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난치성 천식에서 Clarithromycin 항생제는 호중구 염증 반응을 줄인다.

입력일:2008-01-09 / 조회수:8512 / 추천수:355 / 작성자:한만용

천식 환자에서 Macrolide 항생제 계통을 사용하면 천식 증상이 호전된다는 것은 잘 알려진 사실이다. 이에는 다양한 이유를 달고 있는데 한 연구자는 난치성 천식 환자에서 호중구 염증 반응에 관여하는 인터루킨 8(Interleukin 8)을 측정하여 Clarithromycin 항생제가 도움이 된다는 연구결과를 내 놓았다.


연구자는 호주출신으로 45명의 난치성 천식환자에게 한 그룹은 Clarithromycin을 투약하였고 나머지는 플라세보를 투약한 후 인터루킨 8과 가래 검사에서 호중구수, MMP-9과 호중구 elastase를 측정하였다. 임상 증상은 폐기능 검사와 기관지 과민도 검사, 증상 점수를 보았다.


Clarithromycin을 투약한 환자에서 인터루킨 8 이 감소하였고 호중구 수도 감소하였으며 증상 점수도 플라세보보다 호전되었다. 호중구 elastase와 MMP-9 도 감소하였다.


결국 난치성 천식환자에서 clarithromycin은 세균을 죽이는 역할 이외에도 호중구 염증 반응을 줄이는데 중요할 것이라 결론 내렸다.


매력적인 결과이다.


출처 : Am J Respir Crit Care Med. 2008 Jan 15;177(2):148-55. Clarithromycin targets neutrophilic airway inflammation in refractory asthma.Simpson JL, Powell H, Boyle MJ, Scott RJ, Gibson PG. NHMRC Centre for Respiratory and Sleep Medicine, School of Medicine
and Public Health, University of Newcastle, Callaghan, Australia.


RATIONALE: Patients with refractory asthma have persistent symptoms despite maximal treatment with inhaled corticosteroids and long-acting bronchodilators. The availability of add-on therapies is limited, and effective add-on therapies that target noneosinophilic airway inflammation are needed. Macrolide antibiotics, such as clarithromycin, have in vitro efficacy against IL-8 and neutrophils, key inflammatory mediators in noneosinophilic
asthma.


OBJECTIVES: To determine the efficacy of clarithromycin in patients with severe refractory asthma and specifically in a subgroup of patients with noneosinophilic asthma. METHODS: Subjects with severe refractory asthma (n = 45) were randomized to receive clarithromycin (500 mg twice daily) or placebo for 8 weeks.


MEASUREMENTS AND MAIN RESULTS: The primary outcome for this study was sputum IL-8 concentration. Other inflammatory outcomes assessed included sputum neutrophil numbers and concentrations of neutrophil elastase and matrix metalloproteinase (MMP)-9. Clinical outcomes were also assessed, including lung function, airway hyperresponsiveness to hypertonic saline, asthma control, quality of life, and symptoms. Clarithromycin therapy significantly
reduced airway concentrations of IL-8 and neutrophil numbers and improved quality-of-life scores compared with placebo. Reductions in neutrophil elastase and MMP-9 concentrations were also observed. These reductions in inflammation were most marked in those with refractory noneosinophilic asthma.


CONCLUSIONS: Clarithromycin therapy can modulate IL-8 levels and neutrophil accumulation and activation in the airways of patients with refractory asthma. Macrolide therapy may be an important additional therapy that could be used to reduce noneosinophilic airway inflammation, particularly neutrophilic inflammation, in asthma. Clinical trial registered with the Australian Clinical Trials Registry www.actr.org.au (No. 12605000318684).


 


 
100자평 쓰기  이름: 입력일:2019-10-16 
 
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