Chest
Clinical InvestigationsAsthmaEvaluation of Blood Vessels and Edema in the Airways of Asthma Patients: Regulation With Clarithromycin Treatment
Section snippets
Subjects
Twenty-five subjects were recruited via newspaper and radio advertisement from the general Denver, CO community. Nine of these subjects came from our previous report of M pneumoniae detection by polymerase chain reaction.13 Sixteen subjects were new to this study. The asthmatic patients (n = 15) fulfilled criteria for asthma exhibiting a provocative concentration of methacholine causing a 20% fall in FEV1 (PC20) of < 8 mg/mL and reversibility of lung function by at least 15% with a
Subjects
The characteristics of asthmatic patients and normal control subjects are shown in Table 1. The gender distribution and the age of subjects were similar between asthmatic patients and normal control subjects. The baseline FEV1 percent predicted and PC20 were significantly lower in asthmatic patients than in normal control subjects. Five of 15 asthmatic patients were receiving inhaled steroids. None of the asthmatic patients received oral steroids. At baseline, no significant differences were
Discussion
This study demonstrates that as compared to normal control subjects, asthmatic patients had increased size of blood vessels, but not vascularity and the number of blood vessels. Moreover, the edematous area in airway submucosa was similar between the two groups. Antibiotic therapy in asthmatic patients increased the number of blood vessels but reduced the edematous area. Interestingly, after antibiotic treatment, M pneumoniae-positive asthmatic patients had significantly increased vascularity
References (26)
- et al.
Cellular and protein changes in bronchial lavage fluid after late asthmatic reaction in patients with red cedar asthma
J Allergy Clin Immunol
(1987) - et al.
Allergen challenge-induced entry of α2-macroglobulin and tryptase into human nasal and bronchial airways
J Allergy Clin Immunol
(1995) - et al.
Effect of clarithromycin on experimental rhinovirus-16 colds: a randomized, double-blind, controlled trial
Am J Med
(2000) - et al.
Erythromycin suppresses interleukin 6 expression by human bronchial epithelial cells: a potential mechanism of its anti-inflammatory action
Biochem Biophys Res Commun
(1995) - et al.
Airway remodeling and repair
Am J Respir Crit Care Med
(1999) - et al.
Asthma: from bronchoconstriction to airways inflammation and remodeling
Am J Respir Crit Care Med
(2000) - et al.
Small airway dimensions in asthma and in chronic obstructive pulmonary disease
Am Rev Respir Dis
(1993) - et al.
Increased vascularity of the bronchial mucosa in mild asthma
Am J Respir Crit Care Med
(1997) - et al.
Bronchial blood vessel dimensions in asthma
Am J Respir Crit Care Med
(1997) - et al.
Airway inflammation and remodeling in asthma
Curr Opin Pulm Med
(2000)
Plasma exudation and oedema in asthma
Br Med Bull
Respiratory membrane permeability and bronchial hyperreactivity in patients with stable asthma: effects of therapy with inhaled steroids
Am Rev Respir Dis
Increased bronchovascular permeability after allergen exposure in sensitive asthmatics
J Appl Physiol
Cited by (36)
Bronchial Circulation
2021, Encyclopedia of Respiratory Medicine, Second EditionAsthma: Pathogenesis and Phenotypes
2015, Murray and Nadel's Textbook of Respiratory Medicine: Volume 1,2, Sixth EditionPediatric Asthma: Guidelines-Based Care, Omalizumab, and Other Potential Biologic Agents
2015, Immunology and Allergy Clinics of North AmericaCitation Excerpt :More recently, several small studies have suggested that the use of macrolides in children with asthma may reduce bronchial hyperresponsiveness and airway neutrophils, and shorten the duration of symptoms.64,65 There is also some evidence to suggest that asthmatics with colonization by Chlamydia pneumoniae or Mycoplasma pneumoniae may have more benefit from macrolides.16,66,67 Some clinicians have argued that, given the low risk nature of macrolides, a trial of therapy in refractory asthmatics is reasonable, although this recommendation has yet to become part of the US guidelines for pediatric asthma management.5,10
Asthma. A Chronic Infectious Disease?
2012, Clinics in Chest MedicineCitation Excerpt :However, because macrolide antibiotics have been suggested to have some direct anti-inflammatory effects, it is not possible to exclude the possibility that these results may be caused by their anti-inflammatory effect. For example, clarithromycin treatment in patients with asthma could reduce the edematous area as identified by α2-macroglobulin staining, which may lead to airway tissue shrinkage and cause an artificial increase in the number of blood vessels.70 It is possible that chronic airway infection by atypical bacteria promotes persistent airway inflammation that favors progression of asthma and action of viruses or allergens.
Angiogenesis and remodelling in asthma
2009, Revue Francaise d'AllergologieVascular endothelial growth factor-mediated induction of angiogenesis by human rhinoviruses
2006, Journal of Allergy and Clinical Immunology
Supported by the American Lung Association-ARC, and the National Heart, Lung, and Blood Institute, HL 36577.
Drs. Martin and Kraft have received grant funding from Abbott Laboratories.