Effect of Macrolide Antibiotics on Airway Inflammation in People With Chronic Obstructive Pulmonary Disease (COPD)
Effect of Macrolide Antibiotics on Airway Inflammation in People With Chronic Obstructive Pulmonary Disease (COPD)
Chronic obstructive pulmonary disease (COPD) is a chronic lung disease. Azithromycin, an
 antibiotic, may be beneficial at reducing the symptoms and severity of the disease. This
 study will analyze previously collected study data to evaluate the anti-inflammatory
 properties of azithromycin and determine how azithromycin affects the frequency and severity
 of COPD exacerbations.
COPD is a disease in which the lung airways are partly damaged and obstructed, making it
 difficult to breathe. The most common cause is cigarette smoking, but breathing in other
 types of lung irritants, including pollution, dust, and chemicals, over a long period of time
 may also contribute to COPD. It is the fourth leading cause of death in the United States.
 Symptoms include coughing, excess mucus production, shortness of breath, wheezing, and chest
 tightness.

 Some bacterial infections may worsen COPD exacerbations. Current studies are examining if the
 macrolide antibiotic azithromycin may be beneficial at reducing the frequency and/or severity
 of COPD exacerbations. Azithromycin also has anti-inflammatory properties that may reduce the
 severity of COPD exacerbations by inhibiting the matrix metalloprotease (MMP)-catalyzed
 breakdown of collagen and the subsequent generation of proline-glycine-proline (PGP), a
 substance produced in response to collagen breakdown. An increase in PGP levels may indicate
 an increase in inflammation, which can worsen COPD symptoms. NHLBI's COPD Network Macrolide
 study includes people with COPD who were randomly assigned to receive either azithromycin or
 placebo for 1 year. For this current study, researchers will examine the Macrolide
 participants' previously collected blood samples, sputum samples, and study data, including
 information on COPD exacerbations and azithromycin effects. The purpose of this study is to
 examine the anti-inflammatory properties of azithromycin in people with COPD.
Inclusion Criteria:

 -  Participating in the COPD Network Macrolide study

 -  Clinical diagnosis of at least moderate COPD

 -  Cigarette consumption of 10 pack years or more

 Exclusion Criteria:

 -  Diagnosis of asthma

 -  Predicted life expectancy of less than 3 years

 -  History of hypersensitivity to macrolide antibiotics

 -  Long-term kidney insufficiency

 -  Long-term liver insufficiency

 -  Prolonged QT interval

 -  Use of medications that may prolong the QT interval