ITEM METADATA RECORD
Title: Anti-inflammatory and immunomodulatory properties of azithromycin involved in treatment and prevention of chronic lung allograft rejection
Authors: Vos, Robin ×
Vanaudenaerde, Bart
Verleden, Stijn
Ruttens, David
Vaneylen, Annemie
Van Raemdonck, Dirk
dupont, Lieven
Verleden, Geert #
Issue Date: Jul-2012
Publisher: Lippincott Williams & Wilkins
Series Title: Transplantation vol:94 issue:2 pages:101-9
Abstract: Chronic lung allograft rejection is the single most important cause of death in lung transplant recipients after the first postoperative year, resulting in a 5-year survival rate of approximately 50%, which is far behind that of other solid organ transplantations. Spirometry is routinely used as a clinical marker for assessing pulmonary allograft function and diagnosing chronic lung allograft rejection after lung transplantation (LTx). As such, a progressive obstructive decline in pulmonary allograft function (forced expiratory volume in 1 sec [FEV1]) in absence of all other causes (currently defined as bronchiolitis obliterans syndrome [BOS]) is considered to reflect the evolution of chronic lung allograft rejection. BOS has a 5-year prevalence of approximately 45% and is thought to be the final common endpoint of various alloimmunologic and nonalloimmunologic injuries to the pulmonary allograft, triggering different innate and adaptive immune responses. Most preventive and therapeutic strategies for this complex process have thus far been largely unsuccessful. However, the introduction of the neomacrolide antibiotic azithromycin (AZI) in the field of LTx as of 2003 made it clear that some patients with established BOS might in fact benefit from such therapy due to its various antiinflammatory and immunomodulatory properties, as summarized in this review. Particularly in patients with an increased bronchoalveolar lavage neutrophilia (i.e., 15%-20% or more), AZI treatment could result in an increase in FEV1 of at least 10%. More recently, it has become clear that prophylactic therapy with AZI actually may prevent BOS and improve FEV1 after LTx, most likely through its interactions with the innate immune system. However, one should always be aware of possible adverse effects related to AZI when implementing this drug as prophylactic or long-term treatment. Even so, AZI therapy after LTx can generally be considered as safe.
ISSN: 0041-1337
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Experimental Thoracic Surgery
Pneumology
× corresponding author
# (joint) last author

Files in This Item:

There are no files associated with this item.

 


All items in Lirias are protected by copyright, with all rights reserved.

© Web of science