title: Chronic rhinosinusitis and eosinophils: do macrolides have an effect?
abstract: OBJECTIVE
  Long-term, low-dose macrolide therapy is effective in the treatment of chronic airway inflammation. It is believed that macrolide antibiotics produce this benefit through an antiinflammatory effect that is separate from their antibiotic effect. Eosinophils are key mediators in the inflammation seen in chronic rhinosinusitis. This review discusses the effect of macrolides on eosinophilic inflammation.
  
  
  RESULTS
  In vitro studies recently have suggested that macrolides increase eosinophil apoptosis and reduce production of eosinophil chemotactic cytokines and adhesion molecules. In vivo studies have shown a reduction in eosinophil count and activity in asthma and chronic rhinosinusitis. Clinical response to macrolide treatment is thought to be less likely in patients with atopy.
  
  
  CONCLUSIONS
  In contrast to the evidence supporting the effect of macrolides on neutrophilic inflammation, there are limited data to suggest an influence on eosinophilic inflammation. For this reason, patients with prominent eosinophilic inflammation may in the future be identified as being less likely to respond to treatment. Further in vitro and clinical studies are required to investigate this subject.
authors.affiliation: School of Biomolecular and Biomedical Science, Griffith University, Brisbane, Australia. benwallwork@hotmail.com
authors.forename: Ben
authors.initials: B
authors.lastname: Wallwork
authors.forename: William
authors.initials: W
authors.lastname: Coman
mesh_terms: D000818:Animals; D002908:Chronic Disease; D004804:Eosinophils / Q000187:drug effects* / Q000502:physiology*; D006801:Humans; D018942:Macrolides / Q000494:pharmacology*; D012220:Rhinitis / Q000503:physiopathology*; D012852:Sinusitis / Q000503:physiopathology*
chemical_list: D018942:Macrolides