Immunomodulatory role of azithromycin: Potential applications to radiation-induced lung injury

Area of Science:

• Oncology
• Pulmonology
• Pharmacology

Background:

• Radiation-induced lung injury (RILI), encompassing pneumonitis and fibrosis, is a common radiotherapy side effect for thoracic tumors.
• RILI pathogenesis involves intense pro-inflammatory responses and immune system overactivity.
• Azithromycin, a macrolide antibiotic, possesses known immunomodulatory and anti-inflammatory properties.

Purpose of the Study:

• To review the current evidence on azithromycin's mechanisms of action.
• To focus on the potential therapeutic effects of azithromycin in mitigating radiation-induced lung injury.
• To explore azithromycin's impact on the immune response in RILI.

Main Methods:

• Literature review of preclinical and clinical studies.
• Analysis of azithromycin's immunomodulatory effects.
• Examination of its impact on cytokine production, macrophage function, autophagy, and neutrophil influx.

Main Results:

• Azithromycin demonstrates potential benefits in preclinical RILI models.
• Its immunomodulatory effects include inhibiting pro-inflammatory cytokine production.
• Azithromycin may regulate macrophage function, influence autophagy, and reduce neutrophil infiltration.

Conclusions:

• Azithromycin's anti-inflammatory and immunomodulatory properties suggest a potential role in managing RILI.
• Further clinical investigation is warranted to confirm its efficacy in patients with radiation-induced lung injury.
• Targeting the immune response with azithromycin may offer a novel therapeutic strategy for RILI.