Erythromycin Reduces Neutrophils and Neutrophil-derived Elastolytic-like Activity in the Lower Respiratory Tract of Bronchiolitis Patients

作者：Yoichiro Ichikawa, Hideaki Ninomiya, Hideyuki Koga, Masako Tanaka, Masaharu Kinoshita, Naoto Tokunaga, Takafumi Yano, Kotaro Oizumi · 发表于：American Review of Respiratory Disease · 年份：1992 · DOI：10.1164/ajrccm/146.1.196 · 被引用次数：148 · 研究领域：Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis、Chronic Obstructive Pulmonary Disease (COPD) Research、Cystic Fibrosis Research Advances

Diffuse panbronchiolitis (DPB) is a disease of adults characterized by chronic inflammation of the respiratory bronchioles and the infiltration of chronic inflammatory cells. The clinical efficacy of erythromycin therapy has been demonstrated in DPB patients, but the mechanism of action of this drug is unknown. We investigated the localization of neutrophils in lung biopsy specimens, as well as the cell population and elastolytic-like and chemotactic activity of bronchoalveolar lavage (BAL) fluid, before and after treatment with erythromycin or ampicillin in 11 DPB patients (six biopsy-proven and five clinically diagnosed) and one follicular bronchiolitis patient. These bronchiolitis patients had a high percentage of neutrophil and a high neutrophil-derived elastolytic-like activity in BAL fluid compared with chronic bronchitis patients and normal control subjects. The number of neutrophils and the neutrophil-derived elastolytic-like activity in BAL fluid decreased significantly after treatment with erythromycin along with a significant improvement in pulmonary function studies, although there was no significant change in the chemotactic activity of BAL fluid. No significant reduction in BAL fluid neutrophilia was found in the ampicillin-treated patients. These results suggest an important role for the neutrophil in the pathogenesis or development of bronchiolitis, and also suggest that erythromycin may be useful for the treatment of bronchiolitis through its direct action up...