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We investigated the activity of roxithromycin (RU 965) and gamma interferon alone and in combination in a murine model of toxoplasmic encephalitis. Roxithromycin at a dosage of 35 or 50 mg per mouse per day decreased mortality. Gamma interferon alone significantly prolonged time to death. When combined, the two agents were remarkably synergistic.
The pharmacokinetics of the macrolide roxithromycin (RU 28965) were studied during and after administration of 150 mg every 12 h for 3 days (five doses) in six volunteers. The concentrations in serum, blister fluid, and urine were measured. Mean levels in serum taken at 1.5 h after the morning dose increased from 4.4 micrograms/ml on day 1 to 5.9 micrograms/ml on day 2 and 7.4 micrograms/ml on day 3. The mean serum and blister fluid elimination half-lives on day 3 were 13.2 and 12.5 h, respectively. Roxithromycin penetrated blister fluid well; the mean percent penetration (as measured by the ratio of areas under the curve) was 85%. After the final dose, a mean of 10.5% of that dose was recovered in 12 h as microbiologically active compound.
The in vitro effect of roxithromycin on the bactericidal activity of human macrophages was compared with that of erythromycin. At a concentration of half the MIC roxithromycin showed a much more impressive killing capacity on macrophage-ingested live Staphylococcus aureus than did erythromycin, under all the experimental conditions used.
The clinical efficacy of roxithromycin, administered at the daily dosage of 300 mg (150 mg every 12 hours), was evaluated in 25 patients with respiratory tract infections, mostly infectious exacerbations of chronic bronchitis. Pathogens isolated before treatment were Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus beta-haemoliticus, Haemophilus influenzae. Clinical cure or improvement was achieved in 21 out of 22 evaluable patients. The eradication rate was 91%. Tolerability was good: two patients reported gastrointestinal side effects which caused treatment discontinuation. These preliminary data suggest that roxithromycin may have a place in the treatment of respiratory infections.
A clinical trial, involving 16 male subjects affected by a relapse of chronic bronchitis, was performed in order to evaluate the possible interference of roxithromycin (RU 28965) with theophylline plasma levels. Theophylline was administered to patients as a controlled release formulation. Results did not show any clinically relevant change in theophylline blood levels, implying the conclusion that the new macrolide roxithromycin can be administered simultaneously with a controlled release theophylline.
Roxithromycin, a new macrolide, has favorable pharmacological properties: it is acid stable and well absorbed, and its prolonged half-life allows b.i.d. prescription of 150 mg. In our open prospective study we found an etiologic infectious agent in 16 (80%) of 20 patients presenting with "atypical" pneumonia. Ten of the 16 pneumonias were due to an organism sensitive to roxithromycin (gram+ cocci, gram- rods, mycoplasma and chlamydia), and 6 to a virus. Therapeutic success was obtained in greater than or equal to 90%. The treatment was well tolerated with fewer gastrointestinal disorders than with erythromycin.
The antiproliferative effect of roxithromycin (RXM) was studied using human myeloid leukemia HL60 cells. RXM inhibited the growth of HL60 cells in a concentration-dependent manner, and significantly inhibited growth at concentrations above 75 microM. This growth inhibition was not associated with specific cell cycle arrest and DNA synthesis was not impaired. In addition, the number of viable cells remained almost unchanged in the presence of 100 microM RXM. RXM induced growth inhibition at least partly by the formation of multinucleate cells. Both flowcytometric and morphological examination revealed that more than 40% of the RXM-treated cells were binucleate. These findings demonstrate that RXM is a potent new modulator of cell cycle progression in HL60 cells and suggest that the inhibition of cytokinesis by this drug may provide a new model for studying mitosis.
The macrolide antibiotics azithromycin, roxithromycin and spiramycin were examined in parallel for in vivo activity against Toxoplasma gondii. Azithromycin was considerably more active in protecting mice against death due to acute toxoplasmosis even when the other two antibiotics were used at twice its dose. The higher activity of azithromycin prompted a further examination of its activity against five different strains of Toxoplasma gondii, including two isolated from patients with AIDS. Although variable degrees of protection against death were noted, treatment with 200 mg/kg/day for ten days was sufficient to promote survival of 100% of mice infected with inocula as high as 1 x 10(5) tachyzoites of Toxoplasma gondii. 90% of mice inoculated with 1 x 10(5) tachyzoites of strain MO, isolated from an AIDS patient, and treated orally with 200 mg/kg/day for ten days survived the infection whereas only 40% of mice infected with the same inoculum of the SOU strain, also isolated from an AIDS patient, survived. Tissue concentrations of azithromycin were examined in treated infected and non-infected mice. In both groups of mice azithromycin attained high concentrations in liver, spleen and heart, which exceeded concurrent serum levels by 25- to 200-fold. The concentrations in the brain were almost tenfold higher than the concentrations in serum after treatment with 200 mg/kg/day for ten days. Moreover, the concentrations in brains of infected mice were approximately two-fold higher than in brains of non-infected mice.
Effects of macrolide antibiotic, roxithromycin (RXM) on human lymphocytes in culture were studied. The drug showed a dose-dependent inhibition of 3H-thymidine and 35S-methionine uptake responding to T cell mitogens and purified protein derivative of tuberculin (PPD). Activation by PPD, as assessed by 3H-thymidine uptake, was more sensitive to inhibition than the response to T cell mitogens. The drug produced a loss of blasts when added soon after transformation commenced. Immunosuppressive effects of RXM were further characterized by using four different types of metabolized RXM, RU 28111, RU 39001, RU 44981 and RU 45179. The most potent inhibitor of lymphocyte transformation was RU 45179, followed by RU 44981, RU 39001 and RU 28111 have little activity.
We investigated the effects of roxithromycin (RXM), a synthesized macrolide antibiotic on murine cellular immune responses by examining the in vitro proliferative response of lymphocytes, interleukin 1 (IL-1) production and interleukin 2 (IL-2) production. RXM was orally administered to BALB/c mice at a dose of 5 mg/kg once a day for 42 days. Spontaneous blastic activity of lymphocytes prepared from mice administered with RXM for 7 days was higher than those from control mice. The activity peaked at the 14th day, and then decreased gradually to control levels by the 42nd day. Time kinetics of lymphocyte blastogenesis to concanavalin A showed a pattern similar to that observed in spontaneous blastic activity. Oral administration of RXM also influenced cytokine production; short-term (for 14 days) administration of RXM enhanced both IL-1 and IL-2 production but long-term (for 42 days) administration inhibited them.
This study was designed to evaluate the effects of roxithromycin (RXM), a newly synthesized macrolide antibiotic on allergic responses in mice. RXM was orally administered into BALB/c mice once a day for 42 days in a single dose of 5 mg/kg body weight. Spleen cells (Sp C) collected from mice on day 7, 14, 28 and 42 post-RXM administration showed higher blastic activity of lymphocytes than those from control. The activity peaked on the 7th day, then gradually decreased, and returned to the control level by the 42nd day. Production of cytokines, IL-2 and IL-5, by Sp C in response to concanavalin A stimulation was also examined in the course of RXM administration. The capacity of Sp C to produce IL-2 was enhanced by oral administration of RXM for 28 days. However, a long-term (for 42 days) administration inhibited it. On the other hand, the capacity of of Sp C to produce IL-5 was strongly inhibited by oral administration of RXM; the titer of IL-5 was similar to that obtained in cultures of Sp C from control mice. These results strongly suggest that oral administration of RXM inhibits the function of Th2-type helper T lymphocytes and that a long-term administration of RXM may be beneficial in asthma and allergy.
The in vitro antibacterial activity of omeprazole against eight strains of Helicobacter pylori was evaluated. Minimum inhibitory concentration (MIC) values were 32 micrograms/ml and 64 micrograms/ml (MIC50 and MIC90 respectively). We performed a randomized single blind study comparing the efficacy of omeprazole alone (for 4 weeks) or combined with roxithromycin (for 2 weeks) in the treatment of duodenal ulcer and chronic active gastritis associated with H. pylori infection, H. pylori was eradicated in 75% of patients treated with omeprazole alone whereas the patients treated with the combination of these drugs were completely free from H. pylori at the end of the therapy.
Roxithromycin (RXM), a macrolide antibiotic, is used in clinical trials to address secondary prevention of coronary heart disease. However, the effects of RXM on human coronary artery smooth muscle cells (CASMC) proliferation remain unclear. Human CASMC were stimulated with growth medium containing 5% fetal bovine serum and growth factors. RXM at 1 or 10 microg/ml, which are relevant to the therapeutic plasma levels, significantly suppressed mitogen-induced CASMC proliferation, assessed by WST-1 assay and cell counting. Flow cytometry analysis demonstrated that RXM suppressed mitogen-induced G1 to S progression on cell cycle. Western blot showed that RXM inhibited phosphorylation of retinoblastoma gene products, reduced protein levels of cyclin D1 and A, and restored downregulation of cyclin-dependent kinase (CDK) inhibitor p27kip1. The activities of CDK4 and CDK2 were suppressed by RXM without affecting their protein levels. When transfected with both IkappaB kinase alpha and beta constructs as nuclear factor-kappa B (NF-kappaB) activator, CASMC entered S phase at 24 h, and RXM inhibited it. Electrophoretic mobility shift assay and immunostaining of NF-kappaB p65 demonstrated that RXM inhibited mitogen-induced NF-kappaB activation. These results indicate that RXM is an inhibitor of human CASMC proliferation through modulating cell cycle regulatory proteins and inhibiting NF-kappaB signaling pathway.
Roxithromycin (RXM), an anti-bacterial macrolide, has various immunomodulatory activities. To investigate the ability of RXM to downregulate skin-infiltration of T-lymphocytes, we examined the effects of RXM on keratinocyte production of chemokines and T cell expression of chemokine receptors. Normal human and HaCaT keratinocytes were cultured with RXM and stimulants. RXM at 1 or 10 microM significantly suppressed the production/expression of Th2 chemokines MDC and TARC in these keratinocytes, but the production of IP-10 was not affected. The effect of RXM on T-cell expression of the corresponding chemokine receptors was also tested in Th2-rich peripheral blood lymphocytes. The IL-2-enhanced expression level of Th2 chemokine receptor CCR4 was decreased by RXM at 10 microM, whereas the expression of CXCR3 was unchanged. Thus, RXM downmodulates both the production and receptor expression of Th2 but not Th1 chemokines involved in cutaneous immunity, suggesting its beneficial therapeutic effects on Th2-mediated or allergic skin disorders.
Chloroquine (CQ) and mefloquine (MQ) are no longer potent antimalarial drugs due to the emergence of resistant Plasmodium falciparum. Combination therapy has become the standard for many regimes in overcoming drug resistance. Roxithromycin (ROM), a known p-glycoprotein inhibitor, is reported to have antimalarial activity and it is hoped it will potentiate the effects of both CQ/MQ and reverse CQ/MQ-resistance. We assayed the effects of CQ and MQ individually and in combination with ROM on synchronized P. falciparum (Dd2 strain) cultures. The IC(50) values of CQ and MQ were 60.0+/-5.0 and 16.0+/-3.0 ng/ml; these were decreased substantially when combined with ROM. Isobolograms indicate that CQ-ROM combinations were relatively more synergistic (mean FICI 0.70) than MQ-ROM (mean FICI 0.85) with their synergistic effect at par with CQ-verapamil (VRP) (mean FICI 0.64) and MQ-VRP (mean FICI 0.60) combinations. We conclude that ROM potentiates the CQ/MQ response on multidrug-resistant P. falciparum.
BACKGROUND: In addition to their antimicrobial action, roxithromycin (RXM), a new 14-membrane macrolide antibiotics, have immunomodulatory, anti-inflammatory and anti-oxidative activity. Ultraviolet B (UVB) irradiation induces reactive oxygen intermediates and apoptosis of keratinocytes. OBJECTIVE: To examine the anti-apoptotic and anti-oxidative effect of RXM on UVB-irradiated keratinocytes. METHODS: UVB-induced apoptosis was determined by cell death assay using crystal violet staining, and DNA fragmentation assay. Superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GR), and calatase activities were measured in UVB-irradiated SV40-trasnformed human keratinocytes (SVHK cells). Detection of superoxide was performed histologically using hydroethidine and colorimetric quantitative assay using ferrous irons. H(2)O(2) was measured by colorimetrical assay. RESULTS: RXM suppressed UVB-induced apoptosis of SVHK cells. UVB-irradiated SVHK cells showed decreased SOD, GPx, GR, and catalase activities. RXM pretreatment suppressed the decrease in these enzyme activities with the maximal effect detected at 10microM of RXM. The effect was associated with suppression of UVB-induced superoxide and H(2)O(2) production. CONCLUSION: The present study demonstrated that RXM has anti-apoptotic and anti-oxidative effects against UVB-irradiated keratinocytes.
BACKGROUND: Roxithromycin (RXM), a new 14-member macrolide antibiotic, is effective for chronic airway diseases such as diffuse panbronchiolitis and bronchial asthma. Recent study disclosed that RXM inhibits nuclear factor-kappaB (NF-kappaB)-mediated inflammation. Involucrin is one of the precursor proteins of the cornified cell envelope (CE) and is markedly increased in inflammatory skin diseases such as psoriasis. However, its molecular mechanism of action remains unknown. OBJECTIVE: To determine the effect of RXM on involucrin expression of keratinocytes. METHODS: We constructed chloramphenicol acetyltransferase (CAT)-involucrin promoter expression vector and CAT assay was performed. Furthermore, western blot and RT-PCR were performed to examine the expression of involucrin in RXM-treated cultured human keratinocytes. RESULTS: The increased involucrin expression by 12-O-tetradecanoylphorbol acetate (TPA) was suppressed by 10(-6) M RXM and the maximal inhibitory effect was observed at 48 h. RXM suppressed increased CAT activity by TPA and the effect was not inhibited by H-7 or cafferic acid phenethyl ester (CAPE). Deletion of T1 region (-119 to -113) of involucrin promoter completely abolished TPA-dependent stimulatory and RXM-dependent inhibitory promoter activity. Gel shift assay showed that c-Jun (but not p65) selectively binds to the T1 region. The assay of activator protein-1 (AP-1) and NF-kappaB activities revealed that RXM decreased both transcriptional activities. Co-transfection of c-jun and c-fos expression vectors, or p65 and p50 expression vectors, rescued decreased CAT activity by RXM, respectively. CONCLUSION: Our study demonstrated for the first time that involucrin expression of keratinocytes is suppressed by RXM through direct inhibition of AP-1 and indirect inhibition of NF-kappaB.
The influence of roxithromycin (RXM), a macrolide antibiotic, on endogenous corticosterone (CS) levels was examined in BALB/c mice. Mice were sensitized intraperitoneally with two doses of Keyhole Limpet Hemocyanin at 1 week intervals. Mice were given orally 2.5 mg/kg RXM once a day for 14 days starting 7 days after the first sensitization. RXM administration caused markedly increase in endogenous plasma CS levels which was peaked at 60 min after the administration. However, josamycin did not influence on endogenous CS levels in plasma. Injection of dexamethasone inhibits the plasma CS hyperproduction induced by RXM treatment.