Long-term macrolide antibiotics in asthma therapy

Authors

  • Daisuke Takekoshi Section of Pulmonary, Critical Care, Sleep and Allergy Medicine, Department of Medicine, College of Medicine, University of Illinois at Chicago and Jesse Brown VA Medical Center, Chicago, Illinois, U.S.A.
  • Patrick Belvitch Section of Pulmonary, Critical Care, Sleep and Allergy Medicine, Department of Medicine, College of Medicine, University of Illinois at Chicago and Jesse Brown VA Medical Center, Chicago, Illinois, U.S.A.
  • Israel Rubinstein Section of Pulmonary, Critical Care, Sleep and Allergy Medicine, Department of Medicine, College of Medicine, University of Illinois at Chicago and Jesse Brown VA Medical Center, Chicago, Illinois, U.S.A.

DOI:

https://doi.org/10.7175/rhc.v2i4.61

Keywords:

Macrolide, Asthma, Chronic inflammation, Immunomodulation, Noneosinophilic asthma

Abstract

Macrolide antibiotics drew worldwide attention when their use was dramatically successful in the treatment of diffuse panbronchiolitis in 1980s. The success was attributed to their immunomodulatory effects, rather than their antimicrobial properties. Since then, studies have shown that macrolides exert their immunomodulatory effects through several mechanisms, including suppression of proinflammatory cytokines, promoting apoptosis of inflammatory cells, improving phagocytic function, ameliorating airway hypersecretion, and inhibiting production of reactive oxygen species. Macrolides have also been studied in the treatment of asthma. This review highlights the role of macrolides in the treatment of asthma, presenting an overview of the main clinical trials. Despite favourable preclinical data and reports of anecdotal successes, the results of clinical trials are conflicting. This may be due to the heterogeneous nature of asthma. Further studies are needed to identify particular subgroup of asthma that will respond to macrolides.

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Published

2011-09-22

Issue

Vol. 2 No. 4 (2011)

Section

Narrative reviews

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