Randomized trial to evaluate azithromycin's effects on serum and upper airway IL-8 levels and recurrent wheezing in infants with respiratory syncytial virus bronchiolitis.
Randomized trial to evaluate azithromycin's effects on serum and upper airway IL-8 levels and recurrent wheezing in infants with respiratory syncytial virus bronchiolitis.
复制标题
随机试验评估阿奇霉素对血清和上呼吸道IL-8水平的影响，并在患有呼吸道合胞病毒细支气管炎的婴儿中复发。
DOI：
10.1016/j.jaci.2014.10.001
复制
发表时间：
2015-05
期刊：
影响因子：
--
通讯作者：
Bacharier LB
中科院分区：
文献类型：
--
作者：
Beigelman A;Isaacson-Schmid M;Sajol G;Baty J;Rodriguez OM;Leege E;Lyons K;Schweiger TL;Zheng J;Schechtman KB;Castro M;Bacharier LB
婴儿期呼吸道合胞病毒（RSV）毛细支气管炎是反复喘息和哮喘的主要危险因素。由于阿奇霉素在小鼠病毒性细支气管炎模型中减弱了嗜酸性气道炎症，因此在人类中证明了类似的作用，这可能为预防细支气管炎后复发性喘息提供了一种策略。研究阿奇霉素治疗RSV毛细支气管炎是否能降低血清和鼻腔灌洗液中IL-8水平以及毛细支气管炎后反复喘息的发生率。一项随机、双盲、安慰剂对照、概念验证试验，纳入40例因RSV毛细支气管炎住院的健康婴儿，这些婴儿接受阿奇霉素或安慰剂治疗14天。在随机化、第8天和第15天（仅鼻灌洗）测量鼻灌洗和血清中的IL-8水平。在随后的50周内每月评估喘息发作的发生率。与安慰剂相比，阿奇霉素治疗在第8天没有降低血清IL-8水平（p=0.6），但在第15天导致鼻灌洗液IL-8的更大下降（p=0.03）。22%的阿奇霉素治疗参与者经历了至少3次喘息发作，而安慰剂组的参与者为50%（p=0.07）。阿奇霉素治疗导致第三次喘息发作时间延长（p=0.048），与安慰剂相比，在随后的一年中出现呼吸道症状的天数减少（36.7 vs. 70.1天; p=0.01）。在这项概念验证研究中，阿奇霉素治疗RSV毛细支气管炎降低了上气道IL-8水平，延长了第三次喘息发作的时间，并降低了随后一年的总体呼吸道发病率。
Respiratory syncytial virus (RSV) bronchiolitis in infancy is a major risk factor for recurrent wheezing and asthma. As azithromycin attenuated neutrophilic airway inflammation in a murine viral bronchiolitis model, demonstration of similar effects in humans may provide a strategy for the prevention of post-bronchiolitis recurrent wheezing. To investigate whether azithromycin treatment during RSV bronchiolitis reduces serum and nasal lavage IL-8 levels and the occurrence of post-bronchiolitis recurrent wheezing. A randomized, double-masked, placebo-controlled, proof-of-concept trial in 40 otherwise healthy infants hospitalized with RSV bronchiolitis who were treated with azithromycin or placebo for 14 days. IL-8 levels were measured in nasal lavage and serum on randomization, day 8, and day 15 (nasal lavage only). The occurrence of wheezing episodes was assessed monthly over the ensuing 50 weeks. Compared to placebo, azithromycin treatment did not reduce serum IL-8 levels at day 8 (p=0.6), but resulted in a greater decline in nasal lavage IL-8 by day 15 (p=0.03). 22% of azithromycin-treated participants experienced at least 3 wheezing episodes compared to 50% of participants in the placebo group (p=0.07). Azithromycin treatment resulted in prolonged time to the third wheezing episode (p=0.048), and in fewer days with respiratory symptoms over the subsequent year in comparison to placebo (36.7 vs. 70.1 days; p=0.01). In this proof-of-concept study, azithromycin treatment during RSV bronchiolitis reduced upper airway IL-8 levels, prolonged the time to a third wheezing episode, and reduced overall respiratory morbidity over the subsequent year.
登录
查看更多内容
影响因子：
158.5
作者：
Bisgaard, Hans;Hermansen, Mette Northman;Pipper, Christian Bressen
通讯作者：
Pipper, Christian Bressen
影响因子：
10
作者：
Berry, Mike;Morgan, Angela;Pavord, Ian D.
通讯作者：
Pavord, Ian D.
DOI：
10.1001/archpediatrics.2010.177
发表时间：
2010-10-01
影响因子：
--
作者：
Escobar, Gabriel J.;Ragins, Arona;Kipnis, Patricia
通讯作者：
Kipnis, Patricia
影响因子：
9.6
作者：
Friedlander, Adam L.;Albert, Richard K.
通讯作者：
Albert, Richard K.
影响因子：
5.2
作者：
EVERARD, ML;SWARBRICK, A;MILNER, AD
通讯作者：
MILNER, AD