ABSTRACT
Diffuse panbronchiolitis (DPB) was first distinguished from chronic obstructive pulmonary
diseases in the early 1960s and recorded as a new clinicopathologic entity. This disease
affects East Asians for the major part, and is characterized by chronic sinobronchial
infection together with diffuse bilateral micronodular pulmonary lesions consisting
of inflammatory cells. The prognosis at an advanced stage would often be bleak, where
superinfection with Pseudomonas aeruginosa had occurred. Beginning with an initial success of erythromycin therapy, considerable
improvement has been achieved in the prognosis of this disease. Simple bactericidal
activity of macrolides is not a determinant factor for the clinical effect. An in-depth
study, together with its pathogenesis, has been performed to clarify the underlying
mechanism. Inhibitions of excessive mucus and water secretion from airway epithelium,
neutrophil accumulation in the large airway, lymphocyte and macrophage accumulation
around the small airway, and modulation of bacterial virulence have so far been proposed
as possible mechanisms.
KEYWORDS
Macrolides - chronic airway infection