Pneumocystis jiroveci isolates with dihydropteroate synthase mutations in patients with chronic bronchitis

Calderón, E.; Horra, Carmen de la; Medrano, Francisco J.; López-Suárez, A.; Montes-Cano, Marco Antonio; Respaldiza, Nieves; Elvira-González, Javier; Martín-Juan, José; Bascuñana, A; Varela, J.M.

doi:10.1007/s10096-004-1151-3

Cited by 50 publications

(44 citation statements)

References 35 publications

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“…In comparison with animal model experiments on transmission of Pneumocystis infection (5), the airborne transmission of P. jirovecii from the grandfather to the grandmother and the infant is the most probable explanation, especially in view of the high prevalence of P. jirovecii colonization of persons with chronic bronchial disease in our area and the grandfather's sputum production associated with this condition (15).…”

Section: Discussionmentioning

confidence: 90%

Pneumocystis jiroveciiTransmission from Immunocompetent Carriers to Infant

Rivero

Horra

Montes-Cano

et al. 2008

Emerg. Infect. Dis.

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We report a case of Pneumocystis jirovecii transmission from colonized grandparents to their infant granddaughter. Genotyping of P. jirovecii showed the same genotypes in samples from the infant and her grandparents. These findings support P . jirovecii transmission from immunocompetent carrier adults to a susceptible child.

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Section: Discussionmentioning

confidence: 90%

Pneumocystis jiroveciiTransmission from Immunocompetent Carriers to Infant

Rivero

Horra

Montes-Cano

et al. 2008

Emerg. Infect. Dis.

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“…It has been noted that patients with COPD and chronic bronchitis have an increased prevalence of colonization as well. Calderon et al have found that 41% to 100% of subjects with chronic bronchial disease have detectable colonization (28,30). Other groups have found that Pneumocystis is detectable in 37% of patients with severe COPD and only 5% of those with mild disease.…”

Section: Colonization In Animalsmentioning

confidence: 99%

Colonization by Pneumocystis jirovecii and Its Role in Disease

2012

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SUMMARY Although the incidence of Pneumocystis pneumonia (PCP) has decreased since the introduction of combination antiretroviral therapy, it remains an important cause of disease in both HIV-infected and non-HIV-infected immunosuppressed populations. The epidemiology of PCP has shifted over the course of the HIV epidemic both from changes in HIV and PCP treatment and prevention and from changes in critical care medicine. Although less common in non-HIV-infected immunosuppressed patients, PCP is now more frequently seen due to the increasing numbers of organ transplants and development of novel immunotherapies. New diagnostic and treatment modalities are under investigation. The immune response is critical in preventing this disease but also results in lung damage, and future work may offer potential areas for vaccine development or immunomodulatory therapy. Colonization with Pneumocystis is an area of increasing clinical and research interest and may be important in development of lung diseases such as chronic obstructive pulmonary disease. In this review, we discuss current clinical and research topics in the study of Pneumocystis and highlight areas for future research.

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“…In patients with COPD, for example, P. jirovecii DNA is present in approximately 20% of lung specimens obtained at the time of transplantation or lung resection, and the incidence of P. jirovecii colonization increases with worsening severity of COPD (35). P. jirovecii is also frequently found in the sputa of patients with pulmonary disease, and it has been identified in the sputa of approximately 50% of patients with chronic bronchitis (10).…”

mentioning

confidence: 99%

Pneumocystis murinaInfection and Cigarette Smoke Exposure Interact To Cause Increased Organism Burden, Development of Airspace Enlargement, and Pulmonary Inflammation in Mice

et al. 2008

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Chronic obstructive pulmonary disease (COPD) is characterized by the presence of airflow obstruction and lung destruction with airspace enlargement. In addition to cigarette smoking, respiratory pathogens play a role in pathogenesis, but specific organisms are not always identified. Recent reports demonstrate associations between the detection of Pneumocystis jirovecii DNA in lung specimens or respiratory secretions and the presence of emphysema in COPD patients. Additionally, human immunodeficiency virus-infected individuals who smoke cigarettes develop early emphysema, but a role for P. jirovecii in pathogenesis remains speculative. We developed a new experimental model using immunocompetent mice to test the interaction of cigarette smoke exposure and environmentally acquired Pneumocystis murina infection in vivo. We hypothesized that cigarette smoke and P. murina would interact to cause increases in total lung capacity, airspace enlargement, and pulmonary inflammation. We found that exposure to cigarette smoke significantly increases the lung organism burden of P. murina. Pulmonary infection with P. murina, combined with cigarette smoke exposure, results in changes in pulmonary function and airspace enlargement characteristic of pulmonary emphysema. P. murina and cigarette smoke exposure interact to cause increased lung inflammatory cell accumulation. These findings establish a novel animal model system to explore the role of Pneumocystis species in the pathogenesis of COPD.Chronic obstructive pulmonary disease (COPD) is characterized by the presence of airflow obstruction and lung destruction. The main risk factor for developing COPD is cigarette smoking; however, only about 20% of smokers develop lung disease. The mechanisms by which cigarette smoke leads to pathological changes in both airways and lung parenchyma are unclear. Pulmonary inflammation, localized to the airways, is a pathological feature in the lungs of COPD patients. A predominance of macrophages and CD8 ϩ T lymphocytes are found both in bronchial biopsies (43,44) and in the lung parenchyma at sites of parenchymal destruction (29). These findings suggest that CD8 ϩ T lymphocytes may be responsible for damage to the lung, either by directly injuring neighboring cells, by secreting molecules that injure the lung, or by recruiting and activating additional inflammatory cells.The stimuli responsible for triggering inflammation are not known, but infectious pathogens likely play a role in the initiation or perpetuation of pulmonary inflammation in COPD. Much of the work examining the role of infection in the course and pathogenesis of COPD has focused on bacterial colonization (45), but bacterial or viral colonization may be insufficient to explain pathogenesis. An intriguing alternate pathogen that has received recent attention is the fungus Pneumocystis jirovecii. Although it was previously thought to be an opportunistic pathogen that caused serious pneumonia only in severely immunocompromised patients, recent investigations substantiate the exi...

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Pneumocystis jiroveci isolates with dihydropteroate synthase mutations in patients with chronic bronchitis

Cited by 50 publications

References 35 publications

Pneumocystis jiroveciiTransmission from Immunocompetent Carriers to Infant

Pneumocystis jiroveciiTransmission from Immunocompetent Carriers to Infant

Colonization by Pneumocystis jirovecii and Its Role in Disease

Pneumocystis murinaInfection and Cigarette Smoke Exposure Interact To Cause Increased Organism Burden, Development of Airspace Enlargement, and Pulmonary Inflammation in Mice

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