zithromax and Sarcoidosis

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and mainly affects the lungs. Sarcoidosis is an autoinflammatory disease characterized by the diffusion of granulomas in the lungs and other organs. Here, we discuss how the two diseases might involve some common mechanistic cellular pathways around the regulation of autophagy.

Topics: Angiotensin-Converting Enzyme Inhibitors; Autophagy; Azithromycin; Betacoronavirus; Chloroquine; Coronavirus Infections; COVID-19; Host-Pathogen Interactions; Humans; Isoniazid; Lung; Pandemics; Pneumonia, Viral; Pulmonary Edema; Rifampin; Sarcoidosis; SARS-CoV-2; Severe Acute Respiratory Syndrome; Severity of Illness Index

Sarcoidosis is a chronic granulomatous disease for which there are limited therapeutic options. This is the first randomized, placebo-controlled study to demonstrate that antimycobacterial therapy reduces lesion diameter and disease severity among patients with chronic cutaneous sarcoidosis.. To evaluate the safety and efficacy of once-daily antimycobacterial therapy on the resolution of chronic cutaneous sarcoidosis lesions.. A randomized, placebo-controlled, single-masked trial on 30 patients with symptomatic chronic cutaneous sarcoidosis lesions deemed to require therapeutic intervention.. A tertiary referral dermatology center in Nashville, Tennessee.. Participants were randomized to receive either the oral concomitant levofloxacin, ethambutol, azithromycin, and rifampin (CLEAR) regimen or a comparative placebo regimen for 8 weeks with a 180-day follow-up.. Participants were monitored for absolute change in lesion diameter and decrease in granuloma burden, if present, on completion of therapy.. In the intention-to-treat analysis, the CLEAR-treated group had a mean (SD) decrease in lesion diameter of -8.4 (14.0) mm compared with an increase of 0.07 (3.2) mm in the placebo-treated group (P = .05). The CLEAR group had a significant reduction in granuloma burden and experienced a mean (SD) decline of -2.9 (2.5) mm in lesion severity compared with a decline of -0.6 (2.1) mm in the placebo group (P = .02).. Antimycobacterial therapy may result in significant reductions in chronic cutaneous sarcoidosis lesion diameter compared with placebo. These observed reductions, associated with a clinically significant improvement in symptoms, were present at the 180-day follow-up period. Transcriptome analysis of sarcoidosis CD4+ T cells revealed reversal of pathways associated with disease severity and enhanced T-cell function following T-cell receptor stimulation.. clinicaltrials.gov Identifier: NCT01074554.

Topics: Administration, Oral; Adult; Aged; Anti-Bacterial Agents; Azithromycin; CD4-Positive T-Lymphocytes; Chronic Disease; Drug Therapy, Combination; Ethambutol; Female; Follow-Up Studies; Humans; Levofloxacin; Male; Middle Aged; Ofloxacin; Rifampin; Sarcoidosis; Severity of Illness Index; Single-Blind Method; Skin Diseases; Transcriptome; Treatment Outcome; Young Adult

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Antibodies, Monoclonal, Humanized; Antirheumatic Agents; Arthritis, Rheumatoid; Autoimmune Diseases; Azithromycin; Biological Products; COVID-19; COVID-19 Drug Treatment; Enzyme Inhibitors; Female; Glucocorticoids; Hospitalization; Humans; Hydroxychloroquine; Immunomodulation; Immunosuppressive Agents; Inflammatory Bowel Diseases; Intensive Care Units; Janus Kinase Inhibitors; Male; Middle Aged; Respiration, Artificial; Sarcoidosis; SARS-CoV-2; Surveys and Questionnaires; Tumor Necrosis Factor Inhibitors; Young Adult