|
|
| Line 31: |
Line 31: |
|
| |
|
| == Treatment == | | == Treatment == |
|
| |
| [[Macrolide]] [[antibiotic]]s, such as [[erythromycin]], [[clarithromycin]] and [[roxithromycin]], have proven to be an effective long-term treatment for DPB.<ref name=mac>{{cite journal |author=Keicho N, Kudoh S |title=Diffuse panbronchiolitis: role of macrolides in therapy |journal=Am J Respir Med. |volume=1 |issue=2 |pages=119-131 |year=2002 |pmid=14720066 }}</ref><ref name=mac08>{{cite journal |author=Lopez-Boado YS, Rubin BK |title=Macrolides as immunomodulatory medications for the therapy of chronic lung diseases |journal=Curr Opin Pharmacol. |volume=Epub ahead of print |issue= |pages= |year=2008 |pmid=18339582 }}</ref> The successful results of macrolides in DPB and similar lung diseases stems from controlling symptoms through [[immunomodulation]] (adjusting the immune response),<ref name=mac08/> with the added benefit of [[dosing|low-dose]] requirements.<ref name=mac/>
| |
|
| |
| With macrolide therapy in DPB, great reduction in bronchiolar inflammation and damage is achieved through suppression of not only neutrophil granulocyte proliferation, but also lymphocyte activity and obstructive [[mucus]] and sputum [[secretion]]s in airways.<ref name=mac/> The antimicrobial and antibiotic effects of macrolides, however, are not believed to be involved in their beneficial effects toward treating DPB.<ref name=mac04>{{cite journal |author=Schultz MJ |title=Macrolide activities beyond their antimicrobial effects: macrolides in diffuse panbronchiolitis and cystic fibrosis |journal=J Antimicrob Chemother. |volume=54 |issue=1 |pages=21-28 |year=2004 |pmid=15190022 }}</ref> This is evident, as the treatment dosage is much too low to fight infection, and in DPB cases with the occurrence of macrolide-resistant ''pseudomonas aeruginosa'', macrolide therapy still produces substantial anti-inflammatory results.<ref name=mac/>
| |
|
| |
| Advanced cases of DPB, where severely excessive sputum production resistant to macrolides persists, additional therapy with the inhalant [[tiotropium]] has been shown to ease these symptoms and the related shortness of breath.<ref name=tio>{{cite journal |author=Saito Y, Azuma A, Morimoto T, Fujita K, Abe S, Motegi T, Usuki J, Kudoh S |title=Tiotropium ameliorates symptoms in patients with chronic airway mucus hypersecretion which is resistant to macrolide therapy |journal=Intern Med. |volume=47 |issue=7 |pages=585-591 |year=2008 |pmid=18379141 }}</ref>
| |
|
| |
|
| == See also == | | == See also == |
