Azithromycin (AZM), primarily recognized for its antibiotic properties, has gained attention for its ability to modulate the immune system and reduce inflammation. This review explores the impact of AZM on various immune cell types, including T cells, B cells, and natural killer (NK) cells, and its potential in treating chronic inflammatory and autoimmune conditions. AZM inhibits the mTOR signaling pathway in T cells, thereby limiting both T cell proliferation and cytokine production. It also affects B-cell function by modulating pathways such as NF-κB and CD27, thereby influencing antibody synthesis. In NK cells, AZM reduces cytotoxicity and cytokine release while preserving cell viability. The drug’s effects on immune responses, particularly on vaccination responses and reduced antibody levels, have important clinical implications. While AZM shows potential for managing conditions such as graft-versus-host disease and asthma, its varied effects highlight the need for further investigation. Further understanding of these mechanisms is crucial for optimizing AZM’s therapeutic use and minimizing unwanted immune suppression.
This review aims to explore and consolidate the therapeutic potential of colchicine, one of the oldest yet still widely used treatments. Colchicine is an alkaloid compound known for its anti-inflammatory and analgesic effects. It has been effectively used to treat conditions such as gout, familial Mediterranean fever (FMF), and Behcet’s disease. The drug’s mechanism of action involves its interaction with tubulin, a structural component of the cytoskeleton, which disrupts neutrophil functions, including adhesion, migration, and chemotaxis. Colchicine specifically inhibits tyrosine phosphorylation, a key process for neutrophil activation, and affects neutrophil deformability, preventing their extravasation. Additionally, it suppresses the production of superoxide and pro-inflammatory cytokines, such as interleukin 1β and IL-6. The drug also inhibits inflammasome activity, hindering caspase-1 activation and interleukin release. Colchicine has attracted attention during the COVID-19 pandemic due to its potential to treat severe cases and reduce mortality. It is a cost-effective and widely accessible drug with a relatively safe profile. However, its metabolism can be influenced by CYP3A4 and P-glycoprotein inhibitors, as well as by renal and hepatic impairments. Common side effects include gastrointestinal disturbances such as diarrhea, nausea, and vomiting.
Snakebite envenoming remains a significant global health challenge, with high mortality and morbidity rates persisting despite decades of medical attention. Each year, millions are affected by venomous snakebites, often resulting in death or severe disability. Snake venoms exhibit diverse bioactivities, including hemorrhagic, inflammatory, cytotoxic, cardiotoxic, and neurotoxic effects, mainly due to complex mixtures of toxin-rich proteins. Although considerable research has been undertaken, the majority of venom components remain uncharacterized. Recent advancements in proteomics and bioinformatics have enabled more detailed exploration of venom profiles, facilitating the identification and functional prediction of novel toxins. Computational approaches now enable modeling of toxin-target interactions, aiding understanding of venom mechanisms. This review also explores the emerging role of medicinal plants in snakebite treatment, alongside conventional antivenoms. Emphasis is placed on the urgent need to improve access to safe, affordable, and effective antivenoms in low-income tropical regions and to promote their appropriate clinical use.
Eurasian Academy of Medicine and Dentistry