title: Long-term clarithromycin in cystic fibrosis: effects on inflammatory markers in BAL and clinical status.
abstract: Macrolides have antiinflammatory effects that are potentially useful in cystic fibrosis (CF). In this placebo-controlled, randomized, double-blind crossover study, 18 CF patients were randomized to receive either clarithromycin (CM) (Group 1) or placebo (Group 2) for three months. After 15 days, the treatments were crossed over. Bronchoalveolar lavage (BAL) was obtained in the beginning and at the end of each treatment period. There was no significant difference in median cell counts and median cytokine levels at baseline, after CM use and after placebo use between the two groups. In Group 2, the median neutrophil elastase (NE) level decreased with CM. Patients had less acute pulmonary exacerbations and median clinical score decreased with CM in both groups. Median z-scores for weight increased with CM in Group 2. We could not demonstrate a fall in proinflammatory cytokines in BAL; however, some improvement in clinical status could be shown with three-month CM.
authors.affiliation: Pediatric Pulmonary Medicine Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Doğru
authors.forename: Fuheda
authors.initials: F
authors.lastname: Dalgiç
authors.forename: Nural
authors.initials: N
authors.lastname: Kiper
authors.forename: Uğur
authors.initials: U
authors.lastname: Ozçelik
authors.forename: Ebru
authors.initials: E
authors.lastname: Yalçin
authors.forename: Ayşe Tana
authors.initials: AT
authors.lastname: Aslan
authors.forename: Nermin
authors.initials: N
authors.lastname: Gürcan
authors.forename: Fatma
authors.initials: F
authors.lastname: Saricaoğlu
authors.forename: Deniz
authors.initials: D
authors.lastname: Gür
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Karayazgan
authors.forename: Pinar
authors.initials: P
authors.lastname: Firat
mesh_terms: D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000032:analysis; D018893:Bronchoalveolar Lavage; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D017291:Clarithromycin / Q000627:therapeutic use*; D018592:Cross-Over Studies; D003550:Cystic Fibrosis / Q000188:drug therapy* / Q000276:immunology; D018450:Disease Progression; D004311:Double-Blind Method; D005260:Female; D006304:Health Status; D006801:Humans; D016209:Interleukin-8 / Q000032:analysis; D019272:Leukocyte Elastase / Q000032:analysis; D008297:Male; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D019272:Leukocyte Elastase; D017291:Clarithromycin