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Boost of mucosal secretory immunoglobulin A response by clarithromycin in paediatric influenza
Takako Sawabuchi1, Satoshi Suzuki, Kazuhiro Iwase
1Division of Enzyme Chemistry, Institute for Enzyme Research, Tokushima University, Tokushima 770-8503, Japan.
Background And Objective:
The antiviral neuraminidase inhibitor oseltamivir (OSV) is used to treat influenza. The macrolide clarithromycin (CAM) is used to treat bacterial infections and has anti-inflammatory and immunomodulatory activities. This retrospective study investigated the immunomodulatory effects of CAM in children presenting with influenza A.
Methods:
The study recruited 40 children with acute influenza, and grouped them according to the treatment received: 5-day treatment with OSV (n = 14), CAM (n = 8), OSV + CAM (n = 12) and untreated (n = 6). The before and after treatment comparisons were made of the level of secretory IgA (sIgA) against influenza A virus (H3N2) and (H1N1), total sIgA, viral RNA copy numbers in nasopharyngeal aspirates and disease symptoms.
Results:
Infection induced anti-viral mucosal sIgA in the nasopharyngeal aspirates of most patients of all treatment groups. Particularly prominent increases in the levels were found in the CAM and OSV + CAM groups. Low induction of anti-viral sIgA was observed in the OSV group, but the addition of CAM to OSV augmented sIgA production and restored local mucosal sIgA levels. The frequency of residual cough in the OSV + CAM group was significantly lower than in the other groups including the group treated with OSV.
Conclusions:
CAM boosted the nasopharyngeal mucosal immune response in children presenting with influenza A, even in those treated with OSV who had low production of mucosal anti-viral sIgA, and alleviated the symptoms of influenza.
Insights
Clarithromycin (CAM) enhances the mucosal immune response against influenza A in children. This boosts secretory IgA (sIgA) levels and alleviates symptoms, even when combined with oseltamivir (OSV).
Area of Science:
- Immunology
- Virology
- Pediatrics
Background:
- Oseltamivir (OSV) is an antiviral for influenza.
- Clarithromycin (CAM) is an antibiotic with immunomodulatory effects.
- Investigated CAM's immunomodulatory effects in pediatric influenza A.
Purpose of the Study:
- To evaluate the immunomodulatory effects of clarithromycin (CAM) in children with influenza A.
- To assess the impact of CAM on mucosal immune response and symptoms.
Main Methods:
- Retrospective study of 40 children with influenza A.
- Groups: OSV, CAM, OSV + CAM, untreated.
- Measured secretory IgA (sIgA) and viral RNA in nasopharyngeal aspirates.
Main Results:
- CAM and OSV + CAM groups showed prominent increases in anti-viral sIgA.
- OSV alone showed low sIgA induction; CAM addition augmented sIgA.
- OSV + CAM group had significantly less residual cough.
Conclusions:
- CAM boosted nasopharyngeal mucosal immune response in pediatric influenza A.
- CAM enhanced sIgA production, even with OSV treatment.
- CAM alleviated influenza symptoms.
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