Conflicts of interest: None.
Pharmacology and Therapeutics
Effects of azithromycin on intracellular cytokine responses and mucocutaneous manifestations in Behçet's disease
Article first published online: 24 JUL 2013
© 2013 The International Society of Dermatology
International Journal of Dermatology
Volume 52, Issue 12, pages 1561–1566, December 2013
How to Cite
Mumcu, G., İnanç, N., Özdemir, F. T., Tulunay, A., Ekşioğlu-Demiralp, E., Ergun, T. and Direskeneli, H. (2013), Effects of azithromycin on intracellular cytokine responses and mucocutaneous manifestations in Behçet's disease. International Journal of Dermatology, 52: 1561–1566. doi: 10.1111/ijd.12144
- Issue published online: 21 NOV 2013
- Article first published online: 24 JUL 2013
- Marmara University, Scientific Research Project Unit. Grant Number: SAG-BGS-081004-0101
The aim of this study was to investigate the effects of azithromycin on mucocutaneous manifestations and ex vivo intracellular cytokine responses in patients with Behçet's disease (BD).
Ten BD patients with active manifestations and nine healthy controls (HCs) were included in the study. Patients were treated with azithromycin (1500 mg/week) for four weeks. Clinical and immunological responses were evaluated in the pre- and post-azithromycin treatment periods. Peripheral blood mononuclear cells (PBMCs) of patients and controls were stimulated by Streptococcus sanguinis, lipopolysaccharide (LPS), lipoteichoic acid (LTA), and heat shock protein-60 (HSP-60) for three hours. Ex vivo intracellular interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) levels were measured.
Follicular lesions and genital ulcers completely healed, and the number of oral ulcers decreased after treatment (P = 0.000). The stimulated intracellular IFN-γ response to S. sanguinis was higher in BD patients (5.75%) than in HCs (3.9%) before treatment (P = 0.05). Likewise, the pretreatment IFN-γ response was significantly higher than the post-treatment response (1.95%). In BD patients, pretreatment stimulated intracellular IFN-γ responses to LTA (5.8%) were also higher than post-treatment responses (3.15%), but the difference did not reach statistical significance (P = 0.07).
Azithromycin treatment decreased the mucocutaneous manifestations in BD patients and suppressed the intracellular IFN-γ responses of PBMCs to S. sanguinis ex vivo, which suggests this treatment has an immunomodulatory effect.