A Mechanism of Erythromycin Treatment in Patients with Diffuse Panbronchiolitis

作者：Jun‐ichi Kadota, Osamu Sakito, Shigeru KOHNO, Hideaki Sawa, Hiroshi Mukae, Hiroshice Oda, Kazuyos Khiawakami, Kiyoyasu Fukushima, Kazuhito Hiratani, Kohei Hara · 发表于：American Review of Respiratory Disease · 年份：1993 · DOI：10.1164/ajrccm/147.1.153 · 被引用次数：299 · 研究领域：Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis、Neonatal Respiratory Health Research、Pleural and Pulmonary Diseases

Abstract Recently, “low-dose and long-term” erythromycin treatment has been reported as effective on diffuse panbronchiolitis (DPB), but its mechanism is still obscure. Patients with DPB were found to have significantly higher percentages of neutrophils in the pre-erythromycin treatment bronchoalveolar lavage fluid (BALF) than healthy nonsmoking volunteers (p < 0.001). They showed a significant reduction in BALF neutrophil percentages after erythromycin treatment (p < 0.01). The neutrophil chemotactic activity (NCA) was significantly elevated in BALF obtained from 19 patients with DPB compared with that from healthy volunteers (p < 0.001). A significant reduction in the NCA was observed in post-erythromycin treatment BALF of 11 patients with DPB (p < 0.001). Additionally, there was a significant correlation between the reduction of NCA and neutrophil percentage in pre- and post-erythromycin treatment BALF (r = 0.726, p < 0.05). Finally, we investigated the effect of erythromycin on the intrapulmonary influx of neutrophils by intratracheal injection of lipopolysaccharide (LPS) and interleukin-8 (IL-8) in mice. The intrapulmonary influx of neutrophils was significantly suppressed (p < 0.001) in mice intraperitoneally injected with erythromycin at 5 mg per animal 2 h before intratracheal injection of LPS (control group: 6.5 ± 1.6 × 105 versus erythromycintreated group: 1.7 ± 0.5 × 105), but not 10 h before lung challenge. This inhibition was observed at 6 h after lung challenge ...