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Macrolides inhibit epithelial cell-mediated neutrophil survival by modulating granulocyte macrophage colony-stimulating factor release.

Abstract
Macrolides have been shown to be effective in treating diffuse panbronchiolitis (DPB), although the precise modes of action remain unclear. At sites of airway inflammation, respiratory epithelium is considered an active participant in regulating neutrophil survival. We therefore examined the effect of erythromycin, clarithromycin, azithromycin, and josamycin on both neutrophil survival and on epithelial-derived factors, which influence neutrophil longevity. Media conditioned with transiently tumor necrosis factor (TNF)-alpha-stimulated A549 human airway epithelial cells prolonged neutrophil survival compared with control media. The presence of dexamethasone during neutrophil culture led to further prolongation of neutrophil survival. In contrast, none of the tested macrolides modulated neutrophil survival, suggesting a lack of direct effect of these drugs. On the other hand, pretreatment of TNF-alpha-stimulated A549 cells by erythromycin, clarithromycin, azithromycin, or dexamethasone, but not josamycin, decreased the neutrophil survival-enhancing effects in a dose-dependent manner. Neutralizing antibodies to granulocyte macrophage colony-stimulating factor (GM-CSF) dampened the prolonged neutrophil survival observed in TNF-alpha-stimulated A549 conditioned media. Erythromycin, clarithromycin, azithromycin, and dexamethasone inhibited TNF-alpha-induced GM-CSF expression in A549 cells at both the protein and messenger RNA levels. These results suggest that macrolides inhibit epithelial cell-mediated neutrophil survival by modulating GM-CSF release, which may, at least in part, explain the effectiveness of this family of drugs on DPB.
AuthorsHideaki Yamasawa, Katsuhisa Oshikawa, Shoji Ohno, Yukihiko Sugiyama
JournalAmerican journal of respiratory cell and molecular biology (Am J Respir Cell Mol Biol) Vol. 30 Issue 4 Pg. 569-75 (Apr 2004) ISSN: 1044-1549 [Print] United States
PMID14551160 (Publication Type: Journal Article)
Chemical References
  • Antibodies
  • Culture Media, Conditioned
  • Macrolides
  • RNA, Messenger
  • Tumor Necrosis Factor-alpha
  • Dexamethasone
  • Granulocyte-Macrophage Colony-Stimulating Factor
  • Josamycin
Topics
  • Antibodies (pharmacology)
  • Cell Survival (drug effects)
  • Cells, Cultured
  • Culture Media, Conditioned (pharmacology)
  • Dexamethasone (pharmacology)
  • Dose-Response Relationship, Drug
  • Epithelial Cells (cytology)
  • Granulocyte-Macrophage Colony-Stimulating Factor (drug effects, genetics, immunology, metabolism)
  • Humans
  • Josamycin (pharmacology)
  • Macrolides (pharmacology)
  • Neutrophils (drug effects, metabolism)
  • RNA, Messenger (drug effects, metabolism)
  • Respiratory System (drug effects, pathology)
  • Tumor Necrosis Factor-alpha (pharmacology)

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