Effect of clarithromycin on cytokines and chemokines in children with an acute exacerbation of recurrent wheezing: A double-blind, randomized, placebo-controlled trial

Monica Fonseca-Aten, Pamela J. Okada, Karen L. Bowlware, Susana Chavez-Bueno, Asuncion Mejias, Ana Maria Rios, Kathy Katz, Kurt Olsen, Simon Ng, Hasan S. Jafri, George H. McCracken, Octavio Ramilo, R. Doug Hardy

Research output: Contribution to journalArticle

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Abstract

Background: Clarithromycin is postulated to possess immunomodulatory properties in addition to its antimicrobial activity. Objective: To evaluate the effect of clarithromycin on serum and nasopharyngeal cytokine and chemokine concentrations in children with an acute exacerbation of recurrent wheezing. Methods: Children with a history of recurrent wheezing or asthma and who presented with an acute exacerbation of wheezing were enrolled in a double-blind, randomized trial of clarithromycin vs placebo. Concentrations of tumor necrosis factor a (TNF-α), interferon-γ (IFN-γ), interleukin-1β (IL-1β), IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, granulocyte-macrophage colony-stimulating factor, RANTES, eotaxin, macrophage inflammatory protein 1α, macrophage inflammatory protein 1β, and monocyte chemoattractant protein 1 were measured in serum and/or nasopharyngeal aspirates before, during, and after therapy. Mycoplasma pneumoniae and Chlamydophila pneumoniae infection were evaluated for by polymerase chain reaction and serologic testing. Results: Nasopharyngeal concentrations of TNF-α, IL-1β, and IL-10 were significantly and persistently lower in children treated with clarithromycin compared with placebo. There tended to be a greater effect of clarithromycin on nasopharyngeal cytokine concentrations in patients with evidence of C pneumoniae or C pneumoniae infection. No significant differences were detected in serum cytokines for children treated with clarithromycin compared with placebo. Conclusion: Clarithromycin therapy reduces mucosal TNF-α, IL-1β, and IL-10 concentrations in children with an acute exacerbation of recurrent wheezing.

Original languageEnglish (US)
Pages (from-to)457-463
Number of pages7
JournalAnnals of Allergy, Asthma and Immunology
Volume97
Issue number4
StatePublished - Oct 2006

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Clarithromycin
Respiratory Sounds
Chemokines
Randomized Controlled Trials
Placebos
Cytokines
Interleukin-1
Interleukin-10
Macrophage Inflammatory Proteins
Tumor Necrosis Factor-alpha
Pneumonia
Serum
Chemokine CCL5
Chlamydophila pneumoniae
Mycoplasma pneumoniae
Chemokine CCL2
Interleukin-5
Granulocyte-Macrophage Colony-Stimulating Factor
Infection
Interleukin-8

ASJC Scopus subject areas

  • Immunology and Allergy

Cite this

Effect of clarithromycin on cytokines and chemokines in children with an acute exacerbation of recurrent wheezing : A double-blind, randomized, placebo-controlled trial. / Fonseca-Aten, Monica; Okada, Pamela J.; Bowlware, Karen L.; Chavez-Bueno, Susana; Mejias, Asuncion; Rios, Ana Maria; Katz, Kathy; Olsen, Kurt; Ng, Simon; Jafri, Hasan S.; McCracken, George H.; Ramilo, Octavio; Hardy, R. Doug.

In: Annals of Allergy, Asthma and Immunology, Vol. 97, No. 4, 10.2006, p. 457-463.

Research output: Contribution to journalArticle

Fonseca-Aten, M, Okada, PJ, Bowlware, KL, Chavez-Bueno, S, Mejias, A, Rios, AM, Katz, K, Olsen, K, Ng, S, Jafri, HS, McCracken, GH, Ramilo, O & Hardy, RD 2006, 'Effect of clarithromycin on cytokines and chemokines in children with an acute exacerbation of recurrent wheezing: A double-blind, randomized, placebo-controlled trial', Annals of Allergy, Asthma and Immunology, vol. 97, no. 4, pp. 457-463.
Fonseca-Aten, Monica ; Okada, Pamela J. ; Bowlware, Karen L. ; Chavez-Bueno, Susana ; Mejias, Asuncion ; Rios, Ana Maria ; Katz, Kathy ; Olsen, Kurt ; Ng, Simon ; Jafri, Hasan S. ; McCracken, George H. ; Ramilo, Octavio ; Hardy, R. Doug. / Effect of clarithromycin on cytokines and chemokines in children with an acute exacerbation of recurrent wheezing : A double-blind, randomized, placebo-controlled trial. In: Annals of Allergy, Asthma and Immunology. 2006 ; Vol. 97, No. 4. pp. 457-463.
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AU - Okada, Pamela J.

AU - Bowlware, Karen L.

AU - Chavez-Bueno, Susana

AU - Mejias, Asuncion

AU - Rios, Ana Maria

AU - Katz, Kathy

AU - Olsen, Kurt

AU - Ng, Simon

AU - Jafri, Hasan S.

AU - McCracken, George H.

AU - Ramilo, Octavio

AU - Hardy, R. Doug

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N2 - Background: Clarithromycin is postulated to possess immunomodulatory properties in addition to its antimicrobial activity. Objective: To evaluate the effect of clarithromycin on serum and nasopharyngeal cytokine and chemokine concentrations in children with an acute exacerbation of recurrent wheezing. Methods: Children with a history of recurrent wheezing or asthma and who presented with an acute exacerbation of wheezing were enrolled in a double-blind, randomized trial of clarithromycin vs placebo. Concentrations of tumor necrosis factor a (TNF-α), interferon-γ (IFN-γ), interleukin-1β (IL-1β), IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, granulocyte-macrophage colony-stimulating factor, RANTES, eotaxin, macrophage inflammatory protein 1α, macrophage inflammatory protein 1β, and monocyte chemoattractant protein 1 were measured in serum and/or nasopharyngeal aspirates before, during, and after therapy. Mycoplasma pneumoniae and Chlamydophila pneumoniae infection were evaluated for by polymerase chain reaction and serologic testing. Results: Nasopharyngeal concentrations of TNF-α, IL-1β, and IL-10 were significantly and persistently lower in children treated with clarithromycin compared with placebo. There tended to be a greater effect of clarithromycin on nasopharyngeal cytokine concentrations in patients with evidence of C pneumoniae or C pneumoniae infection. No significant differences were detected in serum cytokines for children treated with clarithromycin compared with placebo. Conclusion: Clarithromycin therapy reduces mucosal TNF-α, IL-1β, and IL-10 concentrations in children with an acute exacerbation of recurrent wheezing.

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