Department of Neurology, Georg-August-University, Göttingen, Germany.
Curr Mol Pharmacol. 2008 Jan;1(1):68-79.
There is growing evidence that certain antibiotics exert their beneficial effects not only by killing or inhibiting the growth of bacterial pathogens but also indirectly by immunomodulation. This review aims at giving an overview of the immunomodulatory properties of antibiotics in different diseases: The antiinflammatory properties of macrolides in chronic inflammatory pulmonary disorders were recognized more than 15 years ago and have been well documented in the last decade. Recent data suggest that several antibiotics such as tetracyclines and cephalosporins may have a beneficial immunomodulatory or neuroprotective effect on neuroimmunological and neurodegenerative diseases including multiple sclerosis and amyotrophic lateral sclerosis. Moreover, the non-bacteriolytic but bactericidal antibiotics rifampicin, clindamycin and aminoglycosides kill bacteria without releasing high quantities of proinflammtory cell wall components. The use of bactericidal, non-bacteriolytic protein synthesis inhibitors reduces mortality and long-term sequelae in experimental bacterial sepsis, plague and meningitis. Clinically, macrolides have been well established as an adjunctive treatment to beta-lactam antibiotics in pulmonary diseases. For other indications, appropriate clinical trials are necessary before using the immunomodulatory properties of antibiotics in clinical practice.
越来越多的证据表明，某些抗生素不仅通过杀死或抑制细菌病原体的生长，而且还通过间接的免疫调节发挥其有益作用。这篇综述旨在概述抗生素在不同疾病中的免疫调节特性： 15 年前就已经认识到大环内酯类抗生素在慢性炎症性肺疾病中的抗炎特性，并且在过去十年中已经有充分的文献记载。最近的数据表明，几种抗生素，如四环素类和头孢菌素类，可能对神经免疫和神经退行性疾病，包括多发性硬化症和肌萎缩侧索硬化症具有有益的免疫调节或神经保护作用。此外，非溶菌但杀菌的抗生素利福平、克林霉素和氨基糖苷类抗生素在杀死细菌时不会释放大量促炎的细胞壁成分。在实验性细菌性败血症、鼠疫和脑膜炎中，使用杀菌而非溶菌的蛋白质合成抑制剂可降低死亡率和长期后遗症。临床上，大环内酯类抗生素已被确立为肺部疾病中β-内酰胺类抗生素的辅助治疗药物。对于其他适应症，在将抗生素的免疫调节特性用于临床实践之前，需要进行适当的临床试验。
