Modulation of neutrophil and inflammation markers in chronic obstructive pulmonary disease by short-term azithromycin treatment.
The anti-inflammatory potential of azithromycin in chronic obstructive pulmonary disease (COPD) patients was explored following a standard oral dosing regimen. Patients with moderate and severe COPD were treated with azithromycin (500 mg, n=16) or placebo (n=8) once daily for 3 days in a randomized, double blind design, to compare effects on inflammation markers with those seen in a previous study in healthy volunteers. A battery of tests was made on serum, blood neutrophils and sputum on days 1 (baseline), 3, 4, 11, 18 and 32. In comparison to placebo, azithromycin resulted in an early transient increase in serum nitrites plus nitrates (day 3), associated with a tendency towards an increase in the blood neutrophil oxidative burst to phorbol myristic acetate. Subsequently, prolonged decreases in blood leukocyte and platelet counts, serum acute phase protein (including C reactive protein) and soluble E-selectin and blood neutrophil lactoferrin concentrations and a transient decrease in serum interleukin-8 were observed. Blood neutrophil glutathione peroxidase activity showed a prolonged increase after azithromycin treatment. The biphasic facilitatory-then-inhibitory response to azithromycin seen in healthy volunteers is not so clearly detectable in COPD patients, only potential anti-inflammatory effects. Treatment for longer periods may give therapeutic anti-inflammatory benefit in these patients.
Parnham
Michael J
MJ
PLIVA Research Institute Ltd, Prilaz baruna Filipovića 29, HR-10 000 Zagreb, Croatia. michael.parnham@pliva.hr
Culić
Ognjen
O
Eraković
Vesna
V
Munić
Vesna
V
Popović-Grle
Sanja
S
Barisić
Karmela
K
Bosnar
Martina
M
Brajsa
Karmen
K
Cepelak
Ivana
I
Cuzić
Snjezana
S
Glojnarić
Ines
I
Manojlović
Zoran
Z
Novak-Mircetić
Renata
R
Oresković
Katarina
K
Pavicić-Beljak
Verica
V
Radosević
Senka
S
Sucić
Mirna
M
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D017963:Azithromycin / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001772:Blood Cell Count; D002097:C-Reactive Protein / Q000378:metabolism; D002452:Cell Count; D004311:Double-Blind Method; D019040:E-Selectin / Q000097:blood; D005978:Glutathione / Q000097:blood; D005979:Glutathione Peroxidase / Q000097:blood; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000097:blood; D006098:Granulocytes / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000188:drug therapy*; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007781:Lactoferrin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000187:drug effects* / Q000378:metabolism; D009566:Nitrates / Q000097:blood; D009573:Nitrites / Q000097:blood; D010865:Pilot Projects; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D016897:Respiratory Burst / Q000187:drug effects; D012129:Respiratory Function Tests; D000685:Serum Amyloid A Protein / Q000378:metabolism; D013183:Sputum / Q000166:cytology / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D019040:E-Selectin; D015850:Interleukin-6; D016209:Interleukin-8; D009566:Nitrates; D009573:Nitrites; D000685:Serum Amyloid A Protein; D014409:Tumor Necrosis Factor-alpha; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D017963:Azithromycin; D002097:C-Reactive Protein; D005979:Glutathione Peroxidase; D007781:Lactoferrin; D005978:Glutathione