Hamilton-Miller J M
Department of Medical Microbiology, Royal Free and University College Medical School, London, UK.
J Chemother. 2001 Apr;13(2):107-11. doi: 10.1179/joc.2001.13.2.107.
Antibiotics can alter the host's reaction to an infection (itself an immunomodulating event) in various ways. Indirect actions involve killing of bacteria, changing the intestinal flora, intrinsic antigenicity and preventing bacteria making virulence factors. Direct actions are upon phagocytic function, chemotaxis and lymphocyte activities. Immunomodulation can be positive ("pro-host") or negative, and can be quantitated by means of the parameter "immune index". Among the cephalosporins, cefodizime shows the greatest positive immunomodulating activity, due to the unique nature of the 3-sidechain. Cefotaxime has an immunodepressing effect in vitro. The oral cephalosporin cefaclor appears to have a beneficial effect on polymorph function. While immunomodulation by antibiotics may appear marked in in vitro and ex vivo experiments, and in animal models, this phenomenon does not appear to have decisive effects therapeutically.
抗生素可通过多种方式改变宿主对感染（感染本身就是一种免疫调节事件）的反应。间接作用包括杀灭细菌、改变肠道菌群、内在抗原性以及阻止细菌产生毒力因子。直接作用则作用于吞噬功能、趋化性和淋巴细胞活性。免疫调节可以是正向的（“有利于宿主”）或负向的，并且可以通过“免疫指数”这一参数进行量化。在头孢菌素中，由于3-侧链的独特性质，头孢地嗪显示出最大的正向免疫调节活性。头孢噻肟在体外具有免疫抑制作用。口服头孢菌素头孢克洛似乎对多形核白细胞功能有有益影响。虽然抗生素的免疫调节在体外和离体实验以及动物模型中可能表现明显，但这种现象在治疗上似乎没有决定性作用。
