Abstract

Persistent respiratory infections caused by Chlamydia pneumoniae have been implicated in the pathogenesis of chronic diseases (e.g. asthma). Antibiotics are used to treat C.pneumoniae respiratory infections; however, the use of antibiotics as anti-inflammatory agents in treatment of asthma remains controversial. The current study investigated whether ciprofloxacin, azithromycin, or doxycycline can suppress C.pneumoniae-induced production of immunoglobulin (Ig) E or cytokines in peripheral blood mononuclear cells (PBMC) obtained from asthmatic children. Apart from blood, nasopharyngeal swab specimens were also collected to test for the presence of C.pneumoniae and/or M.pneumoniae (qPCR). PBMC (1.5 x 106) from asthmatic pediatric patients (N=18) were infected or mock infected for 1h±C.pneumoniae AR-39at a multiplicity of infection (MOI)=0.1, and cultured±ciprofloxacin, azithromycin, or doxycycline (0.1 or 1.0μg/mLmL) for either 48h(cytokines) or 10 days (IgE). Interleukin (IL)-4, interferon (IFN)-γ and IgE levels in supernatants were measured (ELISA). When PBMC were infected with C.pneumoniae, IL-4 and IFNγ production increased (p=0.06 and 0.03, respectively); IgE levels were low. The now-elevated levels of IL-4 didn't decrease significantly after addition of ciprofloxacin, azithromycin, or doxycycline. However, infected PBMC IFNγ formation decreased significantly when 0.1μg/mL doxycycline was employed (p=0.04); no dose of ciprofloxacin or azithromycin had any impact. This inhibitory outcome with doxycycline lends support to the use of tetracyclines as immune modulators and anti-inflammatory medications in treatment of C.pneumoniae-infected asthma patients.

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