Non-antimicrobial activity of macrolides: therapeutic potential in chronic inflammatory airway disorders

Abstract

In addition to their conventional antimicrobial activity, the macrolide group of antibiotics are known to have a number of anti-infammatory/ immunomodulatory activities, which may be of beneft to patients with chronic obstructive pulmonary disease (COPD), both in the stable state and during acute exacerbations. These activities involve interactions of the macrolides with the various components of infammation in patients with COPD, namely the ciliated airway epithelium, the immune and phagocytic cells of the host and their proinfammatory mediators, as well as with the microbes themselves. There are a number of factors that have been shown to cause injury to the bronchial epithelium and its mucociliary mechanism, including bacterial, chemical, mechanical and host-derived factors. The macrolide, azalide, ketolide group of antibiotics has been shown in many studies to be cytoprotective of human ciliated epithelium in vitro, protecting against both chemical mediator- and bacterial-mediated injury. Mucus hypers...