Beneficial Response to Macrolide Antibiotic in a Patient With Desquamative Interstitial Pneumonia Refractory to Corticosteroid Therapy*

Knyazhitskiy, Alexey; Masson, R; Corkey, Richard; Joiner, Jane

doi:10.1378/chest.07-2786

Cited by 27 publications

(12 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Based on the potential anti-inflammatory effects of macrolides in steroid-refractory cases, Knyazhitskiy et al (78) reported rapid and dramatic improvement in all clinical and radiological parameters with clarithromycin treatment in a patient who was refractory to steroid therapy. Similarly, in a case where no response was obtained after initiation of oral steroids, clinical and radiological improvement was observed at one month after reduction of the steroid dose and addition of clarithromycin (79).…”

Section: Treatment and Prognosismentioning

confidence: 99%

Desquamative interstitial pneumonia: Risk factors, laboratory and bronchoalveolar lavage findings, radiological and histopathological examination, clinical features, treatment and prognosis (Review)

et al. 2018

View full text Add to dashboard Cite

Desquamative interstitial pneumonia is a type of smoking-associated major idiopathic interstitial pneumonia, which is characterized by accumulation of alveolar macrophages in alveolar lumens and septa and develops secondary to mainly active or passive exposure to cigarette smoke. Desquamative interstitial pneumonia mostly occurs in male smokers in association with non-specific symptoms responsive to steroid therapy and has a better prognosis than usual interstitial pneumonia. To date, no large-scale clinical studies have been performed on desquamative interstitial pneumonia patients. Factors responsible for the scarcity of data on the clinical course of this condition include the retrospective nature of the available information as well as its rare occurrence. Despite this, a general consensus exists as to the nature of its symptoms, association with smoking, age and gender distribution, findings of respiratory function tests, steroid responsivity and mortality. The objective of the present review article was to report on desquamative interstitial pneumonia and to describe its etiology, risk factors and clinical features, as well as the laboratory, bronchoalveolar lavage, radiological and histopathological findings, and the treatment and prognosis of affected patients.

show abstract

Section: Treatment and Prognosismentioning

confidence: 99%

Desquamative interstitial pneumonia: Risk factors, laboratory and bronchoalveolar lavage findings, radiological and histopathological examination, clinical features, treatment and prognosis (Review)

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Macrolide antibiotics demonstrate clinical improvement, increased lung function and anti‐inflammatory properties in patients with asthma, cystic fibrosis, pan‐bronchiolitis and more recently in desquamative interstitial pneumonia (36).…”

Section: Azithromycin/macrolidesmentioning

confidence: 99%

Targeting Allograft Injury and Inflammation in the Management of Post-Lung Transplant Bronchiolitis Obliterans Syndrome

Robertson

Griffin

Murphy

et al. 2009

American Journal of Transplantation

View full text Add to dashboard Cite

Chronic allograft dysfunction, manifesting as bronchiolitis obliterans syndrome (BOS), is the major cause of morbidity and mortality in human lung transplant recipients. While alloimmunity has a definite role, there is increasing interest in overall allograft injury and subsequent inflammation and remodeling. This review deals with nonalloimmune factors that may potentiate alloimmune injury. We discuss infection and reflux/aspiration as examples of allograft injury, which may lead to chronic loss of graft function and BOS. Surgical and nonsurgical treatments aimed at preventing these insults and improving survival are considered. The need for further evidence, including randomizedcontrolled trials, to evaluate the role of medical and surgical therapies is emphasized by the current literature.

show abstract

“…In addition, although macrolide use has been assessed in OP and IPF patients, other ILDs might potentially benefit from it. In this regard, the use of macrolides has been tested in animal models or anecdotally in case reports of patients with extrinsic allergic alveolitis and desquamative interstitial pneumonia [54,55]. It is important to remember that the limited evidence available derives almost exclusively from studies in animal models, case series and retrospective studies.…”

Section: Conclusion and Future Perspectivesmentioning

confidence: 99%

Long-term macrolides in diffuse interstitial lung diseases

Faverio¹,

Bini²,

Vaghi³

et al. 2017

Eur Respir Rev

View full text Add to dashboard Cite

In the present review we provide currently available evidence for the use of macrolides in the treatment of diffuse interstitial lung diseases (ILDs). Up to now, research on macrolides has mainly focused on three areas. First, macrolides have shown some promising results in cellular models and case reports as antifibrotic agents, by promoting autophagy and clearance of intracellular protein aggregates and acting as regulators of surfactant homeostasis. Secondly, macrolides have an immunomodulatory effect, which has been applied in some organising pneumonia cases. In particular, macrolides have been tested in association with systemic corticosteroids as steroid-sparing agents and alone as either first-line agents in mild cases or second-line agents where steroids were poorly tolerated or had failed. Thirdly, a recent area of research concerns the possible role of macrolides as modulators of lung microbiota and the host-microbiota interaction. This function has been particularly studied in idiopathic pulmonary fibrosis patients, in whom changes in microbiota have been proved to be associated with disease progression. However, the lack of high-quality studies makes the application of macrolide therapy in ILDs a field in which research should be conducted on a large scale.

show abstract

Beneficial Response to Macrolide Antibiotic in a Patient With Desquamative Interstitial Pneumonia Refractory to Corticosteroid Therapy*

Cited by 27 publications

References 6 publications

Desquamative interstitial pneumonia: Risk factors, laboratory and bronchoalveolar lavage findings, radiological and histopathological examination, clinical features, treatment and prognosis (Review)

Desquamative interstitial pneumonia: Risk factors, laboratory and bronchoalveolar lavage findings, radiological and histopathological examination, clinical features, treatment and prognosis (Review)

Targeting Allograft Injury and Inflammation in the Management of Post-Lung Transplant Bronchiolitis Obliterans Syndrome

Long-term macrolides in diffuse interstitial lung diseases

Contact Info

Product

Resources

About