+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Macrolides in cystic fibrosis: is there a role?

, : Macrolides in cystic fibrosis: is there a role?. American Journal of Respiratory Medicine 1(4): 235-241

A spectrum of anti-inflammatory properties, evidence of anti-infective action against Pseudomonas aeruginosa at sub-inhibitory concentrations and positive clinical experience in patients with diffuse panbronchiolitis, a disease with features in common with cystic fibrosis (CF), has prompted research to evaluate the role of macrolide therapy in patients with CF. Newer macrolides such as azithromycin have the advantage of improved tolerability and a prolonged intracellular half-life requiring an infrequent dosing regimen. Results from initial studies suggest a benefit from several months of macrolide therapy in patients with CF. An improvement in lung function was initially shown in a small open study in children, while maintenance of lung function compared with placebo, reduced acute respiratory exacerbations, and reduced systemic markers of inflammation were demonstrated in a randomized, placebo-controlled study of macrolide therapy in adult patients with CF. Additional controlled studies are required to determine optimal drug, dosage, and duration of therapy, and long-term adverse effects of prolonged therapy with macrolides in patients with CF. The potential, with long-term use, to induce resistance against other bacteria colonizing the upper respiratory tract e.g. pneumococci has not been explored. Measurement of cytokines and inflammatory mediators from the sputum of patients with CF is technically difficult and does not correlate with disease activity. There is a need for easily measurable, reproducible and clinically meaningful end-points for evaluation of new therapies in CF. The choice of appropriate outcome measures, apart from lung function, to monitor disease activity needs careful consideration in clinical trials determining the efficacy of macrolides in patients with CF. Evidence-based recommendations for the use of macrolides in the treatment of CF are not expected for some years although macrolides are already being prescribed for long-term use in some centers. There is a need for further research into mechanisms of anti-inflammatory action of macrolides in the lungs of patients with CF and whether or not such therapy may be beneficial in the long term.


PMID: 14720043

Other references

Rizzitelli, S.; Giustetto, P.; Faletto, D.; Delli Castelli, D.; Aime, S.; Terreno, E., 2016: The release of Doxorubicin from liposomes monitored by MRI and triggered by a combination of US stimuli led to a complete tumor regression in a breast cancer mouse model. The work aimed at developing a novel MRI-based theranostic protocol for improving the anticancer efficacy of a Doxil-like liposomal formulation. The goal was achieved stimulating the intratumor release of the drug from the nanocarrier and favoring...

Kong, L.; Ao, Q.; Wang, A.; Gong, K.; Wang, X.; Lu, G.; Gong, Y.; Zhao, N.; Zhang, X., 2007: Preparation and characterization of a multilayer biomimetic scaffold for bone tissue engineering. In scaffold based bone tissue engineering, both the pore size and the mechanical properties of the scaffold are of great importance. However, an increase in pore size is generally accompanied by a decrease in mechanical properties. In order to ach...

Benitez-De-Rojas, Carmen, 1999: Micromorphology of leaf trichomes in Sessea (Solanaceae). Scanning electron microscope (SEM) was used to examine leaf trichomes on the species Sessea discolor Francey, S. regnellii Taub. and S. stipulata Ruiz and Pav., belonging to Solanaceae. The trichomes fall under three categories: glandular, biseria...

Payares Trujillo, GA., 1985: Purification and molecular analysis of antigenic and enzymatic polypeptides from surface membranes of Schistosoma mansoni. Unknown

Chadee, D.D.; Haeger, J.S., 1986: A description of the egg of Culex (Culex) nigripalpus Theobald from Florida, with notes on five egg rafts (Diptera: Culicidae). The external morphology of the egg of Culex nigripalpus is described and illustrated for the 1st time, based on material from laboratory colonies originally collected in Florida. The egg rafts of C. nigripalpus are compared with those of C. quinqu...

Wang, L.; Lü, S.; Gao, P.; Li, S., 2003: The resolution of racemic sec-phenethyl alcohol on cellulose tribenzoate-based CSP: influence of different alcohols in the mobile phase. Several primary and secondary alcohols (ethanol, 1-propanol, 2-propanol, 1-butanol) were used as the mobile phase components separately, to investigate their effects on the capacity factor and stereoselectivity of sec-phenethyl alcohol enantiomers...

Khvorostinka V.N.; Pasieshvili L.M.; Teslenko V.G.; Aleksandrova N.K., 1991: Concerning the dispensarization of patients with chronic alcohol induced diseases of the liver. The problems of the dispensarization of patients with chronic alcohol-induced diseases of the liver were considered. Optimal protocols of their treatment were developed, taking into consideration clinical, biochemical and instrumental parameters....

Schmalscheidt, W., 1976: New plant varieties of the Flora Nova 76. Deutsche Baumschule: 28 (6) 138-139

Bland, K.J.; Kroeger, K.F.; Strogen, D.P.; Fohrmann, M., 2009: An allostratigraphic framework for the Cretaceous-Recent fill of Taranaki Basin; insights from the Kupe area. Geological Society of New Zealand Miscellaneous Publication 128: 25

Oberthur, Ch., 1908: Nouvelles especes algeriennes du genre Somabrachys. Bulletin de la Societe Entomologique Paris, 47-48