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Chlamydia pneumoniae-induced tumour necrosis factor alpha responses are lower in children with asthma compared with non-asthma
  1. Tamar Anne Smith-Norowitz1,
  2. Kobkul Chotikanatis1,
  3. Diana Weaver1,
  4. Jared Ditkowsky1,
  5. Yitzchok Meir Norowitz1,
  6. Margaret R Hammerschlag1,
  7. Rauno Joks2 and
  8. Stephan Kohlhoff1
  1. 1 Department of Pediatrics, Division of Infectious Diseases, State University of New York Downstate Medical Center, Brooklyn, New York, USA
  2. 2 Department of Medicine, State University of New York Downstate Medical Center, Brooklyn, New York, USA
  1. Correspondence to Dr Tamar Anne Smith-Norowitz; tamar.smith-norowitz{at}


Introduction Chlamydia pneumoniae respiratory tract infection has been implicated in the pathogenesis of reactive airway disease and asthma. Innate cytokine responses that are protective of infection with intracellular pathogens may be impaired in patients with asthma. Tumour necrosis factor alpha (TNF-α) is a cytokine related to functions of monocytes and may inhibit C. pneumoniae infection. We investigated TNF-α responses in C. pneumoniae-infected peripheral blood mononuclear cells (PBMCs) in patients with asthma and non-asthma, and whether ciprofloxacin, azithromycin or doxycycline affects TNF-α responses.

Methods PBMC (1.5×106) from paediatric patients with asthma (n=19) and non-asthmatic controls (n=6) were infected or mock infected for 1 hour with or without C. pneumoniae AR-39 at a multiplicity of infection=0.1, and cultured+ciprofloxacin, azithromycin or doxycycline (0.1 ug/mL) for 48 hours. TNF-α levels were measured in supernatants by ELISA.

Results When PBMC from patients with asthma were infected with C. pneumoniae, levels of TNF-α were significantly lower than in subjects without asthma (48 hours) (5.5±5.6, 38.4±53.7; p=0.0113). However, baseline responses (no infection with C. pneumoniae) were similar in asthma and non-asthma (1.0±1.7, 1.1±1.2; p=0.89). When PBMC frompatiens with asthma were infected with C. pneumoniae+ciprofloxacin, azithromycin or doxycycline, TNF-α levels increased (25%–45%); this affect was not observed in PBMC from patients without asthma.

Conclusions We identified differences in the quantity of TNF-α produced by C. pneumoniae-infected PBMC in asthma compared with non-asthma.

  • asthma
  • bacterial infection
  • cytokine biology

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  • Contributors All authors listed on this manuscript made substantial contributions to the conception (TAS-N, MRH and SK) or design of the work (YMN and DW) or the analysis (KC) and interpretation of the work (RJ). TAS-N and SK wrote and approved final edits of the manuscript. All authors approved the final version of the paper to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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