Clarithromycin suppresses bronchial hyperresponsiveness associated with eosinophilic inflammation in patients with asthma

被引:131
作者
Amayasu, H
Yoshida, S
Ebana, S
Yamamoto, Y
Nishikawa, T
Shoji, T
Nakagawa, H
Hasegawa, H
Nakabayashi, M
Ishizaki, Y
机构
[1] Yokohama Rosai Hosp, Dept Med, Kohoku Ku, Yokohama, Kanagawa 2220036, Japan
[2] AOKI Int Med Ctr, Dept Med, Yokohama, Kanagawa, Japan
[3] Harvard Univ, Sch Med, Brigham & Womens Hosp, Dept Pulm & Crit Care Med, Boston, MA USA
关键词
D O I
10.1016/S1081-1206(10)62409-X
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Background: Although long-term administration of 14-membered macrolide antibiotics is a therapeutic alternative in asthma, both its pharmacologic mechanism of action and association with the pathogenesis of asthma remain obscure. Objective: This study investigated the suppressive effect of clarithromycin on airway responsiveness to methacholine provocation testing and examined whether chrarithromycin's antiasthmatic activity is associated with a reduction in eosinophilic inflammation. Methods: For 8 weeks, patients received 200 mg of clarithromycin or identical-appearing placebo twice daily. We assessed the effects of treatment with clarithromycin on bronchoconstriction precipitated by inhalation of methacholine in 17 adults with mild or moderate bronchial asthma who were in stable clinical condition. A double-blind, randomized, crossover design was used. Eosinophil counts and eosinophilic cationic protein (ECP) levels were determined in brood and sputum samples obtained on the morning of the methacholine provocation testing day. Results: After 8 weeks of treatment with clarithromycin, patients' symptoms, blood and sputum eosinophils counts and sputum ECP levels were significantly decreased compared with both placebo and baseline. Furthermore, values of PC, methacholine improved in all patients after clarithromycin treatment. Conclusions: Clarithromycin has a bronchial anti-inflammatory effect associated with decreased eosinophilic infiltration. This study suggests interesting therapeutic possibilities for bronchial asthma that warrant further trials.
引用
收藏
页码:594 / 598
页数:5
相关论文
共 19 条
  • [1] Eosinophil apoptosis caused by theophylline, glucocorticoids, and macrolides after stimulation with IL-5
    Adachi, T
    Motojima, S
    Hirata, A
    Fukuda, T
    Kihara, N
    Kosaku, A
    Ohtake, H
    Makino, S
    [J]. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 1996, 98 (06) : S207 - S215
  • [2] [Anonymous], 1987, AM REV RESPIR DIS, V136, P225
  • [3] THE RELATIONSHIP BETWEEN INFLAMMATION AND HYPERREACTIVITY OF THE AIRWAYS IN ASTHMA
    CHAPMAN, ID
    FOSTER, A
    MORLEY, J
    [J]. CLINICAL AND EXPERIMENTAL ALLERGY, 1993, 23 (03) : 168 - 171
  • [4] EVALUATION OF SERUM EOSINOPHILIC CATIONIC PROTEIN AS A MARKER OF DISEASE-ACTIVITY IN CHRONIC ASTHMA
    FERGUSON, AC
    VAUGHAN, R
    BROWN, H
    CURTIS, C
    [J]. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 1995, 95 (01) : 23 - 28
  • [5] Johnston SL, 1999, PEDIATR PULM, P141
  • [6] ANTIASTHMATIC ACTIVITY OF A MACROLIDE ANTIBIOTIC, ROXITHROMYCIN - ANALYSIS OF POSSIBLE MECHANISMS IN-VITRO AND IN-VIVO
    KONNO, S
    ASANO, K
    KUROKAWA, M
    IKEDA, K
    OKAMOTO, K
    ADACHI, M
    [J]. INTERNATIONAL ARCHIVES OF ALLERGY AND IMMUNOLOGY, 1994, 105 (03) : 308 - 316
  • [7] Koyama T, 1998, Jpn J Antibiot, V51 Suppl A, P131
  • [8] Detection of Mycoplasma pneumoniae in the airways of adults with chronic asthma
    Kraft, M
    Cassell, GH
    Henson, JE
    Watson, H
    Williamson, J
    Marmion, BP
    Gaydos, CA
    Martin, RJ
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1998, 158 (03) : 998 - 1001
  • [9] INHIBITION OF METHYLPREDNISOLONE ELIMINATION IN THE PRESENCE OF ERYTHROMYCIN THERAPY
    LAFORCE, CF
    SZEFLER, SJ
    MILLER, MF
    EBLING, W
    BRENNER, M
    [J]. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 1983, 72 (01) : 34 - 39
  • [10] MAKINO S, 1982, JPN J ALLERGOL, V31, P1074