How does azithromycin improve asthma exacerbations? – Author's reply

Gibson, Peter G.

doi:10.1016/s0140-6736(17)33319-6

Cited by 2 publications

(8 citation statements)

References 6 publications

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“…Corticosteroids are the first‐line drugs for the treatment for asthma. However, steroid resistance or insensitivity is a major barrier to the therapy 2,5,6,50,51 . This is indicative of more severe asthma that also often has a neutrophilic and type‐1 inflammatory phenotype.…”

Section: Resultsmentioning

confidence: 99%

“…Currently, corticosteroids are considered the "gold‐standard" treatment for asthma 50,51 . However, asthma is a heterogeneous disease with many different phenotypes and endotypes observed 2–7 .…”

Section: Discussionmentioning

confidence: 99%

“…Total Leukocytes (/mL BALF) Currently, corticosteroids are considered the "gold-standard" treatment for asthma. 50,51 However, asthma is a heterogeneous disease with many different phenotypes and endotypes observed. [2][3][4][5][6][7] Critically, in the context of this research, no pharmacological agent with potent clinical efficacy has yet been approved to treat steroid-resistant asthma, which disproportionately accounts for more than 50% of asthma-associated healthcare costs.…”

Section: F I G U R Ementioning

confidence: 99%

“…2,5,6 Recent studies have investigated the potential of macrolide therapy which has been shown to be beneficial in severe forms of asthma and in chronic obstructive pulmonary disease. 41,[51][52][53] However, prolonged macrolide therapy may induce bacterial resistance in patients, increasing the likelihood of opportunistic infections. 51,52,54 Thus, the use of an endogenous agent such as hBD2 may provide a novel therapeutic approach without side effects.…”

Section: F I G U R Ementioning

confidence: 99%

“…41,[51][52][53] However, prolonged macrolide therapy may induce bacterial resistance in patients, increasing the likelihood of opportunistic infections. 51,52,54 Thus, the use of an endogenous agent such as hBD2 may provide a novel therapeutic approach without side effects.…”

Section: F I G U R Ementioning

confidence: 99%

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Human β‐defensin‐2 suppresses key features of asthma in murine models of allergic airways disease

Pinkerton

Kim

Koeninger

et al. 2020

Clin Experimental Allergy

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Background: Asthma is an airway inflammatory disease and a major health problem worldwide. Anti-inflammatory steroids and bronchodilators are the gold-standard therapy for asthma. However, they do not prevent the development of the disease, and critically, a subset of asthmatics are resistant to steroid therapy. Objective: To elucidate the therapeutic potential of human β-defensins (hBD), such as hBD2 mild to moderate and severe asthma. Methods: We investigated the role of hBD2 in a steroid-sensitive, house dust miteinduced allergic airways disease (AAD) model and a steroid-insensitive model combining ovalbumin-induced AAD with C muridarum (Cmu) respiratory infection. Results: In both models, we demonstrated that therapeutic intranasal application of hBD2 significantly reduced the influx of inflammatory cells into the bronchoalveolar lavage fluid. Furthermore, key type 2 asthma-related cytokines IL-9 and IL-13, as well as additional immunomodulating cytokines, were significantly decreased after administration of hBD2 in the steroid-sensitive model. The suppression of inflammation was associated with improvements in airway physiology and treatment also suppressed airway hyper-responsiveness (AHR) in terms of airway resistance and compliance to methacholine challenge. Conclusions and Clinical relevance: These data indicate that hBD2 reduces the hallmark features and has potential as a new therapeutic agent in allergic and especially steroid-resistant asthma.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: F I G U R Ementioning

confidence: 99%

Section: F I G U R Ementioning

confidence: 99%

Section: F I G U R Ementioning

confidence: 99%

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Human β‐defensin‐2 suppresses key features of asthma in murine models of allergic airways disease

Pinkerton

Kim

Koeninger

et al. 2020

Clin Experimental Allergy

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Dangerous liaisons: Bacteria, antimicrobial therapies, and allergic diseases

Tramper-Stranders

Ambrożej

Arcolaci

et al. 2021

Allergy

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Microbiota composition and associated metabolic activities are essential for the education and development of a healthy immune system. Microbial dysbiosis, caused by risk factors such as diet, birth mode, or early infant antimicrobial therapy, is associated with the inception of allergic diseases. In turn, allergic diseases increase the risk for irrational use of antimicrobial therapy. Microbial therapies, such as probiotics, have been studied in the prevention and treatment of allergic diseases, but evidence remains limited due to studies with high heterogeneity, strain-dependent effectiveness, and variable outcome measures.In this review, we sketch the relation of microbiota with allergic diseases, the overuse and rationale for the use of antimicrobial agents in allergic diseases, and current knowledge concerning the use of bacterial products in allergic diseases. We urgently recommend 1) limiting antibiotic therapy in pregnancy and early childhood as a method contributing to the reduction of the allergy epidemic in children and 2) restricting antibiotic therapy in exacerbations and chronic treatment of allergic diseases, mainly

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How does azithromycin improve asthma exacerbations? – Author's reply

Cited by 2 publications

References 6 publications

Human β‐defensin‐2 suppresses key features of asthma in murine models of allergic airways disease

Human β‐defensin‐2 suppresses key features of asthma in murine models of allergic airways disease

Dangerous liaisons: Bacteria, antimicrobial therapies, and allergic diseases

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