Abstract
Clarithromycin (CAM), a semisynthetic macrolide antibiotic, is a widely used antibacterial drug. Recently, the efficacy of CAM as an add-on drug for treating multiple myeloma (MM) has been noted. Its effect on treating MM has been confirmed in combination chemotherapies that include CAM. However, a single treatment of CAM has no efficacy for treating MM. Many myeloma growth factors (MGFs) including interleukin (IL)-6 are known to be closely involved in the development of MM. CAM has been shown to suppress many MGFs, particularly IL-6. The possible mechanisms of action of CAM in treating MM have been suggested to include its immunomodulatory effect, autophagy inhibition, reversibility of drug resistance, steroid-sparing/enhancing effect and suppression of MGFs. In addition, MM is characterised by uncontrolled cell growth of monoclonal immunoglobulin (Ig)-producing neoplastic plasma cells. Large quantities of unfolded or misfolded Ig production may trigger considerable endoplasmic reticulum stress. Thus, MM is originally a fragile neoplasm particularly susceptible to autophagy-, proteasome- and histone deacetylase 6-inhibitors. Taken together, CAM plays an important role in MM treatments through its synergistic mechanisms.In addition, CAM with its pleiotropic effects on cytokines including IL-6 and indirect antiviral effects might be worth a try for treating COVID-19.
Highlights
Background information onClarithromycin (CAM)Clarithromycin (CAM: Biaxin®) belongs to the 14-membered macrolide antibiotic family together with erythromycin and roxithromycin
The significance of CAM as an add-on drug in MM treatments, its effects on myeloma growth factors (MGFs) [4,5,6,7], and its mechanisms of action leading to the suppression of MM cell proliferation were discussed
Kikuchi et al [49] reported that CAM suppressed lipopolysaccharide (LPS)-induced IL-8 production by human monocytes through activator protein-1 (AP-1) and nuclear factor-κB (NF-κB) transcription factors
Summary
Background information onClarithromycin (CAM)Clarithromycin (CAM: Biaxin®) belongs to the 14-membered macrolide antibiotic family together with erythromycin and roxithromycin. The significance of CAM as an add-on drug in MM treatments, its effects on myeloma growth factors (MGFs) [4,5,6,7], and its mechanisms of action leading to the suppression of MM cell proliferation were discussed. CAM showed a potent inhibitory activity on the release and gene expression of IL-2 induced by Con-A-stimulated human T-cells.
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