title: Azithromycin increases survival and reduces lung inflammation in cystic fibrosis mice.
abstract: OBJECTIVE
  Azithromycin (AZM) has been used as an anti-inflammatory agent in the treatment of cystic fibrosis (CF), particularly those with chronic infection with P. aeruginosa (PA). To investigate mechanisms associated with the beneficial effects of AZM in CF, we examined bacterial load, cytokine levels, and clearance of inflammatory cells in CF mice infected with mucoid PA and treated with AZM.
  
  
  METHODS
  Gut-corrected Cftr(tm1Unc)-TgN(FABPCFTR)#Jaw CF mice infected with an alginate-overproducing PA CF-isolate were treated with AZM or saline and examined for survival of animals, lung bacterial load, inflammation, cytokine levels, and apoptotic cells up to 5 days post-infection.
  
  
  RESULTS
  Administration of AZM (20 mg/kg) 24 h after the infection improved 5-day survival to 95% compared with treatment with saline (56%). AZM administration was associated with significant reductions in bacterial load, decreased lung inflammation, and increased levels of IFN-gamma. AZM increased macrophage clearance of apoptotic neutrophils from the lung.
  
  
  CONCLUSIONS
  Azithromycin enhances bacterial clearance and reduces lung inflammation by improving innate immune defense mechanisms in CF mice.
authors.affiliation: Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI 48105, USA.
authors.forename: Wan C
authors.initials: WC
authors.lastname: Tsai
authors.forename: Marc B
authors.initials: MB
authors.lastname: Hershenson
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhou
authors.forename: Umadevi
authors.initials: U
authors.lastname: Sajjan
mesh_terms: D000464:Alginates / Q000494:pharmacology; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017209:Apoptosis / Q000187:drug effects; D017963:Azithromycin / Q000627:therapeutic use*; D018441:Biofilms; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D003550:Cystic Fibrosis / Q000150:complications* / Q000401:mortality / Q000473:pathology; D016207:Cytokines / Q000378:metabolism; D024881:Drug Resistance, Bacterial; D005260:Female; D008168:Lung / Q000382:microbiology; D051379:Mice; D009504:Neutrophils / Q000187:drug effects; D009195:Peroxidase / Q000378:metabolism; D011014:Pneumonia / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control*; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000473:pathology; D020545:Respiratory Mucosa / Q000382:microbiology; D016019:Survival Analysis
chemical_list: D000464:Alginates; D000900:Anti-Bacterial Agents; D016207:Cytokines; D017963:Azithromycin; D009195:Peroxidase