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Evidence of improved small airways function after azithromycin treatment in diffuse panbronchiolitis
Shane Hanon1, Sylvia Verbanck, Daniel Schuermans
1Respiratory Division, University Hospital UZ Brussel, Brussels, Belgium. shane.hanon@uzbrussel.be
Summary
Azithromycin improved symptoms and lung function in diffuse panbronchiolitis (DPB). However, small airway dysfunction persisted, suggesting structural damage in DPB that azithromycin does not reverse.
Area of Science:
- Pulmonology
- Respiratory Medicine
- Pharmacology
Background:
- Diffuse panbronchiolitis (DPB) is a chronic inflammatory airway disease.
- Small airway dysfunction is a key feature of DPB.
Observation:
- A 67-year-old never-smoker with DPB was treated with azithromycin.
- Lung function, including multiple breath nitrogen washout (MBW), was monitored for 16 months.
Findings:
- Azithromycin improved symptoms, FEV1, FVC, RV/TLC, and S(cond) (conductive space ventilation heterogeneity).
- S(acin) (acinar space ventilation heterogeneity) showed initial improvement but remained abnormal.
- FEF(75) and TL(CO) showed no consistent changes.
Implications:
- Azithromycin effectively treats DPB symptoms and improves conductive airway function.
- Persistent S(acin) abnormalities suggest irreversible acinar structural damage in DPB.
- Further research is needed to address structural abnormalities in DPB.
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