慢性下気道感染症に対するErythromycin長期投与療法の作用機序に関する研究 ： 第1報 ヒト好中球機能などに及ぼす作用

Abstract

The present study was carried out to analyze functions of polymorphonuclear leukocyte (PMN) in the peripheral blood of patients with chronic infections in the lower respiratory tract after long-term treatment with erythromycin (EM). The number of total leukocytes was significantly higher in patients than in healthy controls before treatment, and it returned to normal levels after a 3-month treatment. Phagocytic activity of PMN was determined by measuring the intensity of luminol-mediated chemiluminescence. EM treatment reduced chemiluminescence of PMN in patients to a significant extent, in proportion to the improvement of clinical symptoms. Intracellular production of elastase, which was recognized as one of the predisposing factors in tissue damage of the respiratory tract, did not increase in PMN of patients throughout observation, but extracellular release of elastase from PMN upon stimulation with interleukin 1 (IL-1) was much reduced by EM treatment. Furthermore, serum obtained from EM-treated patients exhibited significanty higher levels of anti-elastase activity as compared with serum of healthy controls. The anti-elastase activity in EM-treated patients was completely neutralized by monoclonal antibody to human α＿1-antitrypsin. These results suggest that EM can modify PMN functions and also increase the anti-elastase activity in serum.