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Side effects of antibiotics on immune response parameters and their possible implications in antimicrobial
1Institute of Medical Microbiology, Medical Faculty, Rheinisch-Westfälische Technische Hochschule, Aachen.
Abstract:
Antibiotics may influence immune response by quite different ways. By screening the multitude of publications on this subject, the aim of this overview was to arrive at a basic generalizing statement on the relationship between chemical structure or mode of action of antibiotics and the effect on immune response and to get an indication on whether certain in vitro and/or ex vivo parameters could represent comparable effects under clinical conditions. - The influence of antibiotics on immune response may arise by direct effects on immunocompetent cells, i.e. in the absence of microorganisms, or indirectly by changes in structure or metabolic products of germs induced by subminimal inhibitory concentrations (subMIC's). In the former case, stimulatory and inhibitory effects have been observed on phagocytosis and intracellular killing activity, on antibody production including IgE, on different parameters of cellular immunity (e.g. foodpad swelling reaction, MIF-production, mitogen/antigen induced lymphocyte proliferation and delayed type hypersensitivity skin reaction), on mediator production as interleukins or prostaglandins and the expression of corresponding receptors on immunocompetent cells as well as on the course of experimental infections with primary resistant microorganisms. - Indirect effects are related to the influence of subMIC's of antibiotics on the morphology and structure of microorganisms, on their antigenicity/immunogenicity or on their serosensitivity and enzyme and toxin production. - This overview shows that - according to the actual knowledge - antibiotics may exhibit immunological side effects which, however, can not strictly be attributed to certain chemical structures or to a certain mode of action. - It has to be considered that a literary study comparing the results of different authors is rendered difficult by the often nonhomogeneity of experimental procedures and the fact that little is known yet about immunological side effects of antibiotics in man, i.e. under clinical conditions.
Insights
Antibiotics can affect the immune system directly or indirectly, influencing various immune cell functions and responses. However, specific antibiotic structures or mechanisms don't consistently predict these immunological side effects in humans.
Area of Science:
- Immunology
- Pharmacology
- Microbiology
Background:
- Antibiotics are known to impact the immune system through various mechanisms.
- Understanding these interactions is crucial for predicting clinical outcomes and potential side effects.
Purpose of the Study:
- To generalize the relationship between antibiotic chemical structure/mode of action and immune response effects.
- To determine if in vitro/ex vivo parameters predict clinical immunological effects of antibiotics.
Main Methods:
- Comprehensive literature screening of publications on antibiotic-immune interactions.
- Analysis of direct effects on immunocompetent cells (in absence of microorganisms).
- Analysis of indirect effects via sub-minimal inhibitory concentrations (subMICs) on microorganisms.
Main Results:
- Antibiotics can directly stimulate or inhibit immune cell functions like phagocytosis, antibody production, and cellular immunity parameters.
- Sub-MICs of antibiotics alter microbial morphology, antigenicity, and toxin production, indirectly affecting immunity.
- No clear correlation established between specific antibiotic structures/mechanisms and predictable immunological side effects.
Conclusions:
- Antibiotics can cause immunological side effects, but these are not consistently linked to specific chemical structures or modes of action.
- Further research is needed to understand antibiotic-induced immunological side effects in humans due to experimental variability and limited clinical data.