الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Asthma is a chronic inflammatory disorder of the airways in which many cells & cellular elements play a role. The respiratory tract infections play an important role in the pathogenesis of asthma. Among these microorganisms Chlamydia pneumoniae is an intracellular pathogen causing persistent infection. The chronic inflammation in COPD and asthma leads to remodeling processes associated with airway wall thickening, impaired lung function, and abnormal contraction to bronchospastic stimuli. (167) Airway remodeling is characterized by the formation of mucus plaques, hyperplasia of myofibroblasts and smooth muscle cells (SMC), and subepithelial fibrosis. (168) C.pneumoniae infection stimulates the production of matrix metalloproteinases (MMPs) so the pathogen may promote increased matrix protein turnover in the airways during respiratory infection.(169) The matrix metalloproteinases (MMPs) are thought to play a central role in breakdown of extracellular matrix (ECM) which is essential for remodeling.(170,171) The balance between MMPs and their inhibitors is critical in tissue repair and remodeling, and its homeostasis plays an important role in the breakdown and deposition of ECM in the airways wall in asthma. (135,136)
50 subjects were included in this study. They were grouped into 35 asthmatic subjects and 15 control subjects. All subjects are non-smokers.
The following investigations were carried out:
1) Pulmonary flow rates including: Forced vital capacity (FVC), Forced expiratory volume in one second (FEV1), FEV1/FVC% and Forced expiratory flow rate at 25%, 50% and75% for asthmatic and control subjects using computerized dry spirometer (Jaeger, Germany).
2) Bronchial reactivity by methacholine inhalation challenge using the five-breath dosimeter protocol and the provocational dose that resulted in 20% DROP in FEV1 (PD20-FEV1) was computed.
3) Measurement of Serum Chlamyidapneumoniae specific IgG, IgA, IgM antibodies and Induced Sputum MMP-9 and TIMP-1.
4) Molecular detection of Chlamydia pneumoniae infection using conventional Polymerase chain reaction (PCR).
5) Data were calculated and analyzed using the SPSS ver.20.
• There was a significant difference in FEV1/FVC%, and FEF25-75% % pred. between asthmatic patients and control subjects (P = 0.000, and 0.000) As regards, there was no significant difference between patients and control subjects in FVC % pred., and FEV1 % pred.
• There was a significant difference in Chlamydia pneumoniae IgM between asthmatic patients and control subjects (P = 0.035). As regards, there was no significant difference between patients and control subjects in Chlamydia pneumoniae IgA and IgG.
• There was a significant negative intermediate correlation (r=-0.487, P=0.003) between IgM and FVC% was detected among asthmatics, a significant negative intermediate correlation (r=-0.395, P=0.019) between Chlamydia pneumoniae IgM and FEV1% was detected among asthmatics, a significant negative intermediate correlation (r=-0.366, P=0.031) between Chlamydia pneumoniae IgG and FVC% was detected among asthmatics, and a significant negative intermediate correlation (r=-0.433, P=0.009) between Chlamydia pneumoniae IgG and FEV1% was detected among asthmatics.
• There was no significant correlation between pulmonary function tests (FVC, FEV1, FEV1/FVC% and the FEF25-75%) and PD 20-FEVı with Sample index of Chlamydia pneumoniae immunoglobulin A, immunoglobulin M, and immunoglobulin G in control subjects.
• There was a significant difference in sputum MMP-9 level between asthmatic patients and control subjects (P = 0.000) . As regards, there was no significant difference between patients and control subjects in TIMP-1
• There was no significant correlation between pulmonary function tests (FVC, FEV1, FEV1/FVC% and the FEF25-75%) ,PD 20-FEVı , Chlamydia pneumoniae immunoglobulin A, immunoglobulin M, and immunoglobulin G with Sputum MMP-9 And TIMP-1 level in asthmatics.
• There was no significant correlation between pulmonary function tests (FVC, FEV1, FEV1/FVC% and the FEF25-75%) , Chlamydia pneumoniae immunoglobulin A, immunoglobulin M, and immunoglobulin G with Sputum MMP-9 And TIMP-1 level in control group.
• Chlamydia pneumonia detection by conventional PCR for asthmatics and patient group performed in this study showed negative result for all subjects groups.