抗生素在哮喘當(dāng)中的應(yīng)用一直備受爭議。近年的研究主要集中于大環(huán)內(nèi)酯類抗生素(Macrolides)的非抗菌效應(yīng),已有研究發(fā)現(xiàn)l4元環(huán)和l5元環(huán)的大環(huán)內(nèi)酯類抗生素具有類激素樣抗炎活性[1]。作為新一代大環(huán)內(nèi)酯類衍生物的泰利霉素(Telithromycin)由于其獨(dú)特的抗細(xì)菌耐藥性,一問世便受到廣泛關(guān)注,而近期公布的TELICAST試驗(yàn)(The Telithromycin,Chlamydophila,and Asthma Trial)中關(guān)于其在哮喘急性加重療效方面的結(jié)果更是令人振奮。該試驗(yàn)發(fā)現(xiàn),對已確診的哮喘急性加重期患者,在指南推薦的常規(guī)治療基礎(chǔ)上加用為期10 d的泰利霉素口服(800 mg/d),可使哮喘癥狀評分明顯下降,肺功能指標(biāo)改善,但其發(fā)揮療效的機(jī)制尚不十分清楚[2]。
引用本文: 姚蓉,梁宗安. 大環(huán)內(nèi)酯類抗生素治療哮喘. 中國呼吸與危重監(jiān)護(hù)雜志, 2007, 6(5): 326-328. doi: 復(fù)制
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1. | Avila PC,Boushey HA.Macrolides,asthma,inflammation,and infection.Ann Allergy Asthma Immunol,2000,84:565-568. |
2. | Johnston SL,Blasi F,Black PN,et al.The effect of telithromycin in acute exacerbations of asthma.N Engl J Med,2006,354:1589-1600. |
3. | 顧覺奮,周海斌.新一代大環(huán)內(nèi)酯類抗生素—酮內(nèi)酯類簡介.抗感染藥學(xué),2006,3:49-53. |
4. | 王登旭,王二兵,彭向前.泰利霉素的藥理作用及臨床應(yīng)用.中國藥物與臨床,2005,5:524-525. |
5. | Balfour JA,F(xiàn)iggitt DP.Telithromycin.Drugs,2001,61:815-829. |
6. | Felmingham D.Microbiological profile of telithromycin,the first ketolides antimicrobial.Clin Microbiol Infect,2001,7(Suppl 3):2-10. |
7. | Lieberman D,Lieberman D,Printz S,et al.Atypical pathogen infection in adults with acute exacerbation of bronchial asthma.Am J Respir Crit Care Med,2003,167:406-410. |
8. | Blasi F.Atypical pathogens and respiratory tract infections.Eur Respir J,2004,24:171-181. |
9. | Little FF.Treating acute asthma with antibiotics--not quite yet.N Engl J Med,2006,354:1632-1634. |
10. | Bousquet J,Jeffery PK,Busse WW,et al Asthma.From bronchoconstriction to airways inflammation and remodeling.Am J Respir Crit Care Med,2000,161,1720-1745. |
11. | Garey KW,Alwani A,Danziger LH,et al.Tissue reparative effects of macrolide antibiotics in chronic inflammatory sinopulmonary diseases.Chest,2003,123:261-265. |
12. | Ogawa N,Sugawara Y,F(xiàn)ujiwara Y,et al.Roxithromycin promotes lymphocyte apoptosis in Dermatophagoides-sensitive asthma patients.Eur J Pharmacol,2003,474:273-281. |
13. | Wales D,Woodhead M.The anti-inflammatory effects of macrolides.Thorax,1999,54:58-62. |
14. | Kohyama T,Takizawa H,Kawasaki S,et al.Fourteen-member macrolides inhibit interleukin-8 release by human eosinophils from atopic donors.Antimicrob Agents Chemother,1999,43:907-911. |
15. | 沈慧,沈策.大環(huán)內(nèi)酯類藥物對免疫調(diào)節(jié)作用的研究進(jìn)展.國外醫(yī)學(xué)呼吸系統(tǒng)分冊,2005,25:818-821. |
16. | Tagaya E,Tamaoki J,Kondo M,et al.Effect of a short course of clarithromycin therapy on sputum production in patients with chronic airway hypersecretion.Chest,2002,122:213-218. |
17. | Niven AS,Argyros G.Alternate treatment in asthma.Chest,2003,123:1254-1265. |
18. | Manchee GR,Eddershaw PJ,Ranshaw LE,et al.The aliphatic oxidation of salmeterol to alpha-hydroxysalmeterol in human liver microsomes is catalyzed by CYP3A.Drug Metab Dispos,1996,24:555-559. |
19. | Nosaka H,Nadai M,Kato M,et al.Effect of a newly developed ketolide antibiotic,telithromycin,on metabolism of theophylline and expression of cytochrome P450 in rats.Life Sci,2006,79:50-56. |
20. | Peeters TL.Erythromycin and other macrolides as prokinetic agents.Gastroenterology,1993,105:1886-1899. |
21. | Caramori G,Papi A.Telithromycin in acute exacerbations of asthma.N Engl J Med,2006,355:96-98. |
- 1. Avila PC,Boushey HA.Macrolides,asthma,inflammation,and infection.Ann Allergy Asthma Immunol,2000,84:565-568.
- 2. Johnston SL,Blasi F,Black PN,et al.The effect of telithromycin in acute exacerbations of asthma.N Engl J Med,2006,354:1589-1600.
- 3. 顧覺奮,周海斌.新一代大環(huán)內(nèi)酯類抗生素—酮內(nèi)酯類簡介.抗感染藥學(xué),2006,3:49-53.
- 4. 王登旭,王二兵,彭向前.泰利霉素的藥理作用及臨床應(yīng)用.中國藥物與臨床,2005,5:524-525.
- 5. Balfour JA,F(xiàn)iggitt DP.Telithromycin.Drugs,2001,61:815-829.
- 6. Felmingham D.Microbiological profile of telithromycin,the first ketolides antimicrobial.Clin Microbiol Infect,2001,7(Suppl 3):2-10.
- 7. Lieberman D,Lieberman D,Printz S,et al.Atypical pathogen infection in adults with acute exacerbation of bronchial asthma.Am J Respir Crit Care Med,2003,167:406-410.
- 8. Blasi F.Atypical pathogens and respiratory tract infections.Eur Respir J,2004,24:171-181.
- 9. Little FF.Treating acute asthma with antibiotics--not quite yet.N Engl J Med,2006,354:1632-1634.
- 10. Bousquet J,Jeffery PK,Busse WW,et al Asthma.From bronchoconstriction to airways inflammation and remodeling.Am J Respir Crit Care Med,2000,161,1720-1745.
- 11. Garey KW,Alwani A,Danziger LH,et al.Tissue reparative effects of macrolide antibiotics in chronic inflammatory sinopulmonary diseases.Chest,2003,123:261-265.
- 12. Ogawa N,Sugawara Y,F(xiàn)ujiwara Y,et al.Roxithromycin promotes lymphocyte apoptosis in Dermatophagoides-sensitive asthma patients.Eur J Pharmacol,2003,474:273-281.
- 13. Wales D,Woodhead M.The anti-inflammatory effects of macrolides.Thorax,1999,54:58-62.
- 14. Kohyama T,Takizawa H,Kawasaki S,et al.Fourteen-member macrolides inhibit interleukin-8 release by human eosinophils from atopic donors.Antimicrob Agents Chemother,1999,43:907-911.
- 15. 沈慧,沈策.大環(huán)內(nèi)酯類藥物對免疫調(diào)節(jié)作用的研究進(jìn)展.國外醫(yī)學(xué)呼吸系統(tǒng)分冊,2005,25:818-821.
- 16. Tagaya E,Tamaoki J,Kondo M,et al.Effect of a short course of clarithromycin therapy on sputum production in patients with chronic airway hypersecretion.Chest,2002,122:213-218.
- 17. Niven AS,Argyros G.Alternate treatment in asthma.Chest,2003,123:1254-1265.
- 18. Manchee GR,Eddershaw PJ,Ranshaw LE,et al.The aliphatic oxidation of salmeterol to alpha-hydroxysalmeterol in human liver microsomes is catalyzed by CYP3A.Drug Metab Dispos,1996,24:555-559.
- 19. Nosaka H,Nadai M,Kato M,et al.Effect of a newly developed ketolide antibiotic,telithromycin,on metabolism of theophylline and expression of cytochrome P450 in rats.Life Sci,2006,79:50-56.
- 20. Peeters TL.Erythromycin and other macrolides as prokinetic agents.Gastroenterology,1993,105:1886-1899.
- 21. Caramori G,Papi A.Telithromycin in acute exacerbations of asthma.N Engl J Med,2006,355:96-98.