Pathogenesis of Mycoplasma pneumoniae infections:adaptive immunity, innate immunity, cell biology, and virulence factors
Mycoplasmas represent the smallest self-replicating organisms. They are unique among bacteria in that they lack a cell wall and require sterols for growth. The limited metabolic and biosynthetic activities of mycoplasmas have complicated development of accurate means for laboratory detection and hampered understanding of their roles as human pathogens. Mycoplasma pneumoniae was first identified and characterized in the 1960s and shown to be a common cause of upper and lower respiratory disease in children and adults. Serious infections requiring hospitalization, while rare, occur in persons of all age groups, and may affect multiple organ systems. 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. Evidence is accumulating for this organism’s contributory role in chronic lung conditions such as asthma. Serology has been the most common means for laboratory detection of M. pneumoniae infection due to the slow growth that makes culture impractical. Newer diagnostic methods utilizing nucleic acid amplification offer the advantages for rapid detection and are likely to become increasingly important in the future, but these techniques have not achieved widespread utilization thus far due to the lack of commercially sold products and non-standardized methodology. Management of M. pneumoniae infections can usually be achieved with macrolides, ketolides, tetracyclines, or fluoroquinolones. As more is learned about pathogenesis and immune response elicited by M. pneumoniae, improved methods for diagnosis and prevention of disease due to this organism are anticipated.
KeywordsThrombotic Thrombocytopenic Purpura Mycoplasma Pneumoniae Respiratory Epithelial Cell Chlamydophila Pneumoniae Major Organ System
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