2016, Número 4
Efecto inmunomodulador anti-inflamatorio de la moxifloxacina como coadyuvante en la terapia periodontal
Ardila MCM, Bedoya GJ, Patiño GJE
Idioma: Español
Referencias bibliográficas: 34
Paginas: 444-451
Archivo PDF: 635.08 Kb.
RESUMEN
Fundamento: la periodontitis es una enfermedad infecciosa que se presenta como producto de la interacción entre algunos microorganismos y diversas reacciones del huésped a la infección. La función inmunomodulatoria anti-inflamatoria de antimicrobianos como la moxifloxacina puede ser una cualidad de gran utilidad en el tratamiento de la periodontitis.
Objetivo: revisar la literatura científica con el fin de determinar si la moxifloxacina presenta un efecto inmunomodulador.
Métodos: se realizó una revisión sistemática de investigaciones realizadas en humanos o células humanas publicadas en las bases de datos Medline-Pubmed, SciELO, LILACS y Google académico entre 1996 y 2015, se utilizaron los siguientes términos en diferentes combinaciones: moxifloxacin, immunomodulation, cytokines, interleukines y tumor necrosis factor. Se excluyeron las series de casos, resultados duplicados debido a las combinaciones de los términos de búsqueda, datos no disponibles, cartas al editor y revisiones históricas.
Desarrollo: un total de nueve estudios presentaron disminución de la liberación de las interleuquinas 1β, 6, 8 mientras que cinco estudios mostraron su inhibición. Tres publicaciones demostraron inhibición del factor de necrosis tumoral α y tres presentaron reducción de su liberación.
Conclusiones: la moxifloxacina, además de su eficacia contra los principales periodontopatógenos, tiene un efecto inmunomodulador importante en el proceso inflamatorio de la periodontitis que debe tenerse en cuenta en la toma de decisiones clínicas para el tratamiento de esta enfermedad.
REFERENCIAS (EN ESTE ARTÍCULO)
Olsen I. From the Acta Prize Lecture 2014: the periodontal-systemic connection seen from a microbiological standpoint. Acta Odon-tol Scand. 2015 Aug;73(8):563-8.
Polepalle T, Moogala S, Boggarapu S, Pesala DS, Palagi FB. Acute Phase Proteins and Their Role in Periodontitis: A Review. J Clin Diagn Res. 2015 Sept;9(11):ZE01-5.
Graves DT, Cochran D. The contribution of interleukin-1 and tumor necrosis factor to periodontal tissue destruction. J Periodontol. 2003 Mar;74(3):391-401.
Garcia Canas P, Khouly I, Sanz J, Loomer PM. Effectiveness of systemic antimicrobial thera-py in combination with scaling and root plan-ing in the treatment of periodontitis: a sys-tematic review. J Am Dent Assoc. 2015 Mar;146(3):150-63.
Ardila CM, Martelo-Cadavid JF, Boderth-Acosta G, Ariza-Garcés AA, Guzmán IC. Ad-junctive moxifloxacin in the treatment of gen-eralized aggressive periodontitis patients: clinical and microbiological results of a ran-domized, triple-blind and placebo-controlled clinical trial. J Clin Periodontol. 2015 Feb;42(2):160-8.
Ardila CM, Fernández N, Guzmán IC. Antimi-crobial susceptibility of moxifloxacin against gram-negative enteric rods from Colombian patients with chronic periodontitis. J Perio-dontol. 2010 Feb;81(2):292-9.
Bode C, Diedrich B, Muenster S, Hentschel V, Weisheit C, Rommelsheim K et al. Antibiotics regulate the immune response in both pres-ence and absence of lipopolysaccharide through modulation of Toll-like receptors, cy-tokine production and phagocytosis in vitro. Int Immunopharmacol. 2014 Jan;18(1):27-34.
Zimmermann GS, Neurohr C, Villena-Hermoza H, Hatz R, Behr J. Anti-inflammatory effects of antibacterials on hu-man bronchial epithelial cells. Respir Res. 2009 Sep 29;10:898.
Araujo FG, Slifer TL, Remington JS. Effect of moxifloxacin on secretion of cytokines by hu-man monocytes stimulated with lipopolysac-charide. Clin Microbiol Infect. 2002 Jan;8(1):26-30.
Giamarellos-Bourboulis EJ, Douzinas EE, Tsaganos T, Pagoulatou A, Livaditi O, Vafi-adou M et al. Cerebrospinal fluid of patients administered moxifloxacin modulates the secretion of cytokines from human mono-cytes. Diagn Microbiol Infect Dis. 2009 Jan;63(1):62-9.
Müller HP, Holderrieth S, Burkhardt U, Höf-fler U. In vitro antimicrobial susceptibility of oral strains of Actinobacillus actinomycetem-comitans to seven antibiotics. J Clin Perio-dontol. 2002 Aug;29(8):736-42.
Williams AC, Galley HF, Watt AM, Webster NR. Differential effects of three antibiotics on T helper cell cytokine expression. J Anti-microb Chemother. 2005 Sep;56(3):502-6.
Hall IH, Schwab UE, Ward ES, Ives TJ. Ef-fects of moxifloxacin in zymogen A or S. au-reus stimulated human THP-1 monocytes on the inflammatory process and the spread of infection. Life Sci. 2003 Oct 10;73(21):2675-85.
Beisswenger C, Honecker A, Kamyschnikow A, Bischoff M, Tschernig T, Bals R. Moxiflox-acin modulates inflammation during murine pneumonia. Respir Res. 2014 Jul 17;15:82.
Shalit I, Kletter Y, Halperin D, Waldman D, Vasserman E, Nagler A. Immunomodulatory effects of moxifloxacin in comparison to ciprofloxacin and G-CSF in a murine model of cyclophosphamide- induced leukopenia. Eur J Haematol. 2001 May;66(5):287-96.
Li H, Zhu S, He S, Hao L. Anti-inflammatory effects of moxifloxacin on rat airway smooth muscle cells exposed to allergen : Inhibition of extracellular-signal-regulated kinase and nuclear factor- k B activation and of inter-leukin-8 and eotaxin synthesis. Respirology. 2012 Aug;17(6):997-1005.
Fabian I, Reuveni D, Levitov A, Halperin D, Priel E, Shalit I. Moxifloxacin enhances anti-proliferative and apoptotic effects of etopo-side but inhibits its proinflammatory effects in THP-1 and Jurkat cells. Br J Cancer. 2006 Oct 23;95(8):1038-46.
Blau H, Klein K, Shalit I, Halperin D, Fabian I. Moxifloxacin but not ciprofloxacin or azithromycin selectively inhibits IL-8 , IL-6 , ERK1 / 2 , JNK , and NF- κ B activation in a cystic fibrosis epithelial cell line. Am J Physiol Lung Cell Mol Physiol. 2007 Jan;292(1):L343-52.
Shalit I, Halperin D, Haite D, Levitov A, Ro-mano J, Osherov N, et al. Anti-inflammatory effects of moxifloxacin on IL-8, IL-1 b and TNFα secretion and NF k B and MAP-kinase activation in human monocytes stimulated with Aspergillus fumigatus. J Antimicrob Chemother. 2006 Feb;57(2):230-5.
Choi JH, Song MJ, Kim SH, Choi SM, Lee DG, Yoo JH. Effect of Moxifloxacin on Production of Proinflammatory Cytokines from Human Peripheral Blood Mononuclear Cells. Antimi-crob Agents Chemother. 2003 Dec;47(12):3704-7.
Wiesner G, Braun SL, Gruber M, Gertler R, Lange R, Tassani P. Neither moxifloxacin nor cefuroxime produces significant attenuation of inflammatory mediator release in patients exposed to cardiopulmonary bypass: a ran-domized controlled trial. J Antimicrob Chemo-ther. 2012 Jan;67(1):230-3.
Ochoa Ramírez LA. Evaluación del efecto de antibióticos quinolónicos de nueva generación e immunepotent CRP sobre el Sistema inmu-ne. México: Facultad de Ciencias Biológicas. Universidad Autónoma de Nuevo León; 2011.
Singh S, Kubler A, Singh UK, Singh A, Gardi-ner H, Prasad R. Metalloproteinases in a Cel-lular Model of Pulmonary Tuberculosis. Anti-microb Agents Chemother. 2014 Aug;58(8):4657-65.
Martínez FJ. Monotherapy versus Dual Thera-py for Community-Acquired Pneumonia in Hospitalized Patients. Clin Infect Dis. 2004 May 15;38 Suppl 4:S328-40.
Shalit I, Horev-Azaria L, Fabian I, Blau H, Kariv N, Shechtman I, et al. Immunomodula-tory and Protective Effects of Moxifloxacin against Candida albicans -Induced Broncho-pneumonia in Mice Injected with Cyclophos-phamide. Antimicrob Agents Chemother. 2002 Aug;46(8):2442-9.
Fávaro WJ, Nunes OS, Seiva FR, Nunes IS, Woolhiser LK, Durán N. Effects of P-MAPA Immunomodulator on Toll-Like Receptors and p53 : Potential Therapeutic Strategies for Infectious Diseases and Cancer. Infect Agent Cancer. 2012 Jun 18;7(1):14.
Dalhoff A, Shalit I. Immunomodulatory ef-fects of quinolones. Lancet Infect Dis. 2003 Jun;3(6):359-71.
Kazama I, Nakajima T. Dual infection of My-coplasma pneumoniae and Chlamydophila pneumoniae predispositions successfully treated by moxifloxacin. Infez Med. 2014 Mar;22(1):41-7.
Haffajee AD, Socransky SS, Gunsolley JC. Systemic anti-infective periodontal therapy. A systematic review. Ann Periodontol. 2003 Dec;8(1):115-81.
Mestnik MJ, Feres M, Figueiredo LC, Soares G, Teles RP, Fermiano D, et al. The effects of adjunctive metronidazole plus amoxicillin in the treatment of generalized aggressive peri-odontitis: A 1-year double-blinded, placebo-controlled, randomized clinical trial. J Clin Periodontol. 2012 Oct;39(10):955-61.
Xajigeorgiou C, Sakellari D, Slini T, Baka A, Konstantinidis A. Clinical and microbiologi-cal effects of different antimicrobials on gen-eralized aggressive periodontitis. J Clin Perio-dontol. 2006 Apr;33(4):254-64.
Haas AN, Silva-Boghossian CM, Colombo AP, Susin C, Albandar JM, Oppermann RV, et al. Adjunctive azithromycin in the treatment of aggressive periodontitis: Microbiological find-ings of a 12-month randomized clinical trial. J Dent. 2012 Jul;40(7):556-63.
Sampaio E, Rocha M, Figueiredo LC, Faveri M, Duarte PM, Gomes Lira EA, et al. Clinical and microbiological effects of azithromycin in the treatment of generalized chronic periodontitis: A randomized placebo-controlled clinical trial. J Clin Periodontol. 2011 Sep;38(9):838-46.
Keestra JA, Grosjean I, Coucke W, Quirynen M, Teughels W. Non-surgical periodontal therapy with systemic antibiotics in patients with untreated aggressive periodontitis: a systematic review and meta-analysis. J Perio-dontal Res. 2015 Dec;50(6):689-706.