Doxycycline: lights and shadows of a mysterious treatment for chronic rhinosinusitis.

IF 3 4区 医学 Q2 ALLERGY
Minh P Hoang, Kachorn Seresirikachorn, Kornkiat Snidvongs
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引用次数: 0

Abstract

Purpose of review: Chronic rhinosinusitis (CRS) is a diverse condition, including different underlying pathophysiologies. Tailoring the treatment for CRS depends on the individual's specific endotype and phenotype rather than using a universal approach. The emergence of biologics in recent years has raised questions about the role of antibiotics, particularly doxycycline, in CRS management. Insights from existing research on the mechanisms and appropriate use of doxycycline therapy may guide physicians in selecting the right treatment target.

Recent findings: CRS with nasal polyps (CRSwNP) is frequently associated with type 2 inflammation and characterized by tissue remodeling process that can result in recalcitrant condition. Doxycycline therapy (100 mg daily) improves CRSwNP by exerting antitissue remodeling effects through matrix metalloproteinase inhibition. Doxycycline seems to provide benefits when used alongside adequate medicine treatment.

Summary: Current evidence on the use of doxycycline therapy is limited to a small number of high-quality studies. Further research is needed to explore the duration and factors of success of doxycycline in treating CRS. Like other antibiotics, doxycycline has limitations related to side effects and the potential for antibiotic resistance. Therefore, treatment decisions should be made with caution, especially when doxycycline is used in combination with other pharmacologic therapies.

强力霉素:慢性鼻炎神秘疗法的光与影。
综述目的:慢性鼻窦炎(CRS)是一种多样的疾病,包括不同的潜在病理生理。CRS的治疗取决于个体的特定内型和表型,而不是使用通用的方法。近年来生物制剂的出现引起了对抗生素,特别是强力霉素在CRS管理中的作用的质疑。现有研究对强力霉素治疗机制和正确使用的见解可以指导医生选择正确的治疗靶点。近期发现:CRS合并鼻息肉(CRSwNP)常与2型炎症相关,并以组织重塑过程为特征,可导致顽固性疾病。多西环素治疗(每日100 mg)通过抑制基质金属蛋白酶发挥抗组织重塑作用,改善CRSwNP。强力霉素与适当的药物治疗一起使用时似乎有好处。摘要:目前使用强力霉素治疗的证据仅限于少数高质量的研究。多西环素治疗CRS的持续时间及成功因素有待进一步研究。与其他抗生素一样,强力霉素在副作用和潜在的抗生素耐药性方面也有局限性。因此,治疗决策应谨慎,特别是当强力霉素与其他药物治疗联合使用时。
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来源期刊
CiteScore
5.90
自引率
3.60%
发文量
109
审稿时长
6-12 weeks
期刊介绍: This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on one to three topics, every issue of Current Opinion in Allergy and Clinical Immunology delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as upper airway disease; mechanisms of allergy and adult asthma; paediatric asthma and development of atopy; food and drug allergies; and immunotherapy.
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