Kinoshita Keiichi, Iwasaki Hiromichi, Uzui Hiroyasu, Ueda Takanori
First Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Transl Res. 2006 Oct;148(4):207-13. doi: 10.1016/j.trsl.2006.07.001.
Systemic inflammatory response syndrome (SIRS) and sepsis have been considered forms of hypercytokinemia in critically ill patients and immunocompromized hosts. It has been reported that some antimicrobial agents, including antifungal agents, not only have an antibiotic effect, but also they affect the host's immunological response. Immunofunctional cells, including monocytes and macrophages, were examined to determine whether they are influenced by the newly synthesized candin family antifungal agent micafungin (MCFG) using the human monocytic cell line THP-1 stimulated with lipopolysaccharide (LPS) as a model of hypercytokinetic conditions. LPS-induced production of TNF-alpha (tumor necrosis factor-alpha) and interleukin-8 (IL-8) in THP-1 cells was significantly suppressed dose-dependently by MCFG, although high concentrations of MCFG may reach toxic levels. It was clarified that MCFG inhibits the LPS-induced expression of TNF-alpha in THP-1 cells at the mRNA (messenger ribonucleic acid) level. In conclusion, administration of MCFG had an immunomodulatory effect on the host by reducing levels of TNF-alpha and IL-8. The effectiveness of MCFG in modulating hypercytokinemia is due not only to its direct antifungal effect, but also to the modulation of cytokine production in macrophages that regulates immunological activity and inflammation.
全身炎症反应综合征(SIRS)和脓毒症被认为是危重症患者和免疫功能低下宿主的高细胞因子血症形式。据报道,一些抗菌药物,包括抗真菌药物,不仅具有抗菌作用,还会影响宿主的免疫反应。以脂多糖(LPS)刺激的人单核细胞系THP-1作为高细胞因子血症状态的模型,检测包括单核细胞和巨噬细胞在内的免疫功能细胞,以确定它们是否受到新合成的棘白菌素类抗真菌药物米卡芬净(MCFG)的影响。MCFG可剂量依赖性地显著抑制LPS诱导的THP-1细胞中肿瘤坏死因子-α(TNF-α)和白细胞介素-8(IL-8)的产生,尽管高浓度的MCFG可能会达到毒性水平。已明确MCFG在信使核糖核酸(mRNA)水平抑制LPS诱导的THP-1细胞中TNF-α的表达。总之,给予MCFG可通过降低TNF-α和IL-8水平对宿主产生免疫调节作用。MCFG调节高细胞因子血症的有效性不仅归因于其直接抗真菌作用,还归因于其对巨噬细胞中细胞因子产生的调节,而巨噬细胞可调节免疫活性和炎症。