毛细支气管炎
喘息
阿奇霉素
医学
儿科
气道
哮喘
内科学
呼吸系统
麻醉
微生物学
生物
抗生素
作者
Avraham Beigelman,Charles W. Goss,Jinli Wang,Mythili Srinivasan,Jonathan S. Boomer,Yanjiao Zhou,S Bram,Timothy J. Casper,Andrea M. Coverstone,Watcharoot Kanchongkittiphon,Cadence Kuklinski,Gregory A. Storch,Kenneth B. Schechtman,Mario Castro,Leonard B. Bacharier
标识
DOI:10.1016/j.anai.2024.01.001
摘要
Early-life RSV bronchiolitis is a significant risk factor for childhood asthma. In-vitro and in-vivo studies suggested that decreasing airway matrix metalloprotease (MMP)-9 during RSV bronchiolitis may be associated with clinical benefits.We aimed to investigate if azithromycin therapy during severe RSV bronchiolitis reduces upper airway MMP-9 levels, if upper airway MMP-9 levels correlate with upper airway IL-8 levels, and whether MMP-9 levels reduction is associated with reduced post-RSV recurrent wheeze (RW).Two hundred otherwise healthy 1-18 month-old infants hospitalized with RSV bronchiolitis were randomized into a double-blind, placebo-controlled trial of oral azithromycin (10mg/kg daily for seven days followed by 5mg/kg daily for seven days) or placebo. Infants were followed for 2-4 years for the outcome of RW (3 or more wheezing episodes). Nasal lavage samples for MMP-9 levels were obtained at baseline, day 14 (end of study treatment), and six months later.Upper airway MMP-9 levels were highly correlated with IL-8 levels at all three-time points: randomization, day 14, and six months (r=0.80; p<0.0001 for all time points). MMP-9 levels were similar between treatment groups at randomization, were lower on day 14 among children treated with azithromycin (p=0.0085), but no longer different six months later. MMP-9 levels at baseline and change from baseline to day 14 were not associated with the development of RW (p=0.49, 0.39, respectively).Azithromycin therapy in children hospitalized with RSV bronchiolitis had a short-term anti-inflammatory effect in reducing upper airway MMP-9 levels. However, the reduction in MMP-9 levels did not relate to subsequent RW post-RSV.
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