Subscribe to Dr. Mirkin's free FITNESS & HEALTH NEWSLETTER
COPD, Infections and Asthma

One in five North Americans have late-onset asthma or chronic obstructive pulmonary disease (COPD), in which they cough and become short of breath, particularly when they get infections. Doctors usually prescribe cortisone-type inhalers and pills which help control lung symptoms, but never offer a cure and cause serious side effects such as osteoporosis, decreased immunity, obesity, high blood pressure and so forth. Chronic lung disease may be caused by mycoplasma, chlamydia and ureaplasma, bacteria that are unique because they live inside of cells and are extraordinarily difficult to grow in culture media in the laboratory and therefore are extremely difficult to find with routine culture techniques.

Mycoplasma is a common cause of pneumonia in young adults and children, a common cause of meningitis, nerve damage, heart muscle infection (myocarditis) and arthritis, and a common cause of asthma in young adults. 35% of people with asthma show evidence (antibodies) of recent infection with chlamydia (45). Many young adults who develop asthma caused by mycoplasma fail to develop antibodies to kill that bacteria, so they continue to be infected for the rest of their lives (56). Other papers show that an intracellular bacteria called ureaplasma is a common cause of asthma in young children (1a), some people with steroid-dependant asthma can get off oral prednisone after they take azithromycin for 6 to 16 weeks (1b).

Asthma and chronic obstructive pulmonary disease (COPD ) lead to permanent lung damage, so most doctors prescribe cortisone-type inhalers early in the disease for asthma (39) and COPD (43). Many papers show that continuous antibiotics effectively controls these chronic lung diseases (1c,55). People with chronic obstructive pulmonary disease have very high titers of antibodies to chlamydia, showing infection with that germ (2). Asthma caused by mycoplasma can be cured (54). Two years of intermittent treatment with antibiotics fails to cure some cases of chlamydia infections in the lungs (3).

People with late-onset asthma and chronic obstructive pulmonary disease usually have no allergies. These conditions are caused by infection with several different viruses and bacteria such as mycoplasma( 4-16,16A,16B). Infections trigger and perpetuate asthma (17-30,47-52,58). Rats that wheeze and cough with viral infections got better when they're given imiquimod, a drug that increases interferon production, a chemical that your cells produce to kill viruses (42). Children with asthma are often infected with chlamydia pneumoniae (43). Asthmatics have high blood antibodies against bacteria and allergens (57). Bacterial infections in the lung lead to permanent damage (40). 37% of hospitalizations for asthmatics are associated with a known infection (31). Doxycycline (100 mg BID) or azithromycin (1 gram once a week) has been shown to cure acute bouts of wheezing (32). Three recent papers show that erythromycin antibiotics (clarithromycin, azithromycin) help to treat asthma by decreasing and loosening mucous in the lungs (33,34,60). Your doctor may prescribe conventional asthma medications containing theophylline or albuteral, but they don't always work (35).

Until recently, the only effective treatment for severe late-onset asthma was cortisone-type medications such as prednisone or a cortisone-type inhaler (36), but azithromycin can prevent mycoplasma-caused asthma (38). Two recent papers show that chlamydia causes asthma (60) and ear infections (61) . People with chronic obstructive pulmonary disease and late-onset asthma may benefit from long-term treatment with doxycycline, 100 mg twice a day, but this is highly controversial. Most allergists disagree and refuse to prescribe long-term antibiotics. Check with your doctor.

More on Mycoplasma, Chlamydia and Ureaplasma.
More on Late Onset Asthma

1a) JAMA, 1997 (December 17);278(23):2051-2.

1b) Annals of Allergy, Asthma and Immunology 1998(Jan);80(1):45-49.

1c) Saint S et al. Antibiotics in chronic obstructive pulmonary disease exacerbations. An analysis. JAMA, 1995;273:957-960.

2) L Vonhertzen, R Isoaho, M Leinonen, R Koskinen, P Laippala, M Toyryla, SL Kivela, P Saikku. Chlamydia pneumoniae antibodies in chronic obstructive pulmonary disease. International Journal of Epidemiology 25: 3 (JUN 1996):658-664.

3) G Falck, J Gnarpe, H Gnarpe. Persistent Chlamydia pneumoniae infection in a Swedish family. Scandinavian Journal of Infectious Diseases 28: 3(1996):271-273.

4) V Macek, J Sorli, S Kopriva, J Marin. Persistent adenoviral infection and chronic airway obstruction in Children. American Journal of Respiratory and Critical Care. Medicine 150: 1 (JUL 1994):7-10.

5) U Emre, RM Roblin, M Gelling, W Dumornay, M Rao, MR Hammerschlag, J Schachter. The association of Chlamydia pneumoniae infection and reactive airway disease in children. Archives of Pediatrics & Adolescent Medicine 148: 7(JUL 1994): 727-732.

6) T Fujii, J Kadota, K Kawakami, K Iida, R Shirai, M Kaseda, S Kawamoto, S Kohno.Long term effect of erythromycin therapy in patients with chronic pseudomonas aeruginosa infection. Thorax 50: 12 (DEC 1995):1246-1252.

7) E Bjornsson, E Hjelm, C Janson, E Fridell, G Boman. Serology of Chlamydia in relation to asthma and bronchial hyperresponsiveness. Scandinavian Journal of Infectious Diseases 28: 1(1996):63-69.

8) LA Jackson, JT Grayston. Chlamydia pneumoniae and Mycoplasma pneumoniae infections. Current Opinion in Infectious Diseases 9: 2(APR 1996):89-93.

9)Ups J Med Sci 1996;101(2):159-168.

10) Epidemiol Infect 1996(Dec);117(3):513-517.

11)Rev Alerg Mex 1996(Mar-Apr);43(2):45-48.

12) Scand J Infect Dis 1996;28(1):63-69.

13) A, J Respir Crit Care Med 1996(Sept);154(3 part 1):654-660.

14) Rev Prat 1996(Nov 1);46(17):2077-2082.

15) Eur Respir J 1996(Jan);9(1):72-77.

16) Curr Opin Pediatr 1996(feb);8(1):3-5.

16a) Chest August, 1993.

16b) Lancet, May 9, 1992.

17) Presse Med 1997(MR);26(sUPPL 2):27-29.

18) Clin Exp Allergy 1997(June);27(1):36-45.

19) Clin Exp Allergy 1996(Jun);26(6):665-676.

20) Am J Respir Crit Care Med 1997(Mar);155(3):833-838.

21) Am J Respir Crit Care Med 1996(Sep);154(3 part 1):661-664.

22) Eur Respir J 1996(July);9(7):1402-1406.

23) NEJM, 1975;292:563-570.

24) Ann Internal Medicine 1982;97:18-21.

25) Ann Inter Med 1987;106:196-204.

26) Am Rev Respir Dis 1992;146:1067-1083.

27) Infect Dis Clin Practice 1994;3:81-86.

28) J Fam Pract 1992;34:585-591.

29) Am J Med 1989;87(Suppl 6C):S52-S56.

30) Am J Med 1991;91:261-266. A Dakhama, TZ Vitalis, RG Hegele. Persistence of respiratory syncytial virus (RSV) infection and development of RSV-specific IgG1 response in a guinea-pig model of acute bronchiolitis. European Respiratory Journal 10: 1 (JAN 1997):20-26. Acute respiratory syncytial virus (RSV) bronchiolitis in children can result in sequelae of recurrent wheezing and asthma and production of RSV-specific immunoglobulin E (IgE). Respiratory syncytial virus chronically persists.

31) H Teichtahl, N Buckmaster, E Pertnikovs. The incidence of respiratory tract infection in adults requiring hospitalization for asthma. Chest 112: 3 (SEP 1997):591-596.

32) Hahn DL. Treatment of chlamydia pneumoniae infection in adult asthma: A before -after trial. J Fam Pract. 1995;41:345-351.

33) BK Rubin, H Druce, OE Ramirez, R Palmer. Effect of clarithromycin on nasal mucus properties in healthy subjects and in patients with purulent rhinitis. American Journal of Respiratory and Critical Care Medicine 155: 6 (JUN 1997):2018-2023.

34) Shimizu T et al. Roxithromycin attenuates acid-induced cough and water-induced bronchocontriction in children with asthma. Journal of Asthma. 1997;34(3):211-217. helps to prevent asthma attacks.

35) ARJ Vankeimpema, M Ariaansz, JAM Raaijmakers, JJP Nauta, PE Postmus. Treatment of nocturnal asthma by addition of oral slow-release albuterol to standard treatment in stable asthma patients. Journal of Asthma 33: 2 (1996):119-124.

36) S Wongtim, S Mogmued, P Chareonlap, S Limthongkul. Effect of inhaled corticosteroids on bronchial hyperresponsiveness in patients with mild asthma. Asian Pacific Journal of Allergy and Immunology 13: 2(DEC 1995):81-85.

36a)Clinical effects were limited and many were not sustained for two years. JA Douglass, FCK Thien, RE Ohehir. Immunotherapy in asthma. Thorax 52: Suppl. 3 (AUG 1997):S22-S29.

37) JM Llibre, A Urban, E Garcia, MA Carrasco, C Murcia. Bronchiolitis obliterans organizing pneumonia associated with acute Mycoplasma pneumoniae infection. Clinical Infectious Diseases 25: 6(DEC 1997):1340-1342.

38) JD Klausner, D Passaro, J Rosenberg, WL Thacker, DF Talkington, SB Werner, DJ Vugia. Enhanced control of an outbreak of Mycoplasma pneumoniae pneumonia with azithromycin prophylaxis. Journal of Infectious Diseases 177: 1 (JAN 1998):161-166.

38a) PM Carter, TL Heinly, SW Yates, PL Lieberman. Asthma: The irreversible airways disease. Journal of Investigational Allergology & Clinical Immunology 7: 6 (NOV-DEC 1997):566-571.

39) DL Hahn, D Bukstein, A Luskin, H Zeitz. Evidence for Chlamydia pneumoniae infection in steroid-dependent asthma. Annals of Allergy Asthma & Immunology 80:1 (JAN 1998):45-49.

40) P Cole. The damaging role of bacteria in chronic lung infection. Journal of Antimicrobial Chemotherapy 40: Suppl.A (DEC 1997):5-10.

41) E Normann, J Gnarpe, H Gnarpe, B Wettergren. Chlamydia pneumoniae in children with acute respiratory tract infections. Acta Paediatrica 87: 1 (JAN 1998):23-27. Chlamydia pneumoniae is a common finding in young children with respiratory tract infections.

42) Paggiaro et al. Lancet, 1998(March 14);351(9105):778-780. 42) JR Stokes, RL Sorkness, MR Kaplan, WL Castleman, MA Tomai, RL Miller, RF Lemanske. Attenuation of virus-induced airway dysfunction in rats treated with imiquimod. European Respiratory Journal 11: 2 (FEB 1998):324-329.

43) AF Cunningham, SL Johnston, SA Julious, FC Lampe, ME Ward. Chronic Chlamydia pneumoniae infection and asthma exacerbations in children. European Respiratory Journal 11: 2 (FEB 1998):345-349. chronic Chlamydia pneumoniae infection is common in schoolage children and immune responses to C. pneumoniae are positively associated with frequency of asthma exacerbations. In contrast Mycoplasma pneumoniae was not found to be important in this study.

44) A Hasani, D Pavia, S Rotondetto, SW Clarke, MA Spiteri, JE Agnew. Effect of oral antibiotics on lung mucociliary clearance during exacerbation of chronic obstructive pulmonary disease. Respiratory Medicine 92: 3 (MAR 1998):442-447. the numbers of coughs and sputum production was reduced.

45) PJ Cook, P Davies, W Tunnicliffe, JG Ayres, D Honeybourne, R Wise. Chlamydia pneumoniae and asthma. Thorax 53: 4 (APR 1998):254-259.

46) Miyashita N, et al. Chlamydia pneumoniae and exacerbations of asthma in adults. Annals of Allergy, Asthma and Immunology 1998(May);80(5):405-410.

47) M Murrisespin. Mycoplasma and Chlamydia: can they induce bronchial hyperreactivity and asthma? Revue Francaise D Allergologie et D Immunologie Clinique 38: 4 (1998):264-266. Among bacterial agents, only Mycoplasma pneumoniae and Chlamydia pneumoniae have been reported to trigger exacerbations of asthma.

48) F Freymuth, A Vabret, J Brouard, JF Duhamel, B Guillois, J Petitjean, E Gennetay, S Gouarin, C Proust. Epidemiology of viral infection and asthma. Revue Francaise D Allergologie et D Immunologie Clinique 38: 4 (1998):319-325.

49) The three most frequent viruses are rhinovirus (RV), respiratory syncytial virus (RSV), and parainfluenza viruses (PIV), detected in 8.8%, 6.4% and 6% of cases, respectively.

50) L Refabert, J Deblic, P Scheinmann. Viral infections, cytokines and asthma attacks in children. Revue Francaise D Allergologie et D Immunologie Clinique 38: 4 (1998):327-332. Respiratory viral infections, particularly rhinoviruses, are very important triggers of asthma.

51) E Serrano, J Percodani, A Didier, JJ Pessey. Nasal polyposis, respiratory infections and asthma. Revue Francaise D Allergologie et D Immunologie Clinique 38: 4 (1998):339-344.

52) N Miyashita, Y Kubota, M Nakajima, Y Niki, H Kawane, T Matsushima. Chlamydia pneumoniae and exacerbations of asthma in adults. Annals of Allergy Asthma & Immunology 80: 5 (MAY 1998):405-409.

53) N Miyashita, Y Kubota, M Nakajima, Y Niki, H Kawane, T Matsushima. Chlamydia pneumoniae and exacerbations of asthma in adults. Annals of Allergy Asthma & Immunology 80: 5 (MAY 1998):405-409.

54)I Kosseianbal, H Bocquet, N Beneton, R Encaoua, L Deforges, JC Roujeau, J Revuz. Hypersensibility syndrome in a patient with Mycoplasma pneumoniae infection. Annales de Dermatologie et de Venereologie 125: 5(MAY 1998):328-330.

55)S Kudoh, A Azuma, M Yamamoto, T Izumi, M Ando. Improvement of survival in patients with diffuse panbronchiolitis treated with low-dose erythromycin. American Journal of Respiratory and Critical Care Medicine 157: 6 (JUN 1998):1829-1832.

56) M Kraft, GH Cassell, JE Henson, H Watson, J Williamson, BP Marmion, CA Gaydos, RJ Martin. Detection of Mycoplasma pneumoniae in the airways of adults with chronic asthma. American Journal of Respiratory and Critical Care Medicine 158: 3 (SEP 1998):998-1001.

57) DH Nahm, HY Kim, HS Park. Elevation of specific immunoglobulin A antibodies to both allergen and bacterial antigen in induced sputum from asthmatics. European respiratory journal 12: 3 (sep 1998):540-545.

58) Hahn DL, McDonald R. Can acute chlamydia pneumoniae respiratroy tract infections initiate chronic asthma? Annals of Allergy, Asthma and Immunology. 1998(October);81:339-344.

59) N Miyashita, Y Niki, M Nakajima, H Kawane, T Matsushima. Chlamydia pneumoniae infection in patients with diffuse panbronchiolitis and COPD. Chest 114: 4 (OCT 1998):969-971.

60) DL Hahn, R Mcdonald. Can acute Chlamydia pneumoniae respiratory tract infection initiate chronic asthma? Annals of Allergy Asthma & Immunology 81: 4 (OCT 1998):339-344.

61) G Falck, I Engstrand, J Gnarpe, H Gnarpe. Association of Chlamydia pneumoniae with otitis media in children. Scandinavian Journal of Infectious Diseases 30: 4(1998):377-380.

62) Miyashita N et al. Chlamydia Pneumoniae infections in patients with diffuse panbronchitis and COPD. Chest 1998(Oct);ED .

63) Chan, T Kalayanamit, DA Lynch, R Tuder, P Arndt, R Winn, MI Schwarz. Mycoplasma pneumoniae - Associated bronchiolitis causing severe restrictive lung disease in adults - Report of three cases and literature review. Chest, 1999, Vol 115, Iss 4, pp 1188-1194.

64) SI Rennard. Inflammation and repair processes in chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine, 1999, Vol 160, Iss 5, Suppl. S, pp S12-S16.

65) MG Cosio, A Guerassimov. Chronic obstructive pulmonary disease - Inflammation of small airways and lung parenchyma. American Journal of Respiratory and Critical Care Medicine, 1999, Vol 160, Iss 5, Suppl. S, pp S21-S25.

66) D Shapiro. The macrophage in chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine, 1999, Vol 160, Iss 5, Suppl. S, pp S29-S32.

67) DM Kemeny, B Vyas, M VukmanovicStejic, MJ Thomas, A Noble, LC Loh, BJ Oconnor. CD8(+) T cell subsets and chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine, 1999, Vol 160, Iss 5, Suppl. S, pp S33-S37.

68) PR Mills, RJ Davies, JL Devalia. Airway epithelial cells, cytokines, and pollutants. American Journal of Respiratory and Critical Care Medicine, 1999, Vol 160, Iss 5, Suppl. S, pp S38-S43.

69) DS Postma, HAM Kerstjens. Are inhaled glucocorticosteroids effective in chronic obstructive pulmonary disease? American Journal of Respiratory and Critical Care Medicine, 1999, Vol 160, Iss 5, Suppl. S, pp S66-S71.

70) PJ Barnes. Novel approaches and targets for treatment of chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine, 1999, Vol 160, Iss 5, Suppl. S, pp S72-S79

71) Hahn et al. Serologic markers for chlamydia pneumoniae in asthma. Ann Allergy Asthma Immunol 2000(Feb);84:227-233. 72) M Radermecker. Atopy and infections.Revue Francaise D Allergologie et D Immunologie Clinique, 2000, Vol 40, Iss 1, pp 119-122.

Checked 12/10/16

January 1st, 2015
|   Share this Report!

About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
Copyright 2016 Drmirkin | All Rights Reserved | Powered by Xindesigns