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Role of macrolide therapy in chronic obstructive pulmonary disease.

Martinez FJ, Curtis JL, Albert R - Int J Chron Obstruct Pulmon Dis (2008)

Bottom Line: In addition, they exert broad-ranging, immunomodulatory effects both in vitro and in vivo, as well as diverse actions that suppress microbial virulence factors.Macrolide antibiotics have been used to successfully treat a number of chronic, inflammatory lung disorders including diffuse panbronchiolitis, asthma, noncystic fibrosis associated bronchiectasis, and cystic fibrosis.Additional, prospective, controlled data are required to define any potential treatment effect, the nature of this effect, and the role of bronchiectasis, baseline colonization, and other cormorbidities.

View Article: PubMed Central - PubMed

Affiliation: Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, MI 48109-0360, USA. fmartine@umich.edu

ABSTRACT
Chronic obstructive pulmonary disease (COPD) is a leading cause of death and disability worldwide. The Global Burden of Disease study has concluded that COPD will become the third leading cause of death worldwide by 2020, and will increase its ranking of disability-adjusted life years lost from 12th to 5th. Acute exacerbations of COPD (AECOPD) are associated with impaired quality of life and pulmonary function. More frequent or severe AECOPDs have been associated with especially markedly impaired quality of life and a greater longitudinal loss of pulmonary function. COPD and AECOPDs are characterized by an augmented inflammatory response. Macrolide antibiotics are macrocyclical lactones that provide adequate coverage for the most frequently identified pathogens in AECOPD and have been generally included in published guidelines for AECOPD management. In addition, they exert broad-ranging, immunomodulatory effects both in vitro and in vivo, as well as diverse actions that suppress microbial virulence factors. Macrolide antibiotics have been used to successfully treat a number of chronic, inflammatory lung disorders including diffuse panbronchiolitis, asthma, noncystic fibrosis associated bronchiectasis, and cystic fibrosis. Data in COPD patients have been limited and contradictory but the majority hint to a potential clinical and biological effect. Additional, prospective, controlled data are required to define any potential treatment effect, the nature of this effect, and the role of bronchiectasis, baseline colonization, and other cormorbidities.

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Potential beneficial effects of macrolides in COPD patient.
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f3-copd-3-331: Potential beneficial effects of macrolides in COPD patient.

Mentions: Taken together, the available data confirm that a macrolide can result in clinical improvement in patients with severe, chronic inflammatory lung diseases associated with frequent bacterial colonization and chronic infection. These data provide a rationale for expansion of the study of macrolide therapy to other, more common, inflammatory airway disorders, including COPD. Given the importance of inflammation and bacterial infection in the pathogenesis of COPD and its exacerbations, it is evident that macrolides may offer unique advantages as disease-modifying agents and that such an effect could be multifactorial (Figure 3).


Role of macrolide therapy in chronic obstructive pulmonary disease.

Martinez FJ, Curtis JL, Albert R - Int J Chron Obstruct Pulmon Dis (2008)

Potential beneficial effects of macrolides in COPD patient.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2629987&req=5

f3-copd-3-331: Potential beneficial effects of macrolides in COPD patient.
Mentions: Taken together, the available data confirm that a macrolide can result in clinical improvement in patients with severe, chronic inflammatory lung diseases associated with frequent bacterial colonization and chronic infection. These data provide a rationale for expansion of the study of macrolide therapy to other, more common, inflammatory airway disorders, including COPD. Given the importance of inflammation and bacterial infection in the pathogenesis of COPD and its exacerbations, it is evident that macrolides may offer unique advantages as disease-modifying agents and that such an effect could be multifactorial (Figure 3).

Bottom Line: In addition, they exert broad-ranging, immunomodulatory effects both in vitro and in vivo, as well as diverse actions that suppress microbial virulence factors.Macrolide antibiotics have been used to successfully treat a number of chronic, inflammatory lung disorders including diffuse panbronchiolitis, asthma, noncystic fibrosis associated bronchiectasis, and cystic fibrosis.Additional, prospective, controlled data are required to define any potential treatment effect, the nature of this effect, and the role of bronchiectasis, baseline colonization, and other cormorbidities.

View Article: PubMed Central - PubMed

Affiliation: Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, MI 48109-0360, USA. fmartine@umich.edu

ABSTRACT
Chronic obstructive pulmonary disease (COPD) is a leading cause of death and disability worldwide. The Global Burden of Disease study has concluded that COPD will become the third leading cause of death worldwide by 2020, and will increase its ranking of disability-adjusted life years lost from 12th to 5th. Acute exacerbations of COPD (AECOPD) are associated with impaired quality of life and pulmonary function. More frequent or severe AECOPDs have been associated with especially markedly impaired quality of life and a greater longitudinal loss of pulmonary function. COPD and AECOPDs are characterized by an augmented inflammatory response. Macrolide antibiotics are macrocyclical lactones that provide adequate coverage for the most frequently identified pathogens in AECOPD and have been generally included in published guidelines for AECOPD management. In addition, they exert broad-ranging, immunomodulatory effects both in vitro and in vivo, as well as diverse actions that suppress microbial virulence factors. Macrolide antibiotics have been used to successfully treat a number of chronic, inflammatory lung disorders including diffuse panbronchiolitis, asthma, noncystic fibrosis associated bronchiectasis, and cystic fibrosis. Data in COPD patients have been limited and contradictory but the majority hint to a potential clinical and biological effect. Additional, prospective, controlled data are required to define any potential treatment effect, the nature of this effect, and the role of bronchiectasis, baseline colonization, and other cormorbidities.

Show MeSH
Related in: MedlinePlus