Common asthma drug azithromycin boosts immune defenses against viruses
A randomized trial shows azithromycin strengthens the airway's antiviral response to rhinovirus in patients with uncontrolled asthma, potentially explaining why the antibiotic reduces asthma attacks triggered by infections. The finding could reshape treatment protocols for severe asthma and inform drug development targeting viral-induced respiratory disease.
Originaltitel: Azithromycin enhances epithelial antiviral immunity in uncontrolled asthma: results from the AZIMUNE randomized controlled trial
BACKGROUND: Viral respiratory infections are the leading trigger of asthma exacerbations and impaired epithelial type I and III interferon responses may contribute to more severe exacerbations. Azithromycin reduces exacerbations clinically, but its effects on epithelial antiviral immunity remain unclear. This study investigated whether azithromycin treatment enhances airway epithelial antiviral responses and modulates alarmin concentration in patients with uncontrolled asthma. METHODS: bronchoscopy at baseline and after week 12, and cultured and infected ex vivo with rhinovirus. Protein levels of IFN-β, IFN-λ, alarmins (IL-33 and thymic stromal lymphopoietin (TSLP)), and proinflammatory cytokines were quantified. RESULTS: placebo were not statistically significant. CONCLUSIONS: Azithromycin enhances epithelial antiviral immunity and attenuates IL-33 concentration in response to rhinoviral infection in asthma. The dual immunomodulatory effect of azithromycin supports its role as adjunctive therapy to prevent virus-induced exacerbations.