml of 5% glucose. The solution was administered at a rate of 50 tg/min, increased by 50 tg/min every 20-30 minutes in response to continued uterine activity until tocolysis or toxicity occurred or a dose of 350 Ftg/min was reached.Of the 150 patients six developed symptoms of parotitis after the administration of ritodrine ( CommentSix pregnant women developed symptoms of parotitis several hours after the administration of ritodrine hydrochloride. Serological tests performed in five of them excluded the possibility of mumps infection.The clinical side effects of ritodrine reflect its 3 mimetic activity.2 To our knowledge, however, 13 mimetics have not been reported to have an effect on the salivary gland in humans, though Selye observed that another 3 mimetic agent, isoprenaline, induced hypertrophy of the salivary gland in rats.3 Following this observation the relation between adrenergic agents and salivary gland function was investigated in rats since hypertrophy of the salivary gland and hypersecretion of amylase occur via the stimulation of 13 adrenoceptors.4 In vitro experiments showed that human salivary gland tissues also secrete amylase in response to isoprenaline.5 The hypersecretion of amylase and the swelling of the salivary glands in our six patients therefore probably resulted from the administration of ritodrine hydrochloride. Clinicians should be aware of this adverse effect of ritodrine, which might also occur in women receiving other (32 agonists for the treatment of premature labour. Patients, methods, and results The study was approved by the local medical ethics committee. Twenty eight patients were randomly recruited (by random numbers sampling from full clinic list) from an outpatient respiratory clinic over six months with the following inclusion criteria: (a) spirometrically proved airways obstruction (a ratio of forced expiratory volume in one second (FEV1) to

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