Azithromycin attenuates airway inflammation in a noninfectious mouse model of allergic asthma.
BACKGROUND
Definitive conclusions regarding the antiinflammatory effects of macrolide antibiotics for treatment of asthma are difficult to formulate since their beneficial effects may be related to their antimicrobial action. We hypothesized that azithromycin possesses distinct antiinflammatory properties and tested this assumption in a noninfectious mouse model of allergic asthma.


METHODS
To induce allergic airway inflammation, 7-week-old BALB/cJ mice underwent intraperitoneal ovalbumin sensitization on days 0 and 7 followed by an intranasal challenge on day 14. Mice were treated with azithromycin or phosphate-buffered saline (PBS) solution on days 13 through 16. On day 17, airway inflammation was assessed by quantifying leukocytes in the airway, expression of multiple inflammatory mediators in the BAL fluid, and mucous cell metaplasia. In a separate set of experiments, azithromycin or PBS solution treatment were initiated after the ovalbumin challenge. Each experiment was repeated 3 times (a total of 9 to 11 mice in each group).


RESULTS
Compared to treatment with PBS solution, azithromycin attenuated the ovalbumin-dependent airway inflammation. We observed a decrease in total leukocytes in the lung tissue and BAL fluid. In addition, azithromycin attenuated the expression of cytokines (eg, interleukin [IL]-13 and IL-5) and chemokines (eg, CCL2, CCL3, and CCL4) in the BAL fluid and abrogated the extent of mucous cell metaplasia. Similar antiinflammatory effects were observed when azithromycin treatment was initiated after the ovalbumin challenge.


CONCLUSIONS
In this noninfectious mouse model of allergic asthma, azithromycin attenuated allergic airway inflammation. These findings demonstrate an antiinflammatory effect of azithromycin and suggest azithromycin may have beneficial effects in treating noninfectious airway inflammatory diseases, including asthma.
Division of Allergy and Pulmonary Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO.
Avraham
A
Beigelman
Department of Pediatrics, and the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO.
Sean
S
Gunsten
Department of Pediatrics, and the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO.
Cassandra L
CL
Mikols
Department of Chemistry, Washington University, St. Louis, MO.
Ilan
I
Vidavsky
Division of Allergy and Pulmonary Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO.
Carolyn L
CL
Cannon
Department of Pediatrics, and the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO.
Steven L
SL
Brody
Department of Pediatrics, and the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO. Electronic address: mwalter@im.wustl.edu.
Michael J
MJ
Walter
D000818:Animals; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D017963:Azithromycin / Q000494:pharmacology*; D016535:Bronchial Hyperreactivity / Q000188:drug therapy* / Q000276:immunology; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D004195:Disease Models, Animal; D005260:Female; D007073:Immunoglobulin E / Q000378:metabolism; D007249:Inflammation / Q000276:immunology / Q000517:prevention & control*; D018836:Inflammation Mediators; D007958:Leukocyte Count; D008168:Lung / Q000473:pathology / Q000503:physiopathology; D051379:Mice; D008807:Mice, Inbred BALB C; D009092:Mucous Membrane / Q000187:drug effects / Q000378:metabolism*; D010047:Ovalbumin / Q000494:pharmacology; D011897:Random Allocation; D012016:Reference Values; D012307:Risk Factors; D012680:Sensitivity and Specificity
D018836:Inflammation Mediators; D007073:Immunoglobulin E; D017963:Azithromycin; D010047:Ovalbumin