Lung transplantation: The role of azithromycin in the management of patients with bronchiolitis obliterans syndrome

被引:19
作者
Fietta, A. M. [1 ]
Meloni, F. [1 ]
机构
[1] Univ Pavia, Dept Hematol Pneumol & Cardiovasc Sci, Sect Pneumol, Fdn IRCCS,Policlin San Matteo, I-27100 Pavia, Italy
关键词
lung transplant; bronchiolitis obliterans syndrome; azithromycin; pulmonary inflammation;
D O I
10.2174/092986708783885228
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Bronchiolitis obliterans syndrome (BOS) is the leading cause of death in lung transplant recipients (LTR). BOS is thought to result from chronic immunologic/inflammatory insults leading to peri-bronchiolar leukocyte infiltration, with a subsequent exuberant tissue re-modelling and fibro-obliteration of the luminal space of the allograft airways. Diagnosis is based on functional criteria and severity is graded on the degree of Forced Expiratory Volume in 1 second (FEV1) impairment. Current strategies to improve pulmonary function once BOS is established have demonstrated little or no impact on disease progression and re-transplantation remains the only therapeutic option. Among the alternative treatments which have been attempted in the last few years, long-term azithromycin treatment seems to be the most promising therapeutic device for BOS treatment. Azithromycin is a macrolide antibiotic, endowed with a broad spectrum of anti-inflammatory/immunomodulatory activities. Long-term oral azithromycin therapy can significantly improve FEV1 in about 42% of patients with established BOS. Moreover, reduced neutrophilia, chemokine release and bacterial exacerbations have been demonstrated. These observations suggest that the drug can down-regulate pulmonary inflammation, even if the precise underlying mechanisms still need to be determined.
引用
收藏
页码:716 / 723
页数:8
相关论文
共 117 条
  • [2] ANDREU G, 1995, J HEART LUNG TRANSPL, V14, P793
  • [3] The effect of azithromycin on reactive oxygen species in rosacea
    Bakar, O.
    Demircay, Z.
    Yuksel, M.
    Haklar, G.
    Sanisoglu, Y.
    [J]. CLINICAL AND EXPERIMENTAL DERMATOLOGY, 2007, 32 (02) : 197 - 200
  • [4] Azithromycin in the extremely low birth weight infant for the prevention of Bronchopulmonary Dysplasia: a pilot study
    Ballard, Hubert O.
    Anstead, Michael I.
    Shook, Lori A.
    [J]. RESPIRATORY RESEARCH, 2007, 8
  • [5] Barlow CN, 2001, TRANSPLANT INT, V14, P234, DOI 10.1007/s001470100314
  • [6] Role of CXCR2/CXCR2 ligands in vascular remodeling during bronchiolitis obliterans syndrome
    Belperio, JA
    Keane, MP
    Burdick, MD
    Gomperts, B
    Xue, YY
    Hong, K
    Mestas, J
    Ardehali, A
    Mehrad, B
    Saggar, R
    Lynch, JP
    Ross, DJ
    Strieter, RM
    [J]. JOURNAL OF CLINICAL INVESTIGATION, 2005, 115 (05) : 1150 - 1162
  • [7] CD4+25+ regulatory T cells limit Th1-autoimmunity by inducing IL-10 producing T cells following human lung transplantation
    Bharat, A.
    Fields, R. C.
    Steward, N.
    Trulock, E. P.
    Patterson, G. A.
    Mohanakumar, T.
    [J]. AMERICAN JOURNAL OF TRANSPLANTATION, 2006, 6 (08) : 1799 - 1808
  • [8] Induction therapy in lung transplantation: A prospective, controlled clinical trial comparing OKT3, anti-thymocyte globulin, and daclizumab
    Brock, MV
    Borja, MC
    Ferber, L
    Orens, JB
    Anzcek, RA
    Krishnan, J
    Yang, SC
    Conte, JV
    [J]. JOURNAL OF HEART AND LUNG TRANSPLANTATION, 2001, 20 (12) : 1282 - 1290
  • [9] Lung retransplantation for bronchiolitis obliterans syndrome -: Long-term follow-up in a series of 15 recipients
    Brugière, O
    Thabut, G
    Castier, Y
    Mal, H
    Dauriat, G
    Marceau, A
    Lesèche, G
    [J]. CHEST, 2003, 123 (06) : 1832 - 1837
  • [10] Bush A, 2003, SEM RESP CRIT CARE M, V24, P737