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Published on: December 15, 2014
Macrolide Use and Neutrophil Function/Cytokine Levels in Hospitalized Patients with Community-Acquired Pneumonia: A
Forest W Arnold1, Jose Bordon2, Rafael Fernandez-Botran3
1Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, 501 E. Broadway; Suite 140 B, Louisville, KY, 40202, USA. f.arnold@louisville.edu.
Purpose:
The objective of this study was to measure plasma cytokine levels and blood neutrophil functions as well as clinical outcomes in hospitalized patients with community-acquired pneumonia (CAP) treated with or without macrolide use--a known modulator of inflammatory response.
Methods:
Subjects with CAP had peripheral blood analyzed for some neutrophil functions (degranulation of secretory vesicles and specific granules, respiratory burst response and phagocytosis) and ten cytokine levels measured in serum and sputum supernatants. Neutrophil function in healthy volunteers was also measured for reference. Values were measured on the day of enrollment, days 2-4 and 5-7, depending on a patient's length of stay. Early and late clinical outcomes were also evaluated. All values were compared between those treated with or without a macrolide.
Results:
A total of 40 subjects were in this study; 14 received macrolide treatment, and 26 did not. Neutrophil function in the macrolide group was not significantly different compared to the non-macrolide group. None of the median cytokine levels or IQRs were statistically significant between the groups. However, a trend toward decreased IL-6, IL-8, and IFN-γ levels, and favorable clinical outcomes were present in the macrolide group.
Conclusions:
This pilot study showed no statistical difference between cytokine levels or neutrophil activity for CAP patients prescribed a macrolide containing regimen. Considering the trend of lower cytokine levels in the macrolide group when comparing the 5- to 7-day time period with the non-macrolide group, a full study with an appropriate sample size may be warranted.
Insights
This pilot study found no significant difference in neutrophil function or cytokine levels in community-acquired pneumonia (CAP) patients treated with macrolides. However, trends suggested potential benefits, warranting further research.
Area of Science:
- Immunology
- Infectious Diseases
- Pharmacology
Background:
- Community-acquired pneumonia (CAP) is a significant cause of morbidity and mortality.
- Macrolides are known modulators of inflammatory responses, but their impact on specific immune markers in CAP is not fully elucidated.
- Understanding the interplay between macrolide treatment, inflammatory markers, and clinical outcomes is crucial for optimizing CAP management.
Purpose of the Study:
- To measure plasma cytokine levels and blood neutrophil functions in hospitalized CAP patients.
- To compare these immune parameters and clinical outcomes between patients treated with and without macrolides.
- To investigate the potential immunomodulatory effects of macrolides in CAP.
Main Methods:
- Peripheral blood neutrophil functions (degranulation, respiratory burst, phagocytosis) and serum/sputum cytokine levels were analyzed in 40 CAP patients.
- Measurements were taken at enrollment, days 2-4, and days 5-7, with comparisons between macrolide and non-macrolide groups.
- Clinical outcomes were assessed, and neutrophil function in healthy volunteers served as a reference.
Main Results:
- No significant differences in neutrophil function or median cytokine levels were observed between the macrolide (n=14) and non-macrolide (n=26) groups.
- A trend towards decreased interleukin-6 (IL-6), interleukin-8 (IL-8), and interferon-gamma (IFN-γ) levels was noted in the macrolide group.
- Favorable clinical outcomes also showed a trend in patients receiving macrolide treatment.
Conclusions:
- This pilot study did not demonstrate statistically significant differences in cytokine levels or neutrophil activity in CAP patients receiving macrolides.
- The observed trends of lower cytokine levels and improved clinical outcomes in the macrolide group suggest that a larger study is warranted.
- Further investigation with an adequate sample size may clarify the immunomodulatory role of macrolides in CAP treatment.
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