An improved protocol for the use of troleandomycin (TAO) in the treatment of steroid-requiring asthma

Wald, Jeffrey; Friedman, Bruce; Farr, Richard S.

doi:10.1016/0091-6749(86)90112-0

Cited by 66 publications

(22 citation statements)

References 12 publications

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“…36 Since these initial reports, a number of studies evaluating the effectiveness of troleandomycin have shown that it can decrease corticosteroid use and improve the symptoms and pulmonary function of children and adults with asthma. [37][38][39][40][41] Some patients who receive concomitant troleandomycin and corticosteroid therapy are able to discontinue steroids completely without worsening their asthma. 42 These data suggest that troleandomycin probably has immunomodulatory activity for the treatment of asthma.…”

Section: Steroid-sparing Effects Of Macrolidesmentioning

confidence: 99%

Immunomodulatory properties of macrolides: Overview and historical perspective

Rubin

2004

The American Journal of Medicine Supplements

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Section: Steroid-sparing Effects Of Macrolidesmentioning

confidence: 99%

Immunomodulatory properties of macrolides: Overview and historical perspective

Rubin

2004

The American Journal of Medicine Supplements

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“…TAO can reduce the clearance of methylprednisolone (276), but the clinical reduction in the dose of methylprednisolone achieved after TAO is far greater than would be anticipated from its effects on corticosteroid metabolism alone (342). A number of patients with steroid-dependent asthma were able to discontinue prednisolone entirely while on TAO (122,237,262,318), suggesting that direct effects on the inflammatory response were involved. Similar properties were not seen with other antibiotics.…”

Section: Clinical Effects Asthmamentioning

confidence: 99%

Mechanisms of Action and Clinical Application of Macrolides as Immunomodulatory Medications

2010

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SUMMARY Macrolides have diverse biological activities and an ability to modulate inflammation and immunity in eukaryotes without affecting homeostatic immunity. These properties have led to their long-term use in treating neutrophil-dominated inflammation in diffuse panbronchiolitis, bronchiectasis, rhinosinusitis, and cystic fibrosis. These immunomodulatory activities appear to be polymodal, but evidence suggests that many of these effects are due to inhibition of extracellular signal-regulated kinase 1/2 (ERK1/2) phosphorylation and nuclear factor kappa B (NF-κB) activation. Macrolides accumulate within cells, suggesting that they may associate with receptors or carriers responsible for the regulation of cell cycle and immunity. A concern is that long-term use of macrolides increases the emergence of antimicrobial resistance. Nonantimicrobial macrolides are now in development as potential immunomodulatory therapies.

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“…[1][2][3][4][5][6] Most of the subsequent work on the immunomodulatory effects of macrolides has been in patients with diffuse panbronchiolitis (DPB), 7-11 a chronic inflammatory airway disease characterized by cough, persistent sinus disease, and neutrophilic airway inflammation. Other chronic inflammatory diseases of the airways affected by macrolides include cystic fibrosis, chronic bronchitis, and asthma.…”

mentioning

confidence: 99%