Macrolide Use and Innate Immunity Components in Hospitalized Patients with Community-Acquired Pneumonia
Macrolides have been shown to modulate inflammatory responses. Because macrolides have potentially adverse effects, discovering the mechanism of immunomodulation is important. The objective of this study was to measure plasma cytokine levels and blood neutrophil functions in hospitalized patients with community-acquired pneumonia (CAP) treated with and without macrolide use. The secondary objective was to evaluate clinical outcomes in each group.
Subjects had peripheral blood analyzed for neutrophil function (secretory vesicle CD35 and specific granule CD66b release), and ten cytokine levels. Neutrophil function in healthy volunteers was also measured for reference. Values were measured on the day of enrollment and one or two more times over the next seven days depending on a patient’s length of stay. Early and late clinical outcomes were also evaluated. All values were compared between those treated with and without a macrolide.
A total of 40 subjects were in the 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, decreased IL-6, IL-8 and IFN-g levels, and favorable clinical outcomes trended towards significance in the macrolide group.
This pilot study found that the components of innate immunity that were measured were similar between patients with CAP treated with and without a macrolide, which suggests that immunomodulatory properties of macrolides do not include altered neutrophil function or systemic cytokine levels.
F. W. Arnold,
R. Fernandez-Botran, None
S. Uriarte, None
R. Kelley, None
T. L. Wiemken, None
P. Peyrani, None
J. Bordon, None