1994 Fiscal Year Final Research Report Summary
Basic and Clinical Aspect of macrolide Therapy for Upper Respiratory Tract Infections
| Project/Area Number |
05671443
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Otorhinolaryngology
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| Research Institution | Teikyo University School of Medicine |
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Principal Investigator |
IINO Yukiko Teikyo University School of Medicine Dept Otolaryngology, Associate Professor, 医学部, 助教授 (30108534)
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| Co-Investigator(Kenkyū-buntansha) |
UEBO Keiyu Teikyo University School of Medicine Dept Otolaryngology, Assistant, 医学部, 助手
SUZUKI Masakazu Teikyo University School of Medicine Dept Otolaryngology, Assistant, 医学部, 助手
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| Project Period (FY) |
1993 – 1994
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| Keywords | erythromycin / new-macrolide / chronic sinusitis / otitis media with effusion / cytokine / submucosal inflammatory cells |
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| Research Abstract |
Low-dose and long-term administration of erythromycin and new-macrolides (macrolide therapy) has been reported to be very effective for patients with diffuse panbronchiolitis, sinobronchial syndrome and other otorhinological lesions such as intractable chronic sinusitis and otitis media with effusion. The clinical efficacy of the therapy has been suggested to have litle to do with the antimicrobial effect but to depend on the antiinflammatory effect or regulation of hyperimmune response. We have been studying the clinical efficacy of the macrolide therapy in chronic upper respiratory tract infections as well as the mechanism of the therapy, and obtained the following results.
1) The macrolide therapy was very effective for the patients with chronic sinusitis with or without lower respiratory tract diseases. Most patients showed improvement of subjective symptoms by the therapy.
2) The macrolide therapy was also effective for the patients including children with otitis media with effusion accompanying sinusitis.
3) Patients with significant lymphocytic infiltration in the subepithelial layr of the paranasal mucosa responded well to the therapy, while the therapy was minimally effective in patients whose subepithelial layr showed marked eosinophilic infiltraion.
4) The number of IgA positive cells in subepithelial layr of paranasal mucosa decreased after the therapy, while the number of IgE positive cells showed little change. In addition, CD4 positive T cells decreased in number after the therapy, indicating suppression of inflammation and normalization of paranasal mucosa.
These results suggest that macrolides suppress chronic inflammatory response except for type I allergic inflammation. It is possible that macrolides may act on and regulate various cytokine networks relating non-allergic inflammation.
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