Abstract: AIM: To investigate the clinical efficacy of azithromycin in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and explore its immunomodulatory role.METHODS: 76 cases of AECOPD patients were enrolled in this study. All the 76 cases were divided into two groups: control treatment group (A, n=38) and azithromycin treatment group(B, n=38). Another 30 healthy person were used as normal control group (C, n=30). The clinic efficacy and effects of drugs was compared between the two groups. The serum levels of IL-17 and TGF-β₁ was measured with ELISA analysis.RESULTS: The clinic efficacy in group A and B was 63.2% and 84.2%, respectively, which was higher in group B than in group A (P<0.05). The serum levels of IL-17 and TGF-β₁ in group A and B were significantly different as compared with group C at pretreatment (P<0.05). Compared with pretreatment, in group A and B the IL-17 level was significantly decreased (P<0.05), and TGF-β₁ level was significantly increased (P<0.05) at post-treatment. At post-treatment, the IL-17 level was significantly lower in group B than that in group A (P<0.01), and the TGF-β₁ level was significantly higher in group B than that in group A (P<0.05). The incidence of side effects in group A and B were 7.9% and 10.5%, respectively. There was no significant difference between the two groups (P<0.05).CONCLUSION: Azithromycin showed more effectively clinical efficacy on AECOPD patients. The regulation of IL-17/TGF-β₁ balance disorder may play a key role on the mechanism of its significant effect.

Key words: Acute exacerbations of chronic obstructive pulmonary disease, Azithromycin, IL-17, TGF-β₁