Journal
CURRENT OPINION IN PULMONARY MEDICINE
Volume 18, Issue 1, Pages 76-84Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MCP.0b013e32834daff8
Keywords
asthma; Chlamydophila pneumoniae; fiberoptic bronchoscopy; macrolides; Mycoplasma pneumoniae
Categories
Funding
- NHLBI (murine and human models)
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Purpose of review This review summarizes the importance of macrolide therapy in the treatment of asthma, discusses macrolide mechanisms of action, and outlines new clinical data supporting their use. The effects of macrolides on both the innate and adaptive immune responses are discussed. Recent findings Subacute bacterial infection with both typical and atypical organisms contributes to poor asthma control. Identification of pathogens using polymerase chain reaction (PCR) and cultures from bronchoscopic samples directs antibiotic therapy and improves asthma control. PCR identification of Mycoplasma pneumoniae and Chlamydophila pneumoniae in asthmatics best identifies the macrolide responsive phenotype. Summary Because of their effect on protein synthesis, macrolides have both antimicrobial and anti-inflammatory properties. Both mechanisms appear to be important in their clinical efficacy in treating a wide variety of pulmonary disorders, including asthma.
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