Immunomodulatory effects of pidotimod in adults with community-acquired pneumonia undergoing standard antibiotic therapy

D. Trabattoni, M. Clerici, S. Centanni, M. Mantero, M. Garziano, F. Blasi

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

The morbidity and mortality of community-acquired pneumonia (CAP) are still elevated and two aspects seem to contribute to a worse outcome: an uncontrolled inflammatory reaction and an inadequate immune response. Adjuvants, including corticosteroids and intravenous immunoglobulins, have been proposed to counterbalance these effects but their efficacy is only partial. We examined the immunomodulatory activity of Pidotimod (PDT), a synthetic dipeptide molecule in adult patients hospitalized for CAP. Sixteen patients with a diagnosis of CAP and a PSI score III or IV and/or a CURB-65 0–2 were randomized to receive either levofloxacin 500 mg b.i.d. alone or levofloxacin plus PDT (800mg, 2 daily doses). Blood samples were drawn at baseline (T0), before initiation of therapy, as well as 3 (T3), and 5 (T5) days after initiation of therapy. Immunologic and clinical parameters were analyzed at each time point. Supplementation of antibiotic therapy with PDT resulted in an upregulation of antimicrobial and of immunomodulatory proteins as well as in an increased percentage of Toll like receptor (TLR)2- and TLR4, and of CD80- and CD86-expressing immune cells. Notably, Pidotimod supplementation was also associated with a robust reduction of TNFα-producing immune cells. No significant differences were observed in clinical parameters. These results confirm that supplementation of antibiotic therapy with Pidotimod in patients with CAP results in a potentially beneficial modulation of innate immunity. © 2017
Original languageEnglish
Pages (from-to)24-29
Number of pages6
JournalPulmonary Pharmacology and Therapeutics
Volume44
DOIs
Publication statusPublished - 2017

Fingerprint

pidotimod
Pneumonia
Anti-Bacterial Agents
Levofloxacin
Therapeutics
Toll-Like Receptor 2
Dipeptides
Intravenous Immunoglobulins
Innate Immunity
Adrenal Cortex Hormones
Blood
Up-Regulation
Modulation
Morbidity
Molecules
Mortality

Keywords

  • B7 antigen
  • CD86 antigen
  • HLA antigen class 1
  • interferon
  • interleukin 12
  • interleukin 6
  • levofloxacin
  • pidotimod
  • polypeptide antibiotic agent
  • toll like receptor 2
  • toll like receptor 4
  • tumor necrosis factor, adult
  • antibiotic therapy
  • Article
  • blood analysis
  • clinical article
  • community acquired pneumonia
  • controlled study
  • cytokine production
  • female
  • human
  • immunocompetent cell
  • immunomodulation
  • male
  • middle aged
  • multicenter study
  • priority journal
  • protein expression
  • randomized controlled trial
  • upregulation

Cite this

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title = "Immunomodulatory effects of pidotimod in adults with community-acquired pneumonia undergoing standard antibiotic therapy",
abstract = "The morbidity and mortality of community-acquired pneumonia (CAP) are still elevated and two aspects seem to contribute to a worse outcome: an uncontrolled inflammatory reaction and an inadequate immune response. Adjuvants, including corticosteroids and intravenous immunoglobulins, have been proposed to counterbalance these effects but their efficacy is only partial. We examined the immunomodulatory activity of Pidotimod (PDT), a synthetic dipeptide molecule in adult patients hospitalized for CAP. Sixteen patients with a diagnosis of CAP and a PSI score III or IV and/or a CURB-65 0–2 were randomized to receive either levofloxacin 500 mg b.i.d. alone or levofloxacin plus PDT (800mg, 2 daily doses). Blood samples were drawn at baseline (T0), before initiation of therapy, as well as 3 (T3), and 5 (T5) days after initiation of therapy. Immunologic and clinical parameters were analyzed at each time point. Supplementation of antibiotic therapy with PDT resulted in an upregulation of antimicrobial and of immunomodulatory proteins as well as in an increased percentage of Toll like receptor (TLR)2- and TLR4, and of CD80- and CD86-expressing immune cells. Notably, Pidotimod supplementation was also associated with a robust reduction of TNFα-producing immune cells. No significant differences were observed in clinical parameters. These results confirm that supplementation of antibiotic therapy with Pidotimod in patients with CAP results in a potentially beneficial modulation of innate immunity. {\circledC} 2017",
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author = "D. Trabattoni and M. Clerici and S. Centanni and M. Mantero and M. Garziano and F. Blasi",
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TY - JOUR

T1 - Immunomodulatory effects of pidotimod in adults with community-acquired pneumonia undergoing standard antibiotic therapy

AU - Trabattoni, D.

AU - Clerici, M.

AU - Centanni, S.

AU - Mantero, M.

AU - Garziano, M.

AU - Blasi, F.

N1 - cited By 1

PY - 2017

Y1 - 2017

N2 - The morbidity and mortality of community-acquired pneumonia (CAP) are still elevated and two aspects seem to contribute to a worse outcome: an uncontrolled inflammatory reaction and an inadequate immune response. Adjuvants, including corticosteroids and intravenous immunoglobulins, have been proposed to counterbalance these effects but their efficacy is only partial. We examined the immunomodulatory activity of Pidotimod (PDT), a synthetic dipeptide molecule in adult patients hospitalized for CAP. Sixteen patients with a diagnosis of CAP and a PSI score III or IV and/or a CURB-65 0–2 were randomized to receive either levofloxacin 500 mg b.i.d. alone or levofloxacin plus PDT (800mg, 2 daily doses). Blood samples were drawn at baseline (T0), before initiation of therapy, as well as 3 (T3), and 5 (T5) days after initiation of therapy. Immunologic and clinical parameters were analyzed at each time point. Supplementation of antibiotic therapy with PDT resulted in an upregulation of antimicrobial and of immunomodulatory proteins as well as in an increased percentage of Toll like receptor (TLR)2- and TLR4, and of CD80- and CD86-expressing immune cells. Notably, Pidotimod supplementation was also associated with a robust reduction of TNFα-producing immune cells. No significant differences were observed in clinical parameters. These results confirm that supplementation of antibiotic therapy with Pidotimod in patients with CAP results in a potentially beneficial modulation of innate immunity. © 2017

AB - The morbidity and mortality of community-acquired pneumonia (CAP) are still elevated and two aspects seem to contribute to a worse outcome: an uncontrolled inflammatory reaction and an inadequate immune response. Adjuvants, including corticosteroids and intravenous immunoglobulins, have been proposed to counterbalance these effects but their efficacy is only partial. We examined the immunomodulatory activity of Pidotimod (PDT), a synthetic dipeptide molecule in adult patients hospitalized for CAP. Sixteen patients with a diagnosis of CAP and a PSI score III or IV and/or a CURB-65 0–2 were randomized to receive either levofloxacin 500 mg b.i.d. alone or levofloxacin plus PDT (800mg, 2 daily doses). Blood samples were drawn at baseline (T0), before initiation of therapy, as well as 3 (T3), and 5 (T5) days after initiation of therapy. Immunologic and clinical parameters were analyzed at each time point. Supplementation of antibiotic therapy with PDT resulted in an upregulation of antimicrobial and of immunomodulatory proteins as well as in an increased percentage of Toll like receptor (TLR)2- and TLR4, and of CD80- and CD86-expressing immune cells. Notably, Pidotimod supplementation was also associated with a robust reduction of TNFα-producing immune cells. No significant differences were observed in clinical parameters. These results confirm that supplementation of antibiotic therapy with Pidotimod in patients with CAP results in a potentially beneficial modulation of innate immunity. © 2017

KW - B7 antigen

KW - CD86 antigen

KW - HLA antigen class 1

KW - interferon

KW - interleukin 12

KW - interleukin 6

KW - levofloxacin

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KW - polypeptide antibiotic agent

KW - toll like receptor 2

KW - toll like receptor 4

KW - tumor necrosis factor, adult

KW - antibiotic therapy

KW - Article

KW - blood analysis

KW - clinical article

KW - community acquired pneumonia

KW - controlled study

KW - cytokine production

KW - female

KW - human

KW - immunocompetent cell

KW - immunomodulation

KW - male

KW - middle aged

KW - multicenter study

KW - priority journal

KW - protein expression

KW - randomized controlled trial

KW - upregulation

U2 - 10.1016/j.pupt.2017.03.005

DO - 10.1016/j.pupt.2017.03.005

M3 - Article

VL - 44

SP - 24

EP - 29

JO - Pulmonary Pharmacology and Therapeutics

JF - Pulmonary Pharmacology and Therapeutics

SN - 1094-5539

ER -