Nonantibiotic macrolides restore airway macrophage phagocytic function with potential anti-inflammatory effects in chronic lung diseases

Am J Physiol Lung Cell Mol Physiol. 2017 May 1;312(5):L678-L687. doi: 10.1152/ajplung.00518.2016. Epub 2017 Mar 3.


We reported defective efferocytosis associated with cigarette smoking and/or airway inflammation in chronic lung diseases, including chronic obstructive pulmonary disease, severe asthma, and childhood bronchiectasis. We also showed defects in phagocytosis of nontypeable Haemophilus influenzae (NTHi), a common colonizer of the lower airway in these diseases. These defects could be substantially overcome with low-dose azithromycin; however, chronic use may induce bacterial resistance. The aim of the present study was therefore to investigate two novel macrolides-2'-desoxy-9-(S)-erythromycylamine (GS-459755) and azithromycin-based 2'-desoxy molecule (GS-560660)-with significantly diminished antibiotic activity against Staphylococcus aureus, Streptococcus pneumonia, Moraxella catarrhalis, and H. influenzae We tested their effects on efferocytosis, phagocytosis of NTHi, cell viability, receptors involved in recognition of apoptotic cells and/or NTHi (flow cytometry), secreted and cleaved intracellular IL-1β (cytometric bead array, immunofluorescence/confocal microscopy), and nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) using primary alveolar macrophages and THP-1 macrophages ± 10% cigarette smoke extract. Dose-response experiments showed optimal prophagocytic effects of GS-459755 and GS-560660 at concentrations of 0.5-1 µg/ml compared with our findings with azithromycin. Both macrolides significantly improved phagocytosis of apoptotic cells and NTHi (e.g., increases in efferocytosis and phagocytosis of NTHi: GS-459755, 23 and 22.5%, P = 0.043; GS-560660, 23.5 and 22%, P = 0.043, respectively). Macrophage viability remained >85% following 24 h exposure to either macrolide at concentrations up to 20 µg/ml. Secreted and intracellular-cleaved IL-1β was decreased with both macrolides with no significant changes in recognition molecules c-mer proto-oncogene tyrosine kinase; scavenger receptor class A, member 1; Toll-like receptor 2/4; or CD36. Particulate cytoplasmic immunofluorescence of NLRP3 inflammasome was also reduced significantly. We conclude that GS-459755 and GS-560660 may be useful for reducing airway inflammation in chronic lung diseases without inducing bacterial resistance.

Keywords: azithromycin; chronic lung disease; chronic obstructive pulmonary disease; nonantibiotic macrolides; nontypeable H. influenzae.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Anti-Inflammatory Agents / pharmacology
  • Anti-Inflammatory Agents / therapeutic use*
  • Apoptosis / drug effects
  • Cell Line
  • Cell Survival / drug effects
  • Chronic Disease
  • Erythromycin / analogs & derivatives
  • Erythromycin / pharmacology
  • Flow Cytometry
  • Fluorescent Antibody Technique
  • Haemophilus influenzae / drug effects
  • Humans
  • Interleukin-1beta / metabolism
  • Lung / pathology*
  • Lung Diseases / drug therapy*
  • Lung Diseases / microbiology
  • Lung Diseases / pathology
  • Macrolides / pharmacology
  • Macrolides / therapeutic use*
  • Macrophages, Alveolar / pathology*
  • NLR Family, Pyrin Domain-Containing 3 Protein / metabolism
  • Phagocytosis / drug effects*
  • Proto-Oncogene Mas
  • Receptors, Cell Surface / metabolism
  • Smoking / adverse effects


  • 2'-desoxy-9-erythromycylamine
  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents
  • Interleukin-1beta
  • MAS1 protein, human
  • Macrolides
  • NLR Family, Pyrin Domain-Containing 3 Protein
  • NLRP3 protein, human
  • Proto-Oncogene Mas
  • Receptors, Cell Surface
  • Erythromycin