title: Azithromycin in combination with riboflavin decreases the severity of Staphylococcus aureus infection induced septic arthritis by modulating the production of free radicals and endogenous cytokines.
abstract: OBJECTIVE
  To determine alternate therapeutic measures to combat Staphylococcus aureus induced arthritis. Thus, azithromycin was combined with riboflavin, which may combat the ROS production and inflammation.
  
  
  METHODS
  An in vivo model of S. aureus infection-induced arthritis was set up by infecting mice with 5 × 10⁶ bacterial cell/mouse. S. aureus was administered intravenously. Azithromycin and riboflavin was injected intraperitoneally at a single dose of 100 and 20 mg/kg body, respectively. The mice were sacrificed at 3, 9, 15 days post infection (dpi). TNF-α, IFN-γ, IL-6 and IL-10 from serum and SOD, catalase and reduced glutathione concentration were observed in hepatic, cardiac, renal and splenic tissue.
  
  
  RESULTS
  CFU was found very prominent in spleen and joints and reduced in blood at 3 and 9 dpi. However, treatment with azithromycin and riboflavin completely eradicated the bacteria from blood and spleen. TNF-α, IFN-γ, IL-6, and MCP-1 were induced due to infection which were downregulated by treatment with azithromycin and riboflavin. Infected mice were also found to have altered antioxidant status, measured in terms of reduced glutathione and anti-oxidant enzymes such as SOD and catalase.
  
  
  CONCLUSIONS
  These changes were found to be ameliorated when the animals were co-treated with azithromycin and riboflavin.
authors.affiliation: Department of Physiology, Immunology Laboratory, University of Calcutta, University Colleges of Science and Technology, 92 APC Road, Calcutta 700009, West Bengal, India.
authors.forename: Pinky
authors.initials: P
authors.lastname: Mal
authors.forename: Kallol
authors.initials: K
authors.lastname: Dutta
authors.forename: Debasish
authors.initials: D
authors.lastname: Bandyopadhyay
authors.forename: Anirban
authors.initials: A
authors.lastname: Basu
authors.forename: Rajni
authors.initials: R
authors.lastname: Khan
authors.forename: Biswadev
authors.initials: B
authors.lastname: Bishayi
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D017963:Azithromycin / Q000627:therapeutic use*; D016207:Cytokines / Q000378:metabolism*; D004195:Disease Models, Animal; D004359:Drug Therapy, Combination; D005609:Free Radicals / Q000378:metabolism*; D008297:Male; D051379:Mice; D017382:Reactive Oxygen Species / Q000378:metabolism; D012256:Riboflavin / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D013211:Staphylococcus aureus; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000975:Antioxidants; D016207:Cytokines; D005609:Free Radicals; D017382:Reactive Oxygen Species; D017963:Azithromycin; D012256:Riboflavin