{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1363670319105923328.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.1164/rccm.200707-1134oc"}},{"identifier":{"@type":"URI","@value":"https://academic.oup.com/ajrccm/article-pdf/177/2/148/67328970/ajrccm_177_2_148.pdf"}}],"dc:title":[{"@value":"Clarithromycin Targets Neutrophilic Airway Inflammation in Refractory Asthma"}],"description":[{"type":"abstract","notation":[{"@value":"<jats:title>Abstract</jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale</jats:title>\n                    <jats:p>Patients with refractory asthma have persistent symptoms despite maximal treatment with inhaled corticosteroids and long-acting bronchodilators. The availability of add-on therapies is limited, and effective add-on therapies that target noneosinophilic airway inflammation are needed. Macrolide antibiotics, such as clarithromycin, have in vitro efficacy against IL-8 and neutrophils, key inflammatory mediators in noneosinophilic asthma.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives</jats:title>\n                    <jats:p>To determine the efficacy of clarithromycin in patients with severe refractory asthma and specifically in a subgroup of patients with noneosinophilic asthma.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods</jats:title>\n                    <jats:p>Subjects with severe refractory asthma (n = 45) were randomized to receive clarithromycin (500 mg twice daily) or placebo for 8 weeks.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results</jats:title>\n                    <jats:p>The primary outcome for this study was sputum IL-8 concentration. Other inflammatory outcomes assessed included sputum neutrophil numbers and concentrations of neutrophil elastase and matrix metalloproteinase (MMP)-9. Clinical outcomes were also assessed, including lung function, airway hyperresponsiveness to hypertonic saline, asthma control, quality of life, and symptoms. Clarithromycin therapy significantly reduced airway concentrations of IL-8 and neutrophil numbers and improved quality-of-life scores compared with placebo. Reductions in neutrophil elastase and MMP-9 concentrations were also observed. These reductions in inflammation were most marked in those with refractory noneosinophilic asthma.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions</jats:title>\n                    <jats:p>Clarithromycin therapy can modulate IL-8 levels and neutrophil accumulation and activation in the airways of patients with refractory asthma. Macrolide therapy may be an important additional therapy that could be used to reduce noneosinophilic airway inflammation, particularly neutrophilic inflammation, in asthma.</jats:p>\n                    <jats:p>Clinical trial registered with the Australian Clinical Trials Registry www.actr.org.au (No. 12605000318684).</jats:p>\n                  </jats:sec>"}]}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1383670319105923456","@type":"Researcher","foaf:name":[{"@value":"Jodie L. Simpson"}],"jpcoar:affiliationName":[{"@value":"NHMRC Centre for Respiratory and Sleep Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, Australia"},{"@value":"Department of Respiratory and Sleep Medicine, and"}]},{"@id":"https://cir.nii.ac.jp/crid/1383670319105923328","@type":"Researcher","foaf:name":[{"@value":"Heather Powell"}],"jpcoar:affiliationName":[{"@value":"Department of Respiratory and Sleep Medicine, and"}]},{"@id":"https://cir.nii.ac.jp/crid/1383670319105923457","@type":"Researcher","foaf:name":[{"@value":"Michael J. Boyle"}],"jpcoar:affiliationName":[{"@value":"Department of Immunology and Infectious Diseases, Hunter Medical Research Institute, John Hunter Hospital, New Lambton, Australia; and"}]},{"@id":"https://cir.nii.ac.jp/crid/1383670319105923459","@type":"Researcher","foaf:name":[{"@value":"Rodney J. Scott"}],"jpcoar:affiliationName":[{"@value":"Department of Medical Genetics, School of Biomedical Science, Hunter Medical Research Institute, University of Newcastle, Callaghan, Australia"}]},{"@id":"https://cir.nii.ac.jp/crid/1383670319105923458","@type":"Researcher","foaf:name":[{"@value":"Peter G. Gibson"}],"jpcoar:affiliationName":[{"@value":"NHMRC Centre for Respiratory and Sleep Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, Australia"},{"@value":"Department of Respiratory and Sleep Medicine, and"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"1073449X"},{"@type":"EISSN","@value":"15354970"}],"prism:publicationName":[{"@value":"American Journal of Respiratory and Critical Care Medicine"}],"dc:publisher":[{"@value":"Oxford University Press (OUP)"}],"prism:publicationDate":"2008-01","prism:volume":"177","prism:number":"2","prism:startingPage":"148","prism:endingPage":"155"},"reviewed":"false","dc:rights":["https://academic.oup.com/pages/standard-publication-reuse-rights"],"url":[{"@id":"https://academic.oup.com/ajrccm/article-pdf/177/2/148/67328970/ajrccm_177_2_148.pdf"}],"createdAt":"2007-10-18","modifiedAt":"2026-03-21","relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1050001202641971968","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"Clinical approaches towards asthma and chronic obstructive pulmonary disease based on the heterogeneity of disease pathogenesis"},{"@value":"Hizawa N Clinical approaches towards asthma and chronic obstructive pulmonary disease based on the heterogeneity of disease pathogenesis"}]},{"@id":"https://cir.nii.ac.jp/crid/1050568772228631424","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Differential Effects of Dexamethasone and Itraconazole on Aspergillus fumigatus-Exacerbated Allergic Airway Inflammation in a Murine Model of Mite-Sensitized Asthma"}]},{"@id":"https://cir.nii.ac.jp/crid/1360002218797932672","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Clarithromycin Inhibits Interleukin-13–Induced Goblet Cell Hyperplasia in Human Airway Cells"}]},{"@id":"https://cir.nii.ac.jp/crid/1360004236775667072","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Trans-basement membrane migration of eosinophils induced by LPS-stimulated neutrophils from human peripheral blood<i>in vitro</i>"}]},{"@id":"https://cir.nii.ac.jp/crid/1360009142573220608","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"The Nonantibiotic Macrolide EM900 Attenuates House Dust Mite-Induced Airway Inflammation in a Mouse Model of Obesity-Associated Asthma"}]},{"@id":"https://cir.nii.ac.jp/crid/1360285707516091904","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Erythromycin prevents the pulmonary inflammation induced by exposure to cigarette smoke"}]},{"@id":"https://cir.nii.ac.jp/crid/1360565168304114432","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Regulation of immune responses by neutrophils"}]},{"@id":"https://cir.nii.ac.jp/crid/1360565168620893056","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Virus Infection-Induced Bronchial Asthma Exacerbation"}]},{"@id":"https://cir.nii.ac.jp/crid/1360567182382008192","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Clarithromycin prevents human respiratory syncytial virus-induced airway epithelial responses by modulating activation of interferon regulatory factor-3"}]},{"@id":"https://cir.nii.ac.jp/crid/1360584340532066688","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Macrolides Decrease the Proinflammatory Activity of Macrolide-Resistant Streptococcus pneumoniae"}]},{"@id":"https://cir.nii.ac.jp/crid/1361131415662209408","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"The non-antibiotic macrolide EM900 attenuates HDM and poly(I:C)-induced airway inflammation with inhibition of macrophages in a mouse model"}]},{"@id":"https://cir.nii.ac.jp/crid/1390001277367536128","@type":"Article","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"VIII. 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