Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang 10380, Republic of Korea.
Int J Mol Sci. 2023 May 30;24(11):9489. doi: 10.3390/ijms24119489.
Various chronic inflammatory airway diseases can be treated with low-dose, long-term (LDLT) macrolide therapy. LDLT macrolides can be one of the therapeutic options for chronic rhinosinusitis (CRS) due to their immunomodulatory and anti-inflammatory actions. Currently, various immunomodulatory mechanisms of the LDLT macrolide treatment have been reported, as well as their antimicrobial properties. Several mechanisms have already been identified in CRS, including reduced cytokines such as interleukin (IL)-8, IL-6, IL-1β, tumor necrosis factor-α, transforming growth factor-β, inhibition of neutrophil recruitment, decreased mucus secretion, and increased mucociliary transport. Although some evidence of effectiveness for CRS has been published, the efficacy of this therapy has been inconsistent across clinical studies. LDLT macrolides are generally believed to act on the non-type 2 inflammatory endotype of CRS. However, the effectiveness of LDLT macrolide treatment in CRS is still controversial. Here, we reviewed the immunological mechanisms related to CRS in LDLT macrolide therapy and the treatment effects according to the clinical situation of CRS.
各种慢性炎症性气道疾病可以通过低剂量、长期（LDLT）大环内酯类药物治疗。由于具有免疫调节和抗炎作用，LDLT 大环内酯类药物可成为慢性鼻-鼻窦炎（CRS）的治疗选择之一。目前，已经报道了 LDLT 大环内酯类药物治疗的多种免疫调节机制及其抗菌特性。在 CRS 中已经确定了几种机制，包括减少细胞因子（如白细胞介素（IL）-8、IL-6、IL-1β、肿瘤坏死因子-α、转化生长因子-β）、抑制中性粒细胞募集、减少黏液分泌和增加黏液纤毛输送。尽管已经发表了一些关于 CRS 有效性的证据，但这种治疗方法在临床研究中的效果并不一致。LDLT 大环内酯类药物通常被认为作用于 CRS 的非 2 型炎症表型。然而，LDLT 大环内酯类药物治疗 CRS 的疗效仍存在争议。在这里，我们综述了 LDLT 大环内酯类药物治疗 CRS 相关的免疫学机制以及根据 CRS 临床情况的治疗效果。
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