Relationships between radiological pattern and cell-mediated immune response in Mycoplasma pneumoniae pneumonia

Tanaka, Hiroshi; Koba, Hayato; Honma, S; Sugaya, Fumiko; Abe, Shosaku

doi:10.1183/09031936.96.09040669

Cited by 40 publications

(29 citation statements)

References 13 publications

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“…Current evidence from human and animal studies suggests that cytokine production and lymphocyte activation may either minimize disease through the enhancement of host defense mechanisms or exacerbate disease through immunological lesion development. Thus, the more vigorous the cell-mediated immune response and cytokine stimulation, the more severe the clinical illness and pulmonary injury (78,201,305,338,342,(404)(405)(406). This concept of immune-mediated lung disease provides a basis for consideration of immunomodulatory therapeutics in addition to conventional antimicrobial therapies in management of disease due to M. pneumoniae.…”

Section: Cytotoxicity and Inflammationmentioning

confidence: 99%

Mycoplasma pneumoniaeand Its Role as a Human Pathogen

2004

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Mycoplasma pneumoniae is a unique bacterium that does not always receive the attention it merits considering the number of illnesses it causes and the degree of morbidity associated with it in both children and adults. Serious infections requiring hospitalization, while rare, occur in both adults and children and may involve multiple organ systems. The severity of disease appears to be related to the degree to which the host immune response reacts to the infection. Extrapulmonary complications involving all of the major organ systems can occur in association with M. pneumoniae infection as a result of direct invasion and/or autoimmune response. The extrapulmonary manifestations are sometimes of greater severity and clinical importance than the primary respiratory infection. Evidence for this organism's contributory role in chronic lung conditions such as asthma is accumulating. Effective management of M. pneumoniae infections can usually be achieved with macrolides, tetracyclines, or fluoroquinolones. As more is learned about the pathogenesis and immune response elicited by M. pneumoniae, improvement in methods for diagnosis and prevention of disease due to this organism may occur

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Section: Cytotoxicity and Inflammationmentioning

confidence: 99%

Mycoplasma pneumoniaeand Its Role as a Human Pathogen

2004

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“…16 Tuberculin skin test reactivity can also act as a risk marker for Mycoplasma pneumonia among the elderly 17 and is correlated with clinical severity and radiographic presentation of pulmonary lesions caused by M pneumonia. 18 Beyond this evidence, the literature on BCG-ALRI associations remain limited, likely due to several factors including historical difficulties in ascertaining vaccination status from health records or vaccination cards, [19][20][21] high BCG vaccination rates in the general population (85% worldwide coverage rate with national coverage ranging from 43% to 99%), 1 and ethical constraints in conducting randomized clinical trials to evaluate routinely used childhood vaccines. 22,23 Further complicating this line of research has been the established ineffectiveness of BCG for inducing protective immunity against tuberculosis among adults and its contraindicated use among HIV-infected individuals.…”

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confidence: 99%

Acute Lower Respiratory Infection Among Bacille Calmette-Guérin (BCG)–Vaccinated Children

Hollm-Delgado¹,

Stuart

Black³

2014

Pediatrics

115

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WHAT'S KNOWN ON THIS SUBJECT: Bacille Calmette-Guerin (BCG) vaccination may provide benefits beyond protecting against pediatric tuberculosis. Evidence suggests links between cellmediated immunity from tuberculosis and bacterial/viral-related pneumonia but the impact of BCG on acute lower respiratory infection is not fully known.WHAT THIS STUDY ADDS: BCG-vaccinated children had a lower risk of suspected acute lower respiratory infection. Protection was amplified when children were vaccinated against diphtheriatetanus-pertussis (DTP). Number of DTP doses did not modify this effect, but order in which vaccines were received did. abstract OBJECTIVE: To determine whether Bacille Calmette-Guerin (BCG) vaccination is linked to the risk of acute lower respiratory infection (ALRI) among children ,5 years of age. METHODS: Data from Macro International Demographic and HealthSurveys and United Nations Children' s Fund Multiple Indicator Cluster Surveys were used to identify a primary cohort of 58 021 children in 19 countries (2005)(2006)(2007)(2008)(2009)(2010) and a secondary cohort of 93 301 children in 18 countries (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007). Information was collected by trained interviewers during home visits using standardized questionnaires, review of vaccination health cards, and measurement of health indicators.RESULTS: BCG vaccination was associated with a 17% to 37% risk reduction for suspected ALRI in both cohorts. The only vaccine or vitamin supplement to modify the effect of BCG was diphtheria-tetanuspertussis (DTP; P , .001). The order in which the vaccines were first received was central to this phenomena (BCG before DTP, adjusted/propensity score-weighted relative risk [apRR]: 0.79, 95% confidence interval [CI]: 0.70-0.89; BCG with DTP, apRR: 0.82, 95% CI: 0.71-0.94; and BCG after DTP, apRR: 1.00, 95% CI: 0.87-1.13) but not number of DTP doses received. Other modifiers included vaccine strain used in immunization programs, chlorinating drinking water, using wood-burning fuel cook stoves, and owning livestock.CONCLUSIONS: Children vaccinated with BCG had a significantly lower risk of suspected ALRI. Clarification is needed as to whether this is due to reductions in the underlying risk of tuberculosis or ALRI per se.

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“…One point which seems to be sure is that pneumonia, the hallmark of M. pneumoniae infection, is a consequence of a host immune response, particularly of cellular immunity (2,4,6). In this respect, previous studies have suggested that a T-helper 1 (Th1)-type response of the host may play an important role in developing pathologic features as well as in radiographical patterns of M. pneumoniae pneumonia (34,35). At the same time, it has been reported that a local immune response on the pulmonary surface of the host may play an important role in developing extrapulmonary diseases associated with M. pneumoniae (23; M. Narita, Letter, Clin.…”

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confidence: 99%