Asthma affects almost 300 million people worldwide
It is a chronic debilitating disease affecting children and adults
It is a cause of absenteeism from school in children and from work place in adults
Some times ,it gets flared up /exacerbated
Exacerbation may be mild,moderate or severe
Severe exacerbation is seen most of the time,80% of time , after Rhinovirus infection
After Rhinovirus infection ,respiratory epithelium releases alarmins like TSLP ,IL25 and IL33
These alarmins activates TH2 reactions with production of TH2 signature cytokines ,which in turn causes ,inflammation, edema and spasm in airways
Interferon beta and gamma decreases these response and lessen the severity and frequency of airway inflammation causing increased symptoms of asthma
In some individuals the increase in symptoms are so severe that it does not respond to asthma medications and the individual has to be managed on ventilator-non invasive/ invasive
In Azimune trial done on individuals above 18 years of age, over 12 weeks ,it was shown that ,Azithromycin reduces the production of IL33 and increases Interferon beta and Interferon gamma in the respiratory epithelium,thereby reducing the severity and frequency of asthma exacerbation induced by Rhinovirus
It was double blinded,placebo controlled ,randomized trial Published in ERS Journal 2026
It may be extrapolated in children in future study and the antiviral role of Azithromycin can be established which may be beneficial in children facing frequent /severe asthma exacerbation
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