Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK.
Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK.
Pulm Pharmacol Ther. 2021 Dec;71:102095. doi: 10.1016/j.pupt.2021.102095. Epub 2021 Nov 3.
Macrolide antibiotics are well known for their antibacterial properties, but extensive research in the context of inflammatory lung disease has revealed that they also have powerful immunomodulatory properties. It has been demonstrated that these drugs are therapeutically beneficial in various lung diseases, with evidence they significantly reduce exacerbations in patients with COPD, asthma, bronchiectasis and cystic fibrosis. The efficacy demonstrated in patients infected with macrolide tolerant organisms such as Pseudomonas aeruginosa supports the concept that their efficacy is at least partly related to immunomodulatory rather than antibacterial effects. Inconsistent data and an incomplete understanding of their mechanisms of action hampers the use of macrolide antibiotics as immunomodulatory therapies. Macrolides recently demonstrated no clinically relevant immunomodulatory effects in the context of COVID-19 infection. This review provides an overview of macrolide antibiotics and discusses their immunomodulatory effects and mechanisms of action in the context of inflammatory lung disease.
大环内酯类抗生素以其抗菌特性而闻名，但在炎症性肺病的背景下进行的广泛研究表明，它们还具有强大的免疫调节特性。已经证明，这些药物在各种肺部疾病中具有治疗益处，有证据表明它们可显著减少 COPD、哮喘、支气管扩张和囊性纤维化患者的恶化。在感染了耐大环内酯类药物的生物体（如铜绿假单胞菌）的患者中证明的疗效支持这样一种概念，即它们的疗效至少部分与免疫调节而非抗菌作用有关。数据不一致以及对其作用机制的不完全理解阻碍了将大环内酯类抗生素用作免疫调节疗法。大环内酯类抗生素最近在 COVID-19 感染的背景下没有显示出临床相关的免疫调节作用。本文综述了大环内酯类抗生素，并讨论了它们在炎症性肺病中的免疫调节作用及其作用机制。
