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Macrolides and Asthma Therapy

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Macrolides as Immunomodulatory Agents

Part of the book series: Progress in Inflammation Research ((PIR,volume 92))

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Abstract

Asthma is a chronic condition of the airways that is typified by bronchial hyperresponsiveness, variable airflow obstruction, and airway inflammation. Most patients can achieve disease control using inhaled corticosteroids, with some needing adjunct long-acting bronchodilator therapy. However, an important minority of patients have persistent symptoms and exacerbations despite these treatments. The landmark AMAZES study showed that the macrolide azithromycin significantly reduced the exacerbation rate in this population, using a randomized parallel group design. The efficacy of macrolides in chronic asthma was recently confirmed in a Cochrane systematic review, which analyzed 25 randomized controlled trials with a total of 1973 patients. Mechanistic studies have shown that this therapeutic effect is mediated by reduced mucosal inflammation, improved airway mucus clearance, and favorable modulation of host-pathogen interactions.

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Authors and Affiliations

  1. Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER) Guwahati, Kamrup, Assam, India

    Krishna Undela

  2. Division of Pulmonary Medicine, Department of Medicine, Faculty of Medicine & Dentistry, College of Health Sciences, University of Alberta, Edmonton, AB, Canada

    Adil Adatia & Giovanni Ferrara

  3. Department of Emergency Medicine, Faculty of Medicine & Dentistry and School of Public Health, both in the College of Health Sciences, University of Alberta, Edmonton, AB, Canada

    Brian H. Rowe

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  1. Krishna Undela
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  2. Adil Adatia
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  3. Brian H. Rowe
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  4. Giovanni Ferrara
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Correspondence to Giovanni Ferrara .

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Editors and Affiliations

  1. School of Medicine, Virginia Commonwealth University, Richmond, VA, USA

    Bruce K. Rubin

  2. Clinical Trial Develop & Research Center, Tokyo Shinagawa Hospital, Tokyo, Japan

    Masaharu Shinkai

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Undela, K., Adatia, A., Rowe, B.H., Ferrara, G. (2024). Macrolides and Asthma Therapy. In: Rubin, B.K., Shinkai, M. (eds) Macrolides as Immunomodulatory Agents. Progress in Inflammation Research, vol 92. Springer, Cham. https://doi.org/10.1007/978-3-031-42859-3_7

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