• 四川大學(xué)華西醫(yī)院呼吸內(nèi)科(四川成都610041);

抗生素在哮喘當中的應(yīng)用一直備受爭議。近年的研究主要集中于大環(huán)內(nèi)酯類抗生素(Macrolides)的非抗菌效應(yīng),已有研究發(fā)現(xiàn)l4元環(huán)和l5元環(huán)的大環(huán)內(nèi)酯類抗生素具有類激素樣抗炎活性[1]。作為新一代大環(huán)內(nèi)酯類衍生物的泰利霉素(Telithromycin)由于其獨特的抗細菌耐藥性,一問世便受到廣泛關(guān)注,而近期公布的TELICAST試驗(The Telithromycin,Chlamydophila,and Asthma Trial)中關(guān)于其在哮喘急性加重療效方面的結(jié)果更是令人振奮。該試驗發(fā)現(xiàn),對已確診的哮喘急性加重期患者,在指南推薦的常規(guī)治療基礎(chǔ)上加用為期10 d的泰利霉素口服(800 mg/d),可使哮喘癥狀評分明顯下降,肺功能指標改善,但其發(fā)揮療效的機制尚不十分清楚[2]。

引用本文: 姚蓉,梁宗安. 大環(huán)內(nèi)酯類抗生素治療哮喘. 中國呼吸與危重監(jiān)護雜志, 2007, 6(5): 326-328. doi: 復(fù)制

1. Avila PC,Boushey HA.Macrolides,asthma,inflammation,and infection.Ann Allergy Asthma Immunol,2000,84:565-568.
2. Johnston SL,Blasi F,Black PN,et al.The effect of telithromycin in acute exacerbations of asthma.N Engl J Med,2006,354:1589-1600.
3. 顧覺奮,周海斌.新一代大環(huán)內(nèi)酯類抗生素—酮內(nèi)酯類簡介.抗感染藥學(xué),2006,3:49-53.
4. 王登旭,王二兵,彭向前.泰利霉素的藥理作用及臨床應(yīng)用.中國藥物與臨床,2005,5:524-525.
5. Balfour JA,F(xiàn)iggitt DP.Telithromycin.Drugs,2001,61:815-829.
6. Felmingham D.Microbiological profile of telithromycin,the first ketolides antimicrobial.Clin Microbiol Infect,2001,7(Suppl 3):2-10.
7. Lieberman D,Lieberman D,Printz S,et al.Atypical pathogen infection in adults with acute exacerbation of bronchial asthma.Am J Respir Crit Care Med,2003,167:406-410.
8. Blasi F.Atypical pathogens and respiratory tract infections.Eur Respir J,2004,24:171-181.
9. Little FF.Treating acute asthma with antibiotics--not quite yet.N Engl J Med,2006,354:1632-1634.
10. Bousquet J,Jeffery PK,Busse WW,et al Asthma.From bronchoconstriction to airways inflammation and remodeling.Am J Respir Crit Care Med,2000,161,1720-1745.
11. Garey KW,Alwani A,Danziger LH,et al.Tissue reparative effects of macrolide antibiotics in chronic inflammatory sinopulmonary diseases.Chest,2003,123:261-265.
12. Ogawa N,Sugawara Y,F(xiàn)ujiwara Y,et al.Roxithromycin promotes lymphocyte apoptosis in Dermatophagoides-sensitive asthma patients.Eur J Pharmacol,2003,474:273-281.
13. Wales D,Woodhead M.The anti-inflammatory effects of macrolides.Thorax,1999,54:58-62.
14. Kohyama T,Takizawa H,Kawasaki S,et al.Fourteen-member macrolides inhibit interleukin-8 release by human eosinophils from atopic donors.Antimicrob Agents Chemother,1999,43:907-911.
15. 沈慧,沈策.大環(huán)內(nèi)酯類藥物對免疫調(diào)節(jié)作用的研究進展.國外醫(yī)學(xué)呼吸系統(tǒng)分冊,2005,25:818-821.
16. Tagaya E,Tamaoki J,Kondo M,et al.Effect of a short course of clarithromycin therapy on sputum production in patients with chronic airway hypersecretion.Chest,2002,122:213-218.
17. Niven AS,Argyros G.Alternate treatment in asthma.Chest,2003,123:1254-1265.
18. Manchee GR,Eddershaw PJ,Ranshaw LE,et al.The aliphatic oxidation of salmeterol to alpha-hydroxysalmeterol in human liver microsomes is catalyzed by CYP3A.Drug Metab Dispos,1996,24:555-559.
19. Nosaka H,Nadai M,Kato M,et al.Effect of a newly developed ketolide antibiotic,telithromycin,on metabolism of theophylline and expression of cytochrome P450 in rats.Life Sci,2006,79:50-56.
20. Peeters TL.Erythromycin and other macrolides as prokinetic agents.Gastroenterology,1993,105:1886-1899.
21. Caramori G,Papi A.Telithromycin in acute exacerbations of asthma.N Engl J Med,2006,355:96-98.
  1. 1. Avila PC,Boushey HA.Macrolides,asthma,inflammation,and infection.Ann Allergy Asthma Immunol,2000,84:565-568.
  2. 2. Johnston SL,Blasi F,Black PN,et al.The effect of telithromycin in acute exacerbations of asthma.N Engl J Med,2006,354:1589-1600.
  3. 3. 顧覺奮,周海斌.新一代大環(huán)內(nèi)酯類抗生素—酮內(nèi)酯類簡介.抗感染藥學(xué),2006,3:49-53.
  4. 4. 王登旭,王二兵,彭向前.泰利霉素的藥理作用及臨床應(yīng)用.中國藥物與臨床,2005,5:524-525.
  5. 5. Balfour JA,F(xiàn)iggitt DP.Telithromycin.Drugs,2001,61:815-829.
  6. 6. Felmingham D.Microbiological profile of telithromycin,the first ketolides antimicrobial.Clin Microbiol Infect,2001,7(Suppl 3):2-10.
  7. 7. Lieberman D,Lieberman D,Printz S,et al.Atypical pathogen infection in adults with acute exacerbation of bronchial asthma.Am J Respir Crit Care Med,2003,167:406-410.
  8. 8. Blasi F.Atypical pathogens and respiratory tract infections.Eur Respir J,2004,24:171-181.
  9. 9. Little FF.Treating acute asthma with antibiotics--not quite yet.N Engl J Med,2006,354:1632-1634.
  10. 10. Bousquet J,Jeffery PK,Busse WW,et al Asthma.From bronchoconstriction to airways inflammation and remodeling.Am J Respir Crit Care Med,2000,161,1720-1745.
  11. 11. Garey KW,Alwani A,Danziger LH,et al.Tissue reparative effects of macrolide antibiotics in chronic inflammatory sinopulmonary diseases.Chest,2003,123:261-265.
  12. 12. Ogawa N,Sugawara Y,F(xiàn)ujiwara Y,et al.Roxithromycin promotes lymphocyte apoptosis in Dermatophagoides-sensitive asthma patients.Eur J Pharmacol,2003,474:273-281.
  13. 13. Wales D,Woodhead M.The anti-inflammatory effects of macrolides.Thorax,1999,54:58-62.
  14. 14. Kohyama T,Takizawa H,Kawasaki S,et al.Fourteen-member macrolides inhibit interleukin-8 release by human eosinophils from atopic donors.Antimicrob Agents Chemother,1999,43:907-911.
  15. 15. 沈慧,沈策.大環(huán)內(nèi)酯類藥物對免疫調(diào)節(jié)作用的研究進展.國外醫(yī)學(xué)呼吸系統(tǒng)分冊,2005,25:818-821.
  16. 16. Tagaya E,Tamaoki J,Kondo M,et al.Effect of a short course of clarithromycin therapy on sputum production in patients with chronic airway hypersecretion.Chest,2002,122:213-218.
  17. 17. Niven AS,Argyros G.Alternate treatment in asthma.Chest,2003,123:1254-1265.
  18. 18. Manchee GR,Eddershaw PJ,Ranshaw LE,et al.The aliphatic oxidation of salmeterol to alpha-hydroxysalmeterol in human liver microsomes is catalyzed by CYP3A.Drug Metab Dispos,1996,24:555-559.
  19. 19. Nosaka H,Nadai M,Kato M,et al.Effect of a newly developed ketolide antibiotic,telithromycin,on metabolism of theophylline and expression of cytochrome P450 in rats.Life Sci,2006,79:50-56.
  20. 20. Peeters TL.Erythromycin and other macrolides as prokinetic agents.Gastroenterology,1993,105:1886-1899.
  21. 21. Caramori G,Papi A.Telithromycin in acute exacerbations of asthma.N Engl J Med,2006,355:96-98.