Summary
From the investigation of DPB as it manifests in chronic persistent biofilm disease, it has been found that the most important factors are the excess antigen-antibody reaction (where alginate acts as the antigen) and the resultant formation of immune complex. The factors which specifically “link the disease state of infected DPB to” the effects of 14- and 15-membered macrolides are the inhibition of immune reaction induced by alginate and their inhibitory effect on alginate production, acting as antigens at the GMD level. Furthermore, the specificity of macrolides on these actions was also evident from the standpoint of structural activity.
The present serial processes represent an approach quite dissimilar to those of conventional reports, and the results thus obtained provide an entirely new facet to current knowledge. The pathologic category of DPB was first presented in Japan and its therapeutic approaches by 14- or 15-membered macrolides have likewise been developed in this country. In my opinion, “macrolide therapy”, i.e., long-term administration of 14- or 15-membered ring macrolides should be tried in patients with infected cystic fibrosis in Europe and North America due to the apparent therapeutic success of utilizing these macrolides in patients with Pseudomonas biofilm disease in Japan.
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Kobayashi, H. Airway biofilm disease: Clinical manifestations and therapeutic possibilities using macrolides. J Infect Chemother 1, 1–15 (1995). https://doi.org/10.1007/BF02347725
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DOI: https://doi.org/10.1007/BF02347725