Astımda uzun süreli makrolid tedavisi

arslan, bahar; Yilmaz, Insu; ÇETİN, gülden

doi:10.5578/tt.20219610

Astımda uzun süreli makrolid tedavisi

Gülden PAÇACI ÇETİN, (Erciyes Üniversitesi Tıp Fakültesi, İmmünoloji ve Alerji Bilim Dalı, Kayseri, Türkiye)

Bahar ARSLAN, (Erciyes Üniversitesi Tıp Fakültesi, İmmünoloji ve Alerji Bilim Dalı, Kayseri, Türkiye)

İnsu YILMAZ (Erciyes Üniversitesi Tıp Fakültesi, İmmünoloji ve Alerji Bilim Dalı, Kayseri, Türkiye)

Tüberküloz ve Toraks

20 1

Yıl: 2021 Cilt: 69 Sayı: 4 Sayfa Aralığı: 520 - 534 Metin Dili: Türkçe DOI: 10.5578/tt.20219610 İndeks Tarihi: 29-05-2022

Astımda uzun süreli makrolid tedavisi

Öz:

Makrolidler bakteriyostatik etkilerinin yanı sıra antiviral, anti-inflamatuvar ve immünmodülatör etkileri olan antibiyotiklerdir. KOAH, kistik fibrozis, diffüz panbronşiolit, bronşektazi gibi kronik solunum yolu hastalıkları üzerine olan yararlı etkilerinin yanında son yıllarda kontrolsüz ağır astım ve alevlenmeleri üzerine olan etkileri de araştırma konusu olmuştur. Randomize kontrollü çalışmalarda bir makrolid olan azitromisinin hem eozinofilik astım hem de eozinofilik olmayan astım fenotiplerinde astım alevlenmelerini azalttığı ve astımla ilgili yaşam kalitesini önemli ölçüde artırdığı gösterilmiştir. Fakat uygulama dozları, süreleri ve bazı çalışmalarda eozinofilik ağır astımda etkinliğinin gösterilememesi gibi farklılıklar da mevcuttur. GINA raporunda da yüksek doz inhaler kortikosteroid/uzun etkili beta2 agonist/uzun etkili antimuskarinirik tedavilerine rağmen kontrolsüz non-T2 ağır astım hastalarında ya da biyolojik ajan tedavisine rağmen astımı kontrol altında olmayan T2 ağır astım hastalarında azitromisin ekleme tedavisi olarak önerilebilmektedir. Bu derlemede makrolidlerden özellikle azitromisinin astım tedavisindeki yeri, immünomodülatör etkinlikleri ve güvenirlik profilleri güncel çalışmalar ve rehberler temelinde ele alınmıştır

Anahtar Kelime:

Long-term macrolide therapy in asthma

Öz:

Macrolides are antibiotics with antiviral, anti-inflammatory and immunomodulatory effects in together with their bacteriostatic effects. In addition to its beneficial effects on chronic respiratory diseases such as COPD, cystic fibrosis, diffuse panbronchiolitis, and bronchiectasis, its effects on uncontrolled severe asthma and asthma exacerbations have been the subject of research in recent years. In randomized controlled trials, azithromycin, a macrolide, has been shown to reduce asthma exacerbations and significantly improve asthma-related quality of life in both eosinophilic and non-eosinophilic asthma phenotypes. However, there are also differences such asdoses, durations and some studies not showing its effectiveness in severe eosinophilic asthma. In the GINA report, azithromycin can be recommended as an add-on therapy in patients with uncontrolled non-T2 severe asthma despite high-dose inhaled corticosteroid/ long-acting beta2-agonist/long-acting antimuscariniric treatments, or in T2 severe asthma patients whose asthma is not under control despite biologic therapy. In this review, the use of macrolides, especially azithromycin, in the treatment of asthma, immunomodulatory activities and safety profiles are discussed on the basis of current studies and guidelines.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık

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APA	ÇETİN g, arslan b, Yilmaz I (2021). Astımda uzun süreli makrolid tedavisi . , 520 - 534. 10.5578/tt.20219610
Chicago	ÇETİN gülden,arslan bahar,Yilmaz Insu Astımda uzun süreli makrolid tedavisi . (2021): 520 - 534. 10.5578/tt.20219610
MLA	ÇETİN gülden,arslan bahar,Yilmaz Insu Astımda uzun süreli makrolid tedavisi . , 2021, ss.520 - 534. 10.5578/tt.20219610
AMA	ÇETİN g,arslan b,Yilmaz I Astımda uzun süreli makrolid tedavisi . . 2021; 520 - 534. 10.5578/tt.20219610
Vancouver	ÇETİN g,arslan b,Yilmaz I Astımda uzun süreli makrolid tedavisi . . 2021; 520 - 534. 10.5578/tt.20219610
IEEE	ÇETİN g,arslan b,Yilmaz I "Astımda uzun süreli makrolid tedavisi ." , ss.520 - 534, 2021. 10.5578/tt.20219610
ISNAD	ÇETİN, gülden vd. "Astımda uzun süreli makrolid tedavisi ". (2021), 520-534. https://doi.org/10.5578/tt.20219610

APA	ÇETİN g, arslan b, Yilmaz I (2021). Astımda uzun süreli makrolid tedavisi . Tüberküloz ve Toraks, 69(4), 520 - 534. 10.5578/tt.20219610
Chicago	ÇETİN gülden,arslan bahar,Yilmaz Insu Astımda uzun süreli makrolid tedavisi . Tüberküloz ve Toraks 69, no.4 (2021): 520 - 534. 10.5578/tt.20219610
MLA	ÇETİN gülden,arslan bahar,Yilmaz Insu Astımda uzun süreli makrolid tedavisi . Tüberküloz ve Toraks, vol.69, no.4, 2021, ss.520 - 534. 10.5578/tt.20219610
AMA	ÇETİN g,arslan b,Yilmaz I Astımda uzun süreli makrolid tedavisi . Tüberküloz ve Toraks. 2021; 69(4): 520 - 534. 10.5578/tt.20219610
Vancouver	ÇETİN g,arslan b,Yilmaz I Astımda uzun süreli makrolid tedavisi . Tüberküloz ve Toraks. 2021; 69(4): 520 - 534. 10.5578/tt.20219610
IEEE	ÇETİN g,arslan b,Yilmaz I "Astımda uzun süreli makrolid tedavisi ." Tüberküloz ve Toraks, 69, ss.520 - 534, 2021. 10.5578/tt.20219610
ISNAD	ÇETİN, gülden vd. "Astımda uzun süreli makrolid tedavisi ". Tüberküloz ve Toraks 69/4 (2021), 520-534. https://doi.org/10.5578/tt.20219610