The topical issues of clinical pharmacology of clarithromycin
Keywords:clarithromycin, indirect antibacterial effects, nonantibacterial effects immunomodulatory effect
Recently, as evidenced by numerous publications and surveys on the topic, the interest in clarithromycin is not reduced. This drug has a wide range of the antibacterial activity, is able to penetrate into cells and create stable and high tissue concentration exceeding the level of the drug in the blood serum. However, in recent years, more attention is paid to the study of nonantibacterial effects of clarithromycin. In modern macrolides, in particular in clarithromycin, the anti-inflammatory, immunomodulatory and mucoregulatory properties have been found. The primary mechanism of the immunomodulatory action of macrolides today is considered to be their ability to affect NF-kB-and MAPK-dependent signaling pathways of cells. Under the effect of clarithromycin the decrease in the synthesis and/or secretion of pro-inflammatory (IL-1, -6, -8, tumour necrosis factor (TNF)) and the increase in the secretion of anti-inflammatory cytokines (IL-2, -4, -10) are observed. The effectiveness of the indirect antimicrobial action of clarithromycin is intensively studied in vitro and in vivo, and it further expands our understanding of the therapeutic possibilities of this drug.
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