Diffuse panbronchiolitis and cystic fibrosis: East meets West.

Høiby, Niels

doi:10.1136/thx.49.6.531

Cited by 113 publications

(62 citation statements)

References 27 publications

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“…In the 1980s it was recognized that treatment of diffuse panbronchiolitis (a biofilm-associated disease of the lung) with macrolides, such as erythromycin, was beneficial in long-term disease prognosis and survival (307,308). Similar findings were reported for cystic fibrosis patients infected with P. aeruginosa (309)(310)(311), where improved lung function in children was seen following six to 15 months of azithromycin (AZM) treatment.…”

Section: Antibiotics As Qs Inhibitorssupporting

confidence: 68%

Exploiting Quorum Sensing To Confuse Bacterial Pathogens

LaSarre

Federle

2013

Microbiol Mol Biol Rev

693

556

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SUMMARY Cell-cell communication, or quorum sensing, is a widespread phenomenon in bacteria that is used to coordinate gene expression among local populations. Its use by bacterial pathogens to regulate genes that promote invasion, defense, and spread has been particularly well documented. With the ongoing emergence of antibiotic-resistant pathogens, there is a current need for development of alternative therapeutic strategies. An antivirulence approach by which quorum sensing is impeded has caught on as a viable means to manipulate bacterial processes, especially pathogenic traits that are harmful to human and animal health and agricultural productivity. The identification and development of chemical compounds and enzymes that facilitate quorum-sensing inhibition (QSI) by targeting signaling molecules, signal biogenesis, or signal detection are reviewed here. Overall, the evidence suggests that QSI therapy may be efficacious against some, but not necessarily all, bacterial pathogens, and several failures and ongoing concerns that may steer future studies in productive directions are discussed. Nevertheless, various QSI successes have rightfully perpetuated excitement surrounding new potential therapies, and this review highlights promising QSI leads in disrupting pathogenesis in both plants and animals.

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Section: Antibiotics As Qs Inhibitorssupporting

confidence: 68%

Exploiting Quorum Sensing To Confuse Bacterial Pathogens

LaSarre

Federle

2013

Microbiol Mol Biol Rev

693

556

View full text Add to dashboard Cite

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“…In 1994, HOIBY [12] highlighted similarities between CF and diffuse panbronchiolitis, a condition associated with chronic P. aeruginosa lung infection, found principally in the East Asian population. He commented on the improvement that many of these patients had experienced in their respiratory condition following treatment with the macrolide antibiotic, erythromycin, and suggested that macrolide antibiotics might have a role in CF through indirect anti-pseudomonal properties.…”

Section: Early Reports Of Macrolides For Cystic Fibrosismentioning

confidence: 99%

Azithromycin for cystic fibrosis

Kw¹

2004

Eur Respir J

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During what is a relatively barren time for new therapies for cystic fibrosis (CF), azithromycin has received a lot of attention as a potential treatment for CF lung disease. Laboratory studies suggest that azithromycin may have indirect actions, including anti-inflammatory, in addition to the standard antibacterial properties. The unique pharmacokinetics of azithromycin sets it aside from other macrolide antibiotics, but may result in increased resistance patterns.Three well-designed randomised controlled trials have demonstrated a small but significant improvement in respiratory function (forced expiratory volume in one second) with azithromycin compared with placebo. These trial results are confirmed by a recent meta-analysis. Mild adverse events (wheeze, diarrhoea and nausea) were significantly increased in one trial. There is no clear consensus regarding the correct dose and length of treatment with azithromycin.The present review discusses the role of azithromycin in the management of cystic fibrosis and the need for close monitoring of patients started on this drug. In addition, clinics should liaise closely with their microbiology departments and monitor resistance patterns.

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“…Independent of their antimicrobial activity, macrolides possess anti-inflammatory properties that may contribute to the clinical benefits observed in patients with chronic airway inflammation [7]. The use of low-dose macrolide therapy was first described in diffuse panbronchiolitis [7], followed by cystic fibrosis [7,30], asthma [31] and chronic obstructive pulmonary disease [32] due to its antiinflammatory potency.…”

Section: Pharmacology Of Azithromycinmentioning

confidence: 99%

A dichotomy in bronchiolitis obliterans syndrome after lung transplantation revealed by azithromycin therapy

Vanaudenaerde

Meyts²,

Vos³

et al. 2008

Eur Respir J

151

110

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Bronchiolitis obliterans syndrome (BOS) is the most important cause of late mortality following lung transplantation, resulting in major morbidity and a huge burden on healthcare resources. Treatment options are limited, resulting in a mere stabilisation of the lung function decline. Recent introduction of the macrolide antibiotic azithromycin raised new hope after demonstrating lung function improvement in subsets of patients.The present study aimed to provide an overview of the clinical effects on azithromycin in the setting of BOS after lung transplantation, with special emphasis on the anti-inflammatory actions. Moreover, the authors proposed a new frame of thinking centred on a dichotomy in the pathogenesis and clinical phenotype of BOS. Subsets of BOS patients were identified who do or do not respond to azithromycin (regarding forced expiratory volume in one second (FEV1), bronchoalveolar lavage (BAL) neutrophilia/interleukin-8). These observations have shed new light on the current belief that BOS represents a homogenous clinical entity in which the neutrophil is the main culprit.Recent clinical observations, supported by research findings, have revealed a dichotomy in the clinical spectrum of BOS with neutrophilic (partially) reversible allograft dysfunction (responding to azithromycin) and fibroproliferative BOS (not responding to azithromycin). This concept is reinforced by unique data obtained in BOS patients, consisting of histology specimens, physical and radiological examination, FEV1 and BAL examination.The acceptance of this dichotomy can improve understanding of the heterogeneous pathological condition that constitutes bronchiolitis obliterans syndrome, thus encouraging a more accurate diagnosis and, ultimately, better tailored treatment for each bronchiolitis obliterans syndrome patient.

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Diffuse panbronchiolitis and cystic fibrosis: East meets West.

Cited by 113 publications

References 27 publications

Exploiting Quorum Sensing To Confuse Bacterial Pathogens

Exploiting Quorum Sensing To Confuse Bacterial Pathogens

Azithromycin for cystic fibrosis

A dichotomy in bronchiolitis obliterans syndrome after lung transplantation revealed by azithromycin therapy

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