Molecular pathways driving clarithromycin benefit in community-acquired pneumonia: analysis of the ACCESS randomised trial - PubMed
5 hours ago
- #clarithromycin
- #immunomodulation
- #community-acquired pneumonia
- The ACCESS trial showed that adding clarithromycin to standard care in hospitalized CAP patients led to earlier symptom resolution and reduced progression to respiratory failure and sepsis.
- Gene expression analysis indicated clarithromycin upregulated genes involved in T-cell activation and MHC II expression, while downregulating IL-1 receptors and neutrophil degranulation pathways.
- Clarithromycin treatment was associated with decreased IL-1 cytokine production (linked to respiratory failure) and increased monocyte-derived pro-inflammatory cytokines and chemokines (linked to clinical benefit), alongside attenuated anti-inflammatory cytokine production.
- The study concludes that clarithromycin's clinical benefits in CAP may stem from modulating immune pathways, including attenuating IL-1, enhancing antigen presentation, and reducing neutrophil degranulation.