{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T06:09:22Z","timestamp":1793686162225,"version":"4.5.1"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,4,29]],"date-time":"2023-04-29T00:00:00Z","timestamp":1682726400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,4,29]],"date-time":"2023-04-29T00:00:00Z","timestamp":1682726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100020218","name":"Chiesi USA","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020218","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]},{"name":"GlaxoSmithKline"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pulm Med"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Long term macrolide treatment has been found beneficial in bronchiectasis (BE) -pathogical bronchial dilatation- possibly due to a combined anti-bacterial and immunomodulatory effect. The exact mechanism of inflammatory response is unknown. Here, we investigated the effect of maintenance macrolide treatment on the inflammatory response in BE. In addition, we assessed the inflammatory profile in BE in relation to disease severity.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>During the BAT randomized controlled trial (investigating the effect of 1\u00a0year of azithromycin (AZM) in 83 BE patients), data on BE severity, lung function and sputum microbiology was collected. For the current study, a wide range of inflammatory markers were analysed in 3- monthly sputum samples in all participants.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>At baseline, marked neutrophilic but also eosinophilic inflammation was present in both groups, which remained stable throughout the study and was not affected by AZM treatment. Significant upregulation of pro-inflammatory markers correlated with FEV<jats:sub>1<\/jats:sub>\u2009&lt;\u200950% (TNF\u03b1, ECP, IL-21, IL-1, <jats:italic>p<\/jats:italic>\u2009=\u20090.01- 0.05), <jats:italic>H. influenzae (HI)<\/jats:italic> colonization (MPO, ECP, MIP-1, TNF\u03b1, IL-21, Il-8, IL-1, IL-1\u03b1, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 \u2013 0.04) and number of exacerbations (MPO, ECP, VEGF, MMP-9, <jats:italic>p<\/jats:italic>\u2009=\u20090.003 \u2013 0.01). Surprisingly, colonization with <jats:italic>P. aeruginosa (PA)<\/jats:italic> was found to correlate with an attenuated inflammatory response compared to non-<jats:italic>PA<\/jats:italic> colonized. In placebo-treated patients, presence of an infectious exacerbation was reflected by a significant excessive increase in inflammation as compared to a non-significant upregulation in the AZM-treated patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>One year of AZM treatment did not result in attenuation of the inflammatory response in BE. Increasing disease severity and the presence of an exacerbation were reflected by upregulation of pro-inflammatory markers<jats:bold>.<\/jats:bold><\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12890-023-02444-1","type":"journal-article","created":{"date-parts":[[2023,4,29]],"date-time":"2023-04-29T02:01:46Z","timestamp":1682733706000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The effect of azithromycin on sputum inflammatory markers in bronchiectasis"],"prefix":"10.1186","volume":"23","author":[{"given":"L. C.","family":"Terpstra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Altenburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. J.","family":"Doodeman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y. S. 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The BAT study protocol was reviewed and approved by independent ethics committees and institutional review boards from all the 14 participating centers. The study was performed in accordance with the Good Clinical Practice guidelines, the International Conference on Harmonization guidelines, and the most recent version of the Declaration of Helsinki. Written informed consent for participation and publication of our results was obtained from all the participants at the screenings visit. The BAT study is registered on Clinical trials.gov number: NCT00415350.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"RL reported grants paid to his institution from Foresee, Nutrileads, Longfonds, Chiesi and AstraZeneca. WGB reported grants paid to his institution from GlaxoSmithKline and reported consulting fee for adviesraad 2021 SOBI. JA reported grants paid to her institution from Longfonds. HH, LCT, HJD, YSP have nothing to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"151"}}