title: Role of doxycycline to resolve different types of non-malignant lung and pleural pathology: The results of a pilot observation.
abstract: BACKGROUND
  Lung lesions may develop from tissue reactions to known or unknown stimuli and present with different morphological descriptions. The pathogenesis may be induced and maintained by different bioactive substances, of which, the upregulation matrix metalloproteinases (MMPs) play a vital role. Inhibition of the MMPs, therefore, may be a prospective mode of therapy for such lesions.
  
  
  METHODS
  A number of patients with lung lesions of different morphologies and presentations were treated empirically with long-term oral doxycycline (100 mg BID) upon exclusion of malignancy and infection in an open, single-arm, prospective, observational pilot study. The effect of the treatment was recorded on serial x-rays/computed tomography (CT) scans and the impact of treatment was measured with a visual analog scale (VAS) or a Likert-like scale. Furthermore, six independent pulmonologists' opinion (expressed on a '0' to '100' scale) were pooled with regard to the significance and the expectedness of such a change.
  
  
  RESULTS
  Twenty-six patients (mean age 49.33 years and male: female ratio = 10:3) with different types of pulmonary parenchymal/pleural lesions were treated with long-term oral doxycycline for a mean duration of 386.88 days related to the available radiological comparison. They showed a mean improvement of 3.99 on the Likert-like scale and 78% on the VAS scale. The mean significance of the change was 83.33%, with a mean expectedness of 18% as per the pooled opinion of the pulmonologists.
  
  
  CONCLUSIONS
  The significant and unexpected resolution of different tissue lesions from long-term doxycycline appears to be a novel observation. This needs proper scientific validation.
authors.affiliation: Department of Clinical pulmonary medicine, Institute of Pulmocare and Research, Kolkata, West Bengal, India.
authors.forename: Parthasarathi
authors.initials: P
authors.lastname: Bhattacharyya
authors.affiliation: Department of Clinical pulmonary medicine, Institute of Pulmocare and Research, Kolkata, West Bengal, India.
authors.forename: Rana
authors.initials: R
authors.lastname: Dey
authors.affiliation: Department of Clinical pulmonary medicine, Institute of Pulmocare and Research, Kolkata, West Bengal, India.
authors.forename: Dipanjan
authors.initials: D
authors.lastname: Saha
authors.affiliation: Department of Clinical pulmonary medicine, Institute of Pulmocare and Research, Kolkata, West Bengal, India.
authors.forename: Saikat
authors.initials: S
authors.lastname: Nag
authors.affiliation: Department of Clinical pulmonary medicine, Institute of Pulmocare and Research, Kolkata, West Bengal, India.
authors.forename: Subhasish
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: Department of Clinical pulmonary medicine, Institute of Pulmocare and Research, Kolkata, West Bengal, India.
authors.forename: Sushmita Roy
authors.initials: SR
authors.lastname: Chowdhury
authors.affiliation: Department of Clinical pulmonary medicine, Institute of Pulmocare and Research, Kolkata, West Bengal, India.
authors.forename: Dhiman
authors.initials: D
authors.lastname: Ganguly
keywords: Doxycycline; lung lesions; matrix metalloproteinase