Immunomodulator clarithromycin enhances mucosal and systemic immune responses and reduces re-infection rate in pediatric patients with influenza treated with antiviral neuraminidase inhibitors: a retrospective analysis.

<h4>Background/aims</h4>Treatment with antiviral neuraminidase inhibitors suppresses influenza viral replication and antigen production, resulting in marked attenuation of mucosal immunity and mild suppression of systemic immunity in mice. This study investigated the effects of immunomod...

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Autores principales:	Wakako Shinahara, Etsuhisa Takahashi, Takako Sawabuchi, Masaru Arai, Nobuo Hirotsu, Yoshio Takasaki, Shizuo Shindo, Kyoko Shibao, Takashi Yokoyama, Kiyoshi Nishikawa, Masahiro Mino, Minako Iwaya, Yuji Yamashita, Satoshi Suzuki, Dai Mizuno, Hiroshi Kido
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f107e3b375a34d86b01d2cd359afb8d5
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spelling	oai:doaj.org-article:f107e3b375a34d86b01d2cd359afb8d52021-11-18T07:37:20ZImmunomodulator clarithromycin enhances mucosal and systemic immune responses and reduces re-infection rate in pediatric patients with influenza treated with antiviral neuraminidase inhibitors: a retrospective analysis.1932-620310.1371/journal.pone.0070060https://doaj.org/article/f107e3b375a34d86b01d2cd359afb8d52013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23875018/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background/aims</h4>Treatment with antiviral neuraminidase inhibitors suppresses influenza viral replication and antigen production, resulting in marked attenuation of mucosal immunity and mild suppression of systemic immunity in mice. This study investigated the effects of immunomodulator clarithromycin (CAM) supplementation on mucosal and systemic immunity in pediatric patients with influenza treated with neuraminidase inhibitors.<h4>Methods</h4>A retrospective, non-randomized case series study was conducted among five treatment groups of 195 children aged 5.9±3.3 years infected with influenza A in 2008/2009 season. The five treatment groups were oseltamivir (OSV), zanamivir (ZNV), OSV+CAM, ZNV+CAM and untreated groups. Anti-viral secretory IgA (S-IgA) levels in nasal washes and IgG levels in sera were measured. The re-infection rate was analyzed among the same five treatment groups in the 2009/2010 season.<h4>Results</h4>Treatment of influenza with OSV and ZNV for 5 days attenuated the induction of anti-viral S-IgA in nasal washes and anti-viral IgG in serum, compared with the untreated group. The combination of CAM plus OSV or ZNV boosted and restored the production of mucosal S-IgA and systemic IgG. The re-infection rates in the subsequent season were significantly higher in the OSV and ZNV groups than the untreated, while CAM+OSV and CAM+ZNV tended to reduce such rate.<h4>Conclusions</h4>CAM restored the attenuated anti-viral mucosal and systemic immunity and reduced the re-infection rate in the subsequent year in pediatric patients with influenza treated with OSV and ZNV.Wakako ShinaharaEtsuhisa TakahashiTakako SawabuchiMasaru AraiNobuo HirotsuYoshio TakasakiShizuo ShindoKyoko ShibaoTakashi YokoyamaKiyoshi NishikawaMasahiro MinoMinako IwayaYuji YamashitaSatoshi SuzukiDai MizunoHiroshi KidoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 7, p e70060 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Wakako Shinahara Etsuhisa Takahashi Takako Sawabuchi Masaru Arai Nobuo Hirotsu Yoshio Takasaki Shizuo Shindo Kyoko Shibao Takashi Yokoyama Kiyoshi Nishikawa Masahiro Mino Minako Iwaya Yuji Yamashita Satoshi Suzuki Dai Mizuno Hiroshi Kido Immunomodulator clarithromycin enhances mucosal and systemic immune responses and reduces re-infection rate in pediatric patients with influenza treated with antiviral neuraminidase inhibitors: a retrospective analysis.
description	<h4>Background/aims</h4>Treatment with antiviral neuraminidase inhibitors suppresses influenza viral replication and antigen production, resulting in marked attenuation of mucosal immunity and mild suppression of systemic immunity in mice. This study investigated the effects of immunomodulator clarithromycin (CAM) supplementation on mucosal and systemic immunity in pediatric patients with influenza treated with neuraminidase inhibitors.<h4>Methods</h4>A retrospective, non-randomized case series study was conducted among five treatment groups of 195 children aged 5.9±3.3 years infected with influenza A in 2008/2009 season. The five treatment groups were oseltamivir (OSV), zanamivir (ZNV), OSV+CAM, ZNV+CAM and untreated groups. Anti-viral secretory IgA (S-IgA) levels in nasal washes and IgG levels in sera were measured. The re-infection rate was analyzed among the same five treatment groups in the 2009/2010 season.<h4>Results</h4>Treatment of influenza with OSV and ZNV for 5 days attenuated the induction of anti-viral S-IgA in nasal washes and anti-viral IgG in serum, compared with the untreated group. The combination of CAM plus OSV or ZNV boosted and restored the production of mucosal S-IgA and systemic IgG. The re-infection rates in the subsequent season were significantly higher in the OSV and ZNV groups than the untreated, while CAM+OSV and CAM+ZNV tended to reduce such rate.<h4>Conclusions</h4>CAM restored the attenuated anti-viral mucosal and systemic immunity and reduced the re-infection rate in the subsequent year in pediatric patients with influenza treated with OSV and ZNV.
format	article
author	Wakako Shinahara Etsuhisa Takahashi Takako Sawabuchi Masaru Arai Nobuo Hirotsu Yoshio Takasaki Shizuo Shindo Kyoko Shibao Takashi Yokoyama Kiyoshi Nishikawa Masahiro Mino Minako Iwaya Yuji Yamashita Satoshi Suzuki Dai Mizuno Hiroshi Kido
author_facet	Wakako Shinahara Etsuhisa Takahashi Takako Sawabuchi Masaru Arai Nobuo Hirotsu Yoshio Takasaki Shizuo Shindo Kyoko Shibao Takashi Yokoyama Kiyoshi Nishikawa Masahiro Mino Minako Iwaya Yuji Yamashita Satoshi Suzuki Dai Mizuno Hiroshi Kido
author_sort	Wakako Shinahara
title	Immunomodulator clarithromycin enhances mucosal and systemic immune responses and reduces re-infection rate in pediatric patients with influenza treated with antiviral neuraminidase inhibitors: a retrospective analysis.
title_short	Immunomodulator clarithromycin enhances mucosal and systemic immune responses and reduces re-infection rate in pediatric patients with influenza treated with antiviral neuraminidase inhibitors: a retrospective analysis.
title_full	Immunomodulator clarithromycin enhances mucosal and systemic immune responses and reduces re-infection rate in pediatric patients with influenza treated with antiviral neuraminidase inhibitors: a retrospective analysis.
title_fullStr	Immunomodulator clarithromycin enhances mucosal and systemic immune responses and reduces re-infection rate in pediatric patients with influenza treated with antiviral neuraminidase inhibitors: a retrospective analysis.
title_full_unstemmed	Immunomodulator clarithromycin enhances mucosal and systemic immune responses and reduces re-infection rate in pediatric patients with influenza treated with antiviral neuraminidase inhibitors: a retrospective analysis.
title_sort	immunomodulator clarithromycin enhances mucosal and systemic immune responses and reduces re-infection rate in pediatric patients with influenza treated with antiviral neuraminidase inhibitors: a retrospective analysis.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/f107e3b375a34d86b01d2cd359afb8d5
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Immunomodulator clarithromycin enhances mucosal and systemic immune responses and reduces re-infection rate in pediatric patients with influenza treated with antiviral neuraminidase inhibitors: a retrospective analysis.

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