Abstract
In addition to their antibiotic effect, macrolides appear to modulate the inflammatory response in cystic fibrosis (CF) and could influence oxidative stress. The objective of this study was to assess oxidation biomarkers and levels of inflammation and to determine whether there is an association between these parameters and the intake of macrolides. The subjects included in this cross-sectional study were, on the one hand, clinically stable patients with CF and, on the other, healthy controls. The following serum and plasma inflammatory and oxidative stress biomarkers were measured: interleukin-6 (IL-6), reactive C protein (RCP), tumor necrosis alpha (TNF-α), glutathione peroxidase (GPx), total antioxidant capacity (TAC), catalase (CAT), and superoxide dismutase (SOD), together with markers of lipid peroxidation (8-isoprostanes and thiobarbituric acid reactive substances [TBARS]). Clinical, anthropometric, lung function, radiological, and analytical variables (albumin, prealbumin, vitamins, and zinc) were also recorded. We studied 36 adults with CF and 41 controls. No differences were observed in age, gender, or anthropometric variables. The patients had significantly higher levels of IL-6, TNF-α, RCP, TBARS, and isoprostanes, and lower levels of SOD than the controls. Twenty-three of the patients were treated with azithromycin, and they had more severe clinical and radiological parameters than those who were not but nevertheless presented significantly lower levels of TNF-α. No differences were observed in the markers of oxidation. Inflammation and oxidation biomarkers were increased in patients with CF compared with controls. The use of azithromycin was associated with reduced TNF-α levels and did not influence oxidation parameters.
Highlights
Patients with cystic fibrosis (CF) endure a progressive pulmonary pathology that is governed by a chronic, exaggerated inflammatory response
Inflammation and oxidation biomarkers were increased in patients with CF compared with controls
The use of azithromycin was associated with reduced TNF-α levels and did not influence oxidation parameters
Summary
Patients with cystic fibrosis (CF) endure a progressive pulmonary pathology that is governed by a chronic, exaggerated inflammatory response. As it happens in other respiratory diseases such as chronic obstructive pulmonary disease (COPD), progression of the disease is characterized by chronic, unopposed, neutrophil-dominated inflammation, which is associated with reduced lung function [1,2,3]. Azithromycin (AZM) presents anti-inflammatory, antimicrobial, and immunomodulatory properties, which contribute to the improvement of clinical parameters, including delayed lung function decline, time to acute pulmonary exacerbation, and the need for antimicrobial treatment [6,7,8,9,10]
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