Title Azithromycin augments rhinovirus-induced IFNbeta via cytosolic MDA5 in experimental models of asthma exacerbation.
Author Menzel, Mandy; Akbarshahi, Hamid; Tufvesson, Ellen; Persson, Carl; Bjermer, Leif; Uller, Lena
Journal Oncotarget Publication Year/Month 2017-May
PMID 28415826 PMCID PMC5458233
Affiliation + expend 1.Respiratory Immunopharmacology, Department of Experimental Medical Science, Lund University, 22184 Lund, Sweden.

Deficient production of anti-viral interferons (IFNs) may be involved in causing viral-induced asthma exacerbations. Hence, drugs inducing lung IFN production would be warranted. Azithromycin may reduce asthma exacerbations but its modus operandi is unknown. Here, we investigated if azithromycin induces IFNbeta expression in vitro in rhinovirus-infected bronchial epithelial cells from asthmatic donors and in vivo in our allergic inflammation-based mouse model of viral stimulus-induced asthma exacerbations. Azithromycin dose-dependently augmented viral-induced IFNbeta expression in asthmatic, but not in healthy bronchial epithelial cells. The effect negatively correlated with viral load. Knockdown of MDA5 and RIG-I by siRNA showed involvement of MDA5 but not RIG-I in azithromycin\'s IFN-inducing effects in vitro. In vivo azithromycin induced IFNbeta protein, restoring a reduced lung IFN response exclusively in allergic exacerbating mice. This was associated with induction of interferon-stimulated genes and MDA5, but not RIG-I. We suggest that clinically relevant concentrations of azithromycin produce MDA5-dependent, anti-viral, IFN-inducing effects in bronchial epithelium distinctly from asthmatic donors. Similarly, azithromycin induced MDA5-associated IFN in virally stimulated lungs in vivo exclusively in allergic mice. Effects of azithromycin and MDA5-active drugs on viral-induced exacerbations deserve further research.

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