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Original Research: ASTHMA |

Azithromycin Attenuates Airway Inflammation in a Noninfectious Mouse Model of Allergic Asthma

Avraham Beigelman, MD; Sean Gunsten, BA; Cassandra L. Mikols, BS; Ilan Vidavsky, PhD; Carolyn L. Cannon, MD, PhD; Steven L. Brody, MD; Michael J. Walter, MD
Author and Funding Information

From the Division of Allergy and Pulmonary Medicine (Drs. Beigelman and Cannon), Department of Pediatrics, and the Division of Pulmonary and Critical Care Medicine (Mr. Gunsten, Ms. Mikols, and Drs. Brody and Walter), Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO; and the Department of Chemistry (Dr. Vidavsky), Washington University, St. Louis, MO.

Michael J. Walter, MD, Washington University School of Medicine, Internal Medicine, Pulmonary and Critical Care Medicine, 660 South Euclid, St. Louis, MO 63110; e-mail: mwalter@im.wustl.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;136(2):498-506. doi:10.1378/chest.08-3056
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Background:  Definitive conclusions regarding the antiinflammatory effects of macrolide antibiotics for treatment of asthma are difficult to formulate since their beneficial effects may be related to their antimicrobial action. We hypothesized that azithromycin possesses distinct antiinflammatory properties and tested this assumption in a noninfectious mouse model of allergic asthma.

Methods:  To induce allergic airway inflammation, 7-week-old BALB/cJ mice underwent intraperitoneal ovalbumin sensitization on days 0 and 7 followed by an intranasal challenge on day 14. Mice were treated with azithromycin or phosphate-buffered saline (PBS) solution on days 13 through 16. On day 17, airway inflammation was assessed by quantifying leukocytes in the airway, expression of multiple inflammatory mediators in the BAL fluid, and mucous cell metaplasia. In a separate set of experiments, azithromycin or PBS solution treatment were initiated after the ovalbumin challenge. Each experiment was repeated 3 times (a total of 9 to 11 mice in each group).

Results:  Compared to treatment with PBS solution, azithromycin attenuated the ovalbumin-dependent airway inflammation. We observed a decrease in total leukocytes in the lung tissue and BAL fluid. In addition, azithromycin attenuated the expression of cytokines (eg, interleukin [IL]-13 and IL-5) and chemokines (eg, CCL2, CCL3, and CCL4) in the BAL fluid and abrogated the extent of mucous cell metaplasia. Similar antiinflammatory effects were observed when azithromycin treatment was initiated after the ovalbumin challenge.

Conclusion:  In this noninfectious mouse model of allergic asthma, azithromycin attenuated allergic airway inflammation. These findings demonstrate an antiinflammatory effect of azithromycin and suggest azithromycin may have beneficial effects in treating noninfectious airway inflammatory diseases, including asthma.

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