Anti‐inflammatory effect of roxithromycin in patients with aspirin‐intolerant asthma

Shoji, Tatsuhiro; Yoshida, Satoshi; Sasaki, Hideo; Hasegawa, Hiroshi; Nakagawa, Hiroshi; Amayasu, Hideaki

doi:10.1046/j.1365-2222.1999.00551.x

Cited by 74 publications

(49 citation statements)

References 20 publications

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“…Roxithromycin, one of the macrolide antibiotics, has been reported to suppress sputum eosinophils and eosinophil cationic protein in asthmatic patients (38).…”

Section: Discussionmentioning

confidence: 99%

Erythromycin Modulates Eosinophil Chemotactic Cytokine Production by Human Lung Fibroblasts in Vitro

Sato

Nelson

Koyama

et al. 2001

Antimicrob Agents Chemother

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Recent studies suggest that erythromycin can suppress the production of some cytokines and may be an effective treatment for asthma. Eosinophil chemotactic cytokines have been suggested to contribute to the pathogenesis of asthma by the recruitment of eosinophils. We hypothesized that erythromycin modulates eosinophil chemotactic cytokine production. To test the hypothesis, we evaluated the potential of erythromycin to modulate the release of eosinophil chemoattractants from the human lung fibroblast cell line HFL-1. HFL-1 released eotaxin, granulocyte-macrophage colony-stimulating factor, and regulated and normal T-cell expressed and presumably secreted (RANTES) in response to interleukin-1␤ or tumor necrosis factor alpha. Erythromycin attenuated the release of these cytokines and eosinophil chemotactic activity by the HFL-1. The suppressive effect on eotaxin was the most marked of these cytokines. Erythromycin therapy also suppressed eotaxin mRNA significantly. These results suggest a mechanism that may account for the apparent beneficial action of macrolide antibiotics in the treatment of allergic airway disorders.

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“…Roxithromycin, one of the macrolide antibiotics, has been reported to suppress sputum eosinophils and eosinophil cationic protein in asthmatic patients (38).…”

Section: Discussionmentioning

confidence: 99%

Erythromycin Modulates Eosinophil Chemotactic Cytokine Production by Human Lung Fibroblasts in Vitro

Sato

Nelson

Koyama

et al. 2001

Antimicrob Agents Chemother

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“…The protective effect of RXM was also evaluated on airway responsiveness to the sulpyrine provocation test. Shoji et al [172] addressed the question of whether this protective activity is associated with a reduction in aspirin-induced excretion of urinary leucotriene E4 (u-LTE4). The latter is important as a marker of cysteinyl leucotriene overproduction that participates in the pathogenesis of aspirinintolerant asthma.…”

Section: Macrolides and Asthmamentioning

confidence: 99%

Macrolides: from in vitro anti-inflammatory and immunomodulatory properties to clinical practice in respiratory diseases

Zarogoulidis

Παπάνας

Kioumis

et al. 2011

Eur J Clin Pharmacol

257

196

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“…[17][18][19][20][21][22][23][24][25][26] A 2005 Cochrane review concluded that there was insufficient evidence to confirm or refute the role of macrolide treatment in chronic asthma. 1 Since 2005, 3 additional trials of macrolides in chronic adult asthma have reported patient-oriented outcomes.…”

Section: Previous Studiesmentioning

confidence: 99%

Azithromycin for Bronchial Asthma in Adults: An Effectiveness Trial

Hahn¹,

Grasmick²,

Hetzel³

et al. 2012

The Journal of the American Board of Family Medicine

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on behalf of the AZMATICS (AZithroMycin-Asthma Trial In Community Settings) Study GroupBackground: Macrolides have antimicrobial and anti-inflammatory properties that may be useful in the treatment of chronic asthma.Methods: We performed a randomized, placebo-controlled, double-blinded effectiveness trial of 12 weekly doses of adjunctive azithromycin, with follow-up to 1 year after randomization, in adults with persistent asthma. Measurements included overall asthma symptoms, asthma quality of life (AQL), and asthma control. Eligible subjects who declined to participate in randomization were offered enrollment into a parallel open-label (OL) azithromycin treatment arm.Results: Of 304 adult asthma patients screened, 97 (32%) were enrolled: 38 were randomized to azithromycin, 37 were randomized to placebo, and 22 opted in as OL subjects. OL subjects had higher rates of severe persistent asthma compared with randomized subjects (32% vs 8%, respectively; P ‫؍‬ .012). At 1 year, compared with the placebo arm, subjects randomized to azithromycin were more likely to have an AQL score >1 unit increase compared with baseline, but this difference was not statistically significant (36% vs 21% for placebo; P ‫؍‬ .335). Compared with placebo, OL subjects had significant improvements in overall asthma symptoms from baseline (P ‫؍‬ .0196), AQL (P ‫؍‬ .0006), and asthma control (P ‫؍‬ .0148).Conclusions: Adults with asthma who were randomized to azithromycin did not show statistically significant improvement in asthma outcomes, although the study was underpowered to detect clinical improvement in 15% (number needed to treat ‫؍‬ 7). Adults with severe persistent asthma who elected OL treatment documented clinical improvements in asthma symptoms, AQL, and asthma control that persisted after completion of OL azithromycin (number needed to treat ‫؍‬ 2). (J Am Board Fam Med 2012;25:442-459.)

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Anti‐inflammatory effect of roxithromycin in patients with aspirin‐intolerant asthma

Cited by 74 publications

References 20 publications

Erythromycin Modulates Eosinophil Chemotactic Cytokine Production by Human Lung Fibroblasts in Vitro

Erythromycin Modulates Eosinophil Chemotactic Cytokine Production by Human Lung Fibroblasts in Vitro

Macrolides: from in vitro anti-inflammatory and immunomodulatory properties to clinical practice in respiratory diseases

Azithromycin for Bronchial Asthma in Adults: An Effectiveness Trial

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