Mycoplasma pneumoniae (Mp) is a leading cause of community acquired
pneumonia. Knowledge regarding Mp
pneumonia obtained from animal models or human subjects has been discussed in many different reports. Accumulated expertise concerning this critical issue has been hard to apply clinically, and potential problems may remain undiscovered. Therefore, our multidisciplinary team extensively reviewed the literature regarding Mp
pneumonia, and compared findings from animal models with those from human subjects. In human beings, the characteristic pathological features of Mp
pneumonia have been reported as alveolar infiltration with neutrophils and lymphocytes and lymphocyte/plasma cell infiltrates in the peri-bronchovascular area. Herein, we demonstrated the novel aspects of Mp
pneumonia that the severity of the Mp
pneumonia seemed to depend on the host innate immunity to the Mp, which might be accelerated by antecedent Mp exposure (re-exposure or latent respiratory
infection) through up-regulation of
Toll-like receptor 2 expression on bronchial epithelial cells and alveolar macrophages. The
macrolides therapy might be beneficial for the patients with
macrolide-resistant Mp
pneumonia via not bacteriological but immunomodulative effects. This exhaustive review focuses on pathogenesis and extends to some therapeutic implications such as
clarithromycin, and discusses the various diverse aspects of Mp
pneumonia. It is our hope that this might lead to new insights into this common respiratory disease.