Vitamin E attenuates the injurious effects of bioactive phospholipids on human ciliated epithelium<i>in vitro</i>

Feldman, Charles; Anderson, Ronald; Theron, Annette J.; Steel, Helen C.; Rensburg, C. E. J. Van; Cole, Peter; Wilson, Robert

doi:10.1183/09031936.01.00037401

Cited by 34 publications

(29 citation statements)

References 47 publications

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“…Erythromycin was also reported to attenuate bronchial hyperresponsiveness in patients with bronchial asthma, probably through its inhibitory action on superoxide production and chemotaxis of neutrophils [32]. Erythromycin may also be helpful in asthma management, through protection of the ciliated airway epithelium from the action of bioactive phospholipids [33], reduction of mucus production [34] and improvement of the biophysical properties of mucus [35]. Finally, it has been suggested that erythromycin inhibits glucocorticoid clearance and enhances the effect of steroid therapy on asthma [36].…”

Section: Discussionmentioning

confidence: 99%

Treatment of chronic rhinosinusitis and its effects on asthma

Ragab

Scadding²,

Lund³

et al. 2006

Eur Respir J

144

100

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The effects of rhinosinusitis treatment upon asthma are disputed.The first randomised prospective study of surgical compared with medical therapy of chronic rhinosinusitis in 90 patients with and without nasal polyps was previously reported. Asthma symptoms, control, forced expiratory volume in one second (FEV1), peak flow, exhaled nitric oxide, medication use and hospitalisation at 6 and 12 months from the start of the study were also monitored. This paper reports these results in 43 of those patients with concomitant asthma.Both medical and surgical treatment of chronic rhinosinusitis were associated with subjective and objective improvements in asthma. Overall asthma control improved significantly following both treatment modalities, but was better maintained after medical therapy, where improvement could also be demonstrated in the subgroup with nasal polyps. Medicine was superior to surgery with respect to a decrease in exhaled nitric oxide and increase in FEV1 in the polyp patients. Two patients noted worsening of asthma post-operatively.Improvement in upper airway symptoms, as assessed using a visual analogue scale, correlated with improvement in asthma symptoms and control. Treatment of chronic rhinosinusitis, medical or surgical, benefits concomitant asthma; that associated with nasal polyposis benefits more from medical therapy.KEYWORDS: Asthma, chronic rhinosinusitis, endoscopic sinus surgery, exhaled nitric oxide, forced expiratory volume in one second, nasal polyps R hinosinusitis coexisted with asthma in 34% of patients in one study [1]. Radiological studies have shown abnormal sinus radiographs in 53% [2,3] and mucosal thickening on sinus computed tomography (CT) scans in 74% [4] of patients with asthma. Recently, .84% of CT scans were found to be abnormal in severe asthma, with a correlation between the extent of CT changes, sputum eosinophilia and pulmonary function [5].A number of authors have investigated the effect of surgical treatment of rhinosinusitis upon asthma, with improvement [6-8], worsening [9, 10] and equivocal effect [11,12] being reported. Only two studies of medical chronic rhinosinusitis (CRS) treatment exist, one included four medical patients [13], whereas the other considered CRS with polyposis alone and was nonrandomised [14]. MATERIALS AND METHODSPatients were recruited over 2 yrs from the Rhinology Clinics of the Royal National Throat, Nose and Ear Hospital (London, UK). The study was approved by the Ethics Committee of the Royal Free Hospital (London, UK). After application of exclusion criteria, the study was discussed with 327 consecutive patients with a primary diagnosis of CRS. Of these, 90 patients who agreed to the process of randomisation were finally included and were randomised equally into the medical and surgical groups. The study design and flow chart showing the course of the study are presented in figures 1 and 2, respectively. Diagnosis of CRS was based on the criteria described by the Staging and Therapy Group [15]. The criteria for diagnosis of...

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Section: Discussionmentioning

confidence: 99%

Treatment of chronic rhinosinusitis and its effects on asthma

Ragab

Scadding²,

Lund³

et al. 2006

Eur Respir J

144

100

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“…Macrolides could exert their anti-inflammatory effects via several antioxidant properties of their molecule, resulting in inhibition of superoxide generation by polymorphonuclear leucocytes [6]. FELDMAN et al [19] proposed that macrolides may have beneficial effects on airway inflammation in asthma by protecting ciliated epithelium against oxidative damage inflicted by phospholipid-sensitised phagocytes. Interestingly, newer macrolides have inhibitory effects on cytokine secretion from leukocytes, especially interleukins-2, -3 and -4 and tumour necrosis factor-a [20], whereas erythromycin and clarithromycin exert a concentration-dependent suppressive effect on interleukin-8 release by human eosinophils from atopic donors [21].…”

Section: Discussionmentioning

confidence: 99%

Clarithromycin reduces the severity of bronchial hyperresponsiveness in patients with asthma

Kostadima¹,

Tsiodras²,

Alexopoulos³

et al. 2004

Eur Respir J

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A randomised double-blind placebo-controlled study was designed to evaluate the effects of a semisynthetic macrolide antibiotic, clarithromycin, on bronchial hyperresponsiveness to methacholine in patients with a diagnosis of asthma.Adult asthma patients undergoing treatment with budesonide 400 mg b.i.d. and salbutamol 200 mg p.r.n. less than twice weekly were studied. Arm A (16 males/six females, aged 48 ¡ 16 yrs) received clarithromycin 250 mg b.i.d. for 8 weeks, arm B (eight males/12 females, aged 42¡12 yrs) clarithromycin 250 mg t.i.d. and arm C (six males/15 females, aged 41¡16 yrs) placebo dextrose tablets. Bronchial hyperresponsiveness was quantified by measurement of the provocative dose of methacholine causing a 20% fall in forced expiratory volume in one second (PD20).Median (interquartile range) PD20 in the three groups before and after treatment with clarithromycin were: arm A: 0.3 (0.1-1) and 1.3 (0.6-2) mg; arm B: 0.4 (0.1-0.9) and 2 (2-2) mg; and arm C: 0.4 (0.1-0.9) and 0.3 (0.1-0.6) mg, respectively. Serum free cortisol levels were determined and remained unchanged from baseline in the clarithromycin-treated patients.It is concluded that clarithromycin reduces the degree of bronchial hyperresponsiveness in patients with asthma. Asthma is characterised by bronchial hyperresponsiveness (BHR) to nonspecific stimuli such as histamine, methacholine, cold air and exercise. BHR is related to airway inflammation and the degree of BHR indirectly reflects the severity of the disease [1]. Systemic corticosteroids administered on a long-term basis reduce BHR, but their use has been associated with significant side-effects. Modern asthma research is orientated towards the use of inhaled corticosteroids, which also decrease BHR, or alternative drug therapies possessing less toxic immunosuppressive, immunomodulating and antiinflammatory qualities.Macrolides such as troleandomycin and erythromycin have been shown to be effective in the treatment of asthma [2,3]. Their action in the steroid-dependent asthmatic patient is mediated at least in part by decreased corticosteroid metabolism. For example, troleandomycin and clarithromycin decrease methylprednisolone clearance and increase plasma methylprednisolone levels [4,5]. However, clarithromycin does not have a significant effect on prednisolone elimination [5]. Erythromycin and especially the newer macrolides (e.g. roxithromycin, clarithromycin and azithromycin) exert specific anti-inflammatory effects, including inhibition of generation of reactive oxygen species by polymorphonuclear leucocytes [6,7]. In addition, macrolide antibiotics may improve lung function due to their activity against Mycoplasma pneumoniae and Chlamydia pneumoniae, which are involved in asthma exacerbations [8][9][10].As a result of the actions described above, macrolides probably reduce the severity of BHR in adults and children with asthma. Most published data on reduction of BHR refer to erythromycin, roxithromycin or azithromycin [11][12][13]. There are very few data on the ...

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“…Macrolides are known to reduce airway hyperresponsiveness in asthmatic patients, attenuate pulmonary inflammation by protecting ciliated epithelium against oxidative damage, stabilize cell membranes, and decrease sputum purulence (133). Mycoplasmas have been detected by PCR in airways even when cultures and serological results are negative, suggesting that low numbers of organisms may evade detection by the immune system (239).…”

Section: Asthma and Other Chronic Lung Conditionsmentioning

confidence: 99%

Mycoplasma pneumoniaeand Its Role as a Human Pathogen

2004

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Mycoplasma pneumoniae is a unique bacterium that does not always receive the attention it merits considering the number of illnesses it causes and the degree of morbidity associated with it in both children and adults. Serious infections requiring hospitalization, while rare, occur in both adults and children and may involve multiple organ systems. The severity of disease appears to be related to the degree to which the host immune response reacts to the infection. Extrapulmonary complications involving all of the major organ systems can occur in association with M. pneumoniae infection as a result of direct invasion and/or autoimmune response. The extrapulmonary manifestations are sometimes of greater severity and clinical importance than the primary respiratory infection. Evidence for this organism's contributory role in chronic lung conditions such as asthma is accumulating. Effective management of M. pneumoniae infections can usually be achieved with macrolides, tetracyclines, or fluoroquinolones. As more is learned about the pathogenesis and immune response elicited by M. pneumoniae, improvement in methods for diagnosis and prevention of disease due to this organism may occur

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Vitamin E attenuates the injurious effects of bioactive phospholipids on human ciliated epitheliumin vitro

Cited by 34 publications

References 47 publications

Treatment of chronic rhinosinusitis and its effects on asthma

Treatment of chronic rhinosinusitis and its effects on asthma

Clarithromycin reduces the severity of bronchial hyperresponsiveness in patients with asthma

Mycoplasma pneumoniaeand Its Role as a Human Pathogen

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