Body Mass Index (BMI) Significantly Increased with Macrolide Treatment in Patients with Chronic Necrotizing Pulmonary Aspergillosis.


Author address: 

Nagasaki Univ.Grad.Sch.Biomed.Sci, Nagasaki, Japan.


Background: Some patients with aspergillosis show emaciation, that has been accounted by exhaustion due to chronic infection. Aspergillus fumigatus is known to excrete various kinds of toxins such as gliotoxin and proteases. These excreted pathogens could attribute to host’s cell damage, resulting to exhaustion. Macrolides have been using in patients with cyctic fibrosis and DPB for other purposes than antibacterial activity, and contributed to increased survival. Since we showed that macrolides inhibited elastase secretion from A. fumigatus in vitro, we studied if macrolides could affect to patients’ general conditions in patients with chronic necrotizing pulmonary aspergillosis (CNPA), whose BMI (body mass index) was less than 18. Methods: Three patients with stable CNPA accepted to undergo macrolide therapy. All patients had previously completed antifungal treatments, but radiological findings resulted to partial response at the end of therapy. Since all patients were seriously emaciated with BMI of less than 16, they were confirmed not to have other causes for emaciation such as hormonal diseases including hyperthyroidism, malnutritions or cancers. Before clinical study, macrolides were shown to inhibit elastase secretion from A. fumigatus strains that have been isolated from the tested patients. Clinical symptoms including BMI, mycological examination, biochemical tests including liver function, and chest radiographs were observed every other 2 - 4 wk. Results: Other observatory components than BMI stayed unchanged in all three patients. BMI in each patients before treatment, after 4wk and 32 wk were 13.5, 14.1, 15.1 in pt.1, 15.3,16.1, 16.8 in pt. 2, and 15.8, 16.9, 17.1 in pt.3. (p

abstract No: 


Full conference title: 

46th Interscience Conference on Antimicrobial Agents and Chemotherapy
    • ICAAC 46th