An anti-inflammatory action of macrolides has recently been detected in diffuse panbronchiolitis. Inflammatory cells and cytokines/chemokines seem to play an important role in the ful-like reaction to bronchoscopy. We measured the plasma interleukin-6 and soluble CD14 levels in patients who underwent bronchoscopy with or without administration of azithromycin.
Patients underwent bronchoscopy with or without azithromycin were recruited. Blood samples were collected before and after bronchoscopy (4 hour and next day). Peripheral blood cell count was measured and plasma soluble CD14 (sCD14) and interleukin-6 (IL-6) levels were measured with a monoclonal antibody-based ELISA kits.
In patients who were not administered azithromycin, there was a significant increase of interleukin-6 at 4 hours after bronchoscopy (15.477 ± 28.896 versus 44.763 ± 69.315, p<0.001, n=30), sCD14 on the day after bronchoscopy (4.534 ± 1.411 versus 5.575 ± 2.769, p<0.05, n=30), and neutrophils and monocytes at 4 hours and the day after bronchoscopy (monocytes: 349 ± 133 versus 475 ± 142, p<0.05, n=12 versus 451 ± 147, n=12, p<0.05). In contrast, the increase of these parameters except neutrophils was suppressed in patients who treated with azithromycin (IL-6: 10.750 ± 9.321 versus 17.410 ± 13.446, p>0.05, n=10; sCD14: 4.396 ± 1.232 versus 4.522 ± 1.288, p>0.05, n=10; monocytes: 341 ± 120 versus 385 ± 215, p>0.05, n=8; versus 328 ± 165, p>0.05, n=8).
We conclude that activated monocytes/macrophages are heavily involved in bronchial events. Azithromycin had anti-inflammatory effect, especially on monocytes/macrophages.
The anti-inflammatory effect, especially on monocytes/macrophages of azithromycin may help to prevent for bronchial events in which activated monocytes have a role.
K. Yamaguchi, None.