Systemic administration of macrolide antibiotics results in intracellular accumulation of the compounds that may modulate various cellular functions. The immunomodulatory effects may be significant among the non-antimicrobial activities and be of pronounced importance in certain disease states. Alteration of phospholipid metabolism as well as modulation of NF-κB activity participate in the immunomodulatory effects: secretion of proinflammatory cytokines is reduced. Clinically relevant immunomodulation is seen is several chronic inflammatory diseases, such as diffuse panbronchiolitis, bronchiectasy, chronic sinusitis and Crohn's disease. Macrolides - especially clarithromycin - possess pronounced anti-tumor effects, anti-angiogenesis may be pivotal among them. In the case of multiple myeloma, the effect of clarithromycin monotherapy is uncertain, however, the recently inroduced BLTD protocol (clarithromycin, low-dose thalidomide and dexamethason) is reported to be one of the most effective experimental regimes, even in post-transplant relapsing or therapy-resistant disease cases.
|Number of pages||9|
|Publication status||Published - Dec 1 2002|
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