Boost of mucosal secretory immunoglobulin A response by clarithromycin in paediatric influenza
Boost of mucosal secretory immunoglobulin A response by clarithromycin in paediatric influenza
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DOI：
10.1111/j.1440-1843.2009.01639.x
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发表时间：
2009-11-01
期刊：
影响因子：
6.9
通讯作者：
Kido, Hiroshi
中科院分区：
文献类型：
--
作者：
Sawabuchi, Takako;Suzuki, Satoshi;Kido, Hiroshi
背景与目的：抗病毒神经氨酸酶抑制剂奥司他韦（oseltamivir，OSV）用于治疗流感。大环内酯类克拉霉素（CAM）用于治疗细菌感染，具有抗炎和免疫调节活性。本回顾性研究调查CAM的免疫调节作用，在儿童提出与流感A。方法：该研究招募了40名儿童急性流感，并根据接受的治疗分组：5天治疗OSV（n = 14），CAM（n = 8），OSV + CAM（n = 12）和未治疗（n = 6）。比较治疗前后鼻咽分泌物中抗甲型流感病毒（H3N2）和（H1N1）的分泌型伊加（sIgA）水平、总sIgA、病毒RNA拷贝数和疾病症状。在CAM和OSV + CAM组中发现了水平的特别显著的增加。在OSV组中观察到抗病毒sIgA的低诱导，但在OSV中加入CAM增加了sIgA的产生并恢复了局部粘膜sIgA水平。残留咳嗽的频率在OSV + CAM组显着低于其他组，包括OSV治疗组。结论：CAM增强鼻咽粘膜免疫反应，在儿童提出与流感A，即使在那些治疗OSV谁有低生产的粘膜抗病毒sIgA，并减轻流感症状。
Background and objective: The antiviral neuraminidase inhibitor oseltamivir (OSV) is used to treat influenza. The macrolide clarithromycin (CAM) is used to treat bacterial infections and has anti-inflammatory and immunomodulatory activities. This retrospective study investigated the immunomodulatory effects of CAM in children presenting with influenza A.Methods: The study recruited 40 children with acute influenza, and grouped them according to the treatment received: 5-day treatment with OSV (n = 14), CAM (n = 8), OSV + CAM (n = 12) and untreated (n = 6). The before and after treatment comparisons were made of the level of secretory IgA (sIgA) against influenza A virus (H3N2) and (H1N1), total sIgA, viral RNA copy numbers in nasopharyngeal aspirates and disease symptoms.Results: Infection induced anti-viral mucosal sIgA in the nasopharyngeal aspirates of most patients of all treatment groups. Particularly prominent increases in the levels were found in the CAM and OSV + CAM groups. Low induction of anti-viral sIgA was observed in the OSV group, but the addition of CAM to OSV augmented sIgA production and restored local mucosal sIgA levels. The frequency of residual cough in the OSV + CAM group was significantly lower than in the other groups including the group treated with OSV.Conclusions: CAM boosted the nasopharyngeal mucosal immune response in children presenting with influenza A, even in those treated with OSV who had low production of mucosal anti-viral sIgA, and alleviated the symptoms of influenza.