Asthma Impact on Invasive Pneumococcal Disease

Asthma, characterised by chronic airway inflammation and variable airflow obstruction, has been increasingly recognised as a risk factor for invasive pneumococcal disease (IPD). Individuals with asthma exhibit a combination of structural airway alterations, immune-modulatory treatments and specialised immunological profiles that collectively compromise mucosal defence against Streptococcus pneumoniae invasion. Impaired mucociliary clearance, corticosteroid-induced suppression of local immunity and a predominance of T helper 2 (Th2) responses converge to diminish opsonophagocytic activity and antibody generation. Epidemiological data reveal that children with asthma face particularly high susceptibility, with risk estimates more than double those of non-asthmatic peers, while adults also show a modest but significant elevation in IPD incidence. Vaccine responses in asthma display heterogeneity; subsets of patients, notably those prone to frequent exacerbations, often exhibit suboptimal antibody titres to both conjugate and polysaccharide formulations. From a public health standpoint, these observations underline the need for tailored immunisation schedules, vigilant clinical monitoring and enhanced education on timely antibiotic therapy. Ongoing research seeks to clarify mechanistic pathways, refine risk stratification and optimise preventive strategies, thereby reducing the global burden of IPD among the growing population of individuals with asthma.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Asthma Impact on Invasive Pneumococcal Disease publication trend

The graph below shows the total number of articles in asthma impact on invasive pneumococcal disease across all publications each year (not limited to Nature Index journals).

Technical terms

Invasive pneumococcal disease (IPD): Infection in normally sterile sites by Streptococcus pneumoniae, such as blood or cerebrospinal fluid.

Pneumococcal conjugate vaccine (PCV): A vaccine combining polysaccharide antigens with a carrier protein to induce T cell–dependent immunity and long-term memory.

Polysaccharide vaccine (PPSV-23): A vaccine containing purified capsular polysaccharides from 23 pneumococcal serotypes, eliciting T cell–independent antibody responses.

Th2-skewed immunity: An immune response dominated by T helper 2 cells producing cytokines such as IL-4 and IL-5, often at the expense of effective antibacterial defence.

Mucociliary clearance: The mechanism by which mucus and entrapped pathogens are transported out of the airways by coordinated ciliary motion.

References

1. Association between asthma and invasive pneumococcal disease risk: a systematic review and meta-analysis. Allergy, Asthma & Clinical Immunology (2020).
2. Impact of pneumococcal vaccine response on asthma exacerbation frequency in young children. Immunity Inflammation and Disease (2020).
3. Can PPSV-23 Vaccine Impact Exacerbations of Chronic Cough Symptoms and Medication Use in Younger Adult Asthmatics? A Clinical Question That Needs Answering. Vaccines (2022).