title: Effect of long-term, low-dose clarithromycin on T helper 2 cytokines, eosinophilic cationic protein and the 'regulated on activation, normal T cell expressed and secreted' chemokine in the nasal secretions of patients with nasal polyposis.
abstract: BACKGROUND
  Little is known about the effects of macrolides on the cytokines and chemokines that modulate the function of eosinophils in nasal polyposis.
  
  
  METHODS
  Twenty-two non-allergic and 18 allergic patients with nasal polyps were administered clarithromycin 500 mg/day (single oral dose) for eight weeks. We measured the nasal secretion levels of the T helper 2 (also known as Th2) cytokines interleukin 4, 5 and 6, the 'regulated on activation, normal T cell expressed and secreted' (also known as RANTES) chemokine, and the eosinophilic cationic protein, before and after treatment.
  
  
  RESULTS
  After clarithromycin treatment, we found reduced levels of the 'regulated on activation, normal T cell expressed and secreted' chemokine in samples from both non-allergic and allergic patients (p < 0.05). Clarithromycin treatment decreased the levels of eosinophilic cationic protein only in non-allergic patients (p < 0.05), and decreased the level of interleukin 6 only in allergic patients (p < 0.05). Decreased levels of the 'regulated on activation, normal T cell expressed and secreted' chemokine were associated with a reduction in polyp size both in non-allergic and allergic patients.
  
  
  CONCLUSIONS
  Clarithromycin has a strong anti-inflammatory effect in nasal polyposis, but has different immunomodulatory effects in allergic and non-allergic nasal polyposis patients.
authors.affiliation: Rhinology Unit, Department of Otorhinolaryngology, Military Medical Academy, Belgrade, Serbia. alexneta@sezampro.rs
authors.forename: A
authors.initials: A
authors.lastname: Perić
authors.forename: D
authors.initials: D
authors.lastname: Vojvodić
authors.forename: S
authors.initials: S
authors.lastname: Matković-Jožin
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D018946:Chemokine CCL5 / Q000187:drug effects / Q000378:metabolism; D017291:Clarithromycin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D016207:Cytokines / Q000187:drug effects / Q000378:metabolism*; D047150:Eosinophil Cationic Protein / Q000187:drug effects / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009093:Mucus / Q000737:chemistry / Q000187:drug effects*; D009297:Nasal Mucosa / Q000187:drug effects* / Q000378:metabolism; D009298:Nasal Polyps / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D011446:Prospective Studies; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy* / Q000378:metabolism; D013601:T-Lymphocytes / Q000187:drug effects / Q000378:metabolism; D018418:Th2 Cells / Q000378:metabolism; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D018946:Chemokine CCL5; D016207:Cytokines; D047150:Eosinophil Cationic Protein; D017291:Clarithromycin