A Case of Diffuse Panbronchiolitis Relieved Rapidly by the Treatment of Roxithromycin

Suppression of Pseudomonas aeruginosa quorum-sensing systems by macrolides: a promising strategy or an oriental mystery?

“…This favorable effect was observed even in patients with P. aeruginosa infection, and some of these effects were later confi rmed by a placebo-controlled, double-blind clinical trial. Subsequently, other macrolide antibiotics, including clarithromycin, 22 roxithromycin, 23 and azithromycin, 24 were also confi rmed to be effective in longterm treatment for DPB, whereas, importantly, fl uoroquinolone was not effective. 25 The clinical impact was impressive, resulting in an increase of 10-year survival from 12.4% to more than 90%.…”

Interleukin 1β, Tumor Necrosis Factor Alpha, and Interleukin 8 in Bronchoalveolar Lavage Fluid of Patients with Diffuse Panbronchiolitis: A Potential Mechanism of Macrolide Therapy

“…A low-dose and long-term erythromycin treatment is effective in DPB [2,3]. Recently, long-term administra tion of clarithromycin and roxithromycin, new macrolide antibiotics which have a 14-atom-membered macrocycline ring structure, as well as of erythromycin has also BALF Cytokine Levels in Diffuse Panbronchiolitis been reported to be effective in the treatment of DPB [4,25,26], Our study also demonstrated the clinical efficacy of long-term administration of roxithromycin which was similar to that of erythromycin. However, the mechanism of drug action is still controversial, although several inves tigators [5][6][7][8][9][10] have suggested an anti-inflammatory rath er than bactericidal action.…”

“…Since the effectiveness of low-dose and long-term erythromycin treatment was established, the disease has become easy to control and is now curable [2,3]. Roxithromycin, a new macrolide antibiotic, which has the same 14-atom-membered macrocycline ring structure as erythromycin, is also useful in DPB [4], Although it has been suggested that these drugs have anti-inflammatory rather than bacteri cidal properties [5][6][7][8][9][10], their site of action is still obscure. We have recently reported that treatment with erythro mycin reduces the number of neutrophils accumulated in the airways of patients with DPB and the neutrophil chemotactic activity (NCA) in the bronchoalveolar lavage fluid (BALF) [10], In addition, we also demonstrated a significant correlation between reduction in NCA and neutrophil percentage [10], Interleukin (IL) 8 is a major neutrophil chemotactic factor in the lung.…”

Effect of Roxithromycin on Peripheral Neutrophil Adhesion Molecules in Patients with Chronic Lower Respiratory Tract Disease

“…Mean ± S D o f healthy volunteers was 0.45 ± 0.14 and o f chronic lower respi ratory tract disease 0.68 ± 0. 16. macrolide antibiotics which have the 14-atom-membered macrocycline ring structure as well as erythromycin, have also been reported as being effective in the disease with long-term administration [10,11], However, the mecha nism o f the drugs is still controversial although several investigators have reported it to be anti-inflammatory rather than bactericidal [12,15].…”

“…Respiratory diseases are no exception; various adhesion molecules have been suggested to be overexpressed locally in the lung in bronchial asthma and sarcoidosis [1][2][3]. In chronic low er respiratory tract diseases including diffuse panbron chiolitis (DPB), peripheral neutrophils are considered to adhere to vascular endothelial cells in the process o f infil tration into the airway, penetrate into tissues through intercellular spaces, adhere to airway epithelial cells, and accumulate in the airway [4], When neutrophils adhere to vascular endothelial cells, the expression o f adhesion mole cules such as lymphocyte function-associated antigen-1 (LFA-1) and Mac-1 on neutrophils, and such as intercellu lar adhesion molecule-1 (ICAM -1) on endothelial cells is known to be enhanced quantitatively and/or qualitatively [5,6], A similar interaction is considered to occur between neutrophils and tracheal epithelial cells, inducing neutro phil infiltration into the airway [4,7], There have been several studies on the effectiveness of low-dose and long-term administration o f erythromycin in patients with chronic lower respiratory tract disease including D P B , and recent reports have also suggested the effectiveness o f other macrolide antibiotics [8][9][10][11]. How ever, the mechanism o f this effect is still controversial in spite o f several studies.…”