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Macrolide Use in Chronic Obstructive Pulmonary Disease

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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

Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory airway disease characterized by non-reversible airflow limitation and chronic respiratory symptoms. Symptoms may periodically worsen during events called acute exacerbations (AECOPD), which are associated with increased airway inflammation. AECOPD are the main drivers of poor disease outcomes, making their prevention and effective treatment key elements of COPD care. Because a significant proportion of events have an infectious trigger, antibiotics remain a mainstay of exacerbation management. Particularly as prophylaxis, macrolides have been associated with greater benefit compared with other antibiotic classes, possibly due to their additive immunomodulatory actions. However, treatment failures are frequent, the effectivity of long-term administration is unclear, and there is concern for the risk of adverse events and bacterial resistance. Presumably, patients with frequent and bacteria-associated exacerbations benefit most. Yet, a better characterization of the responding disease traits is vital, both for prophylaxis and treatment of exacerbations.

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Authors and Affiliations

  1. Department of Respiratory Diseases, University Hospitals Leuven & BREATHE lab, department CHROMETA, KU, Leuven, Belgium

    Iwein Gyselinck & Wim Janssens

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  1. Iwein Gyselinck
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  2. Wim Janssens
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Correspondence to Iwein Gyselinck .

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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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© 2024 The Author(s), under exclusive license to Springer Nature Switzerland AG

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Gyselinck, I., Janssens, W. (2024). Macrolide Use in Chronic Obstructive Pulmonary Disease. 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_6

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