Table 1. Studies on Microbial Agents and Antimicrobial Therapy in Pulmonary Fibrosis.
| A. Microbial Agent implicated in Pulmonary Fibrosis | ||
| Viruses | References | |
| Hepatitis C Virus (HCV) | [46-50] | |
| Epstein-Barr Virus (EBV) | [21,27,32-35,54] | |
| Cytomegalovirus (CMV) | [27,41,42] | |
| Human Herpes Virus 1 (HHV-1) | [43] | |
| Human Herpes Virus 6 (HHV-6) | [44] | |
| Human Herpes Virus 7 (HHV-7) | [27] | |
| Human Herpes Virus 8 (HHV-8) | [27] | |
| Adenovirus | [22,51,52] | |
| Torque-Teno Virus (TTV) | [53-56] | |
| Murine gammaherpes virus type 68 (MHV-68) | [29,36-38,67,95] | |
| Parainfluenza Virus | [54] | |
| Parvovirus B19 | [42] | |
| Bacteria | ||
| Pseudomonas aeruginosa | [58] | |
| Streptococcus pneumonia | [20,58] | |
| Moraxella catarrhalis | [58] | |
| Proteus mirabilis | [58] | |
| Propionibacterium acnes | [77] | |
| Staphylococcus aureus | [28] | |
| Pneumocystis jirovecii | [60] | |
| Haemophilus influenza | [19] | |
| Mycobacteria | [57] | |
| Fungi | ||
| Aspergillus fumigatus | [73] | |
| Paracoccidiodes brasiliensis | [69-71] | |
| B. Antimicrobial Studies on infectious Agents involved in Pulmonary Fibrosis | ||
| Antivirals | Findings | |
| Ganciclovir | 2-week course of ganciclovir may attenuate disease progression in a subgroup of advanced IPFa patients [26]. | |
| Valacyclovir | Treatment with this antiviral led to a decrease in sputum viral load in lungs of patients with IPF [27]. | |
| Cidovir | Antiviral treatment administered to symptomatic animals, improved survival from 20 to 80% compared with untreated symptomatic animals, but lung fibrosis persisted in 60% of the mice [96]. | |
| Antibiotics | ||
| Clarithromycin | Antibiotic treatment with clarithromycin or amoxicillin led to significantly decreased lung hydroxyproline contents, thereby in blocking S. pneumoniae-induced fibrosis exacerbation in mice [20]. | |
| Amoxicillin | Antibiotic treatment with clarithromycin or amoxicillin led to significantly decreased lung hydroxyproline contents, thereby in blocking S. pneumoniae-induced fibrosis exacerbation in mice [20]. | |
| Azithromycin | This antibiotic showed a significant reduction in both fibrosis and restrictive lung function pattern in a bleomycin-induced PFb mouse model [25]. | |
| Co-trimoxazole | Treating IPF patients with the addition of co-trimoxazole 960mg twice daily had no effect on lung function but resulted in improved quality of life and a reduction in mortality in those adhering to treatment [24]. | |
| Antifungals | ||
| Combined antifungal (Itraconazole) and immunomodulatory (Pentoxifylline) therapy | A study conducted on the development of fibrosis in a model of experimental chronic pulmonary PCMc, employing a combined antifungal (Itraconazole) and immunomodulatory (Pentoxifylline) therapy resulted in a significant reduction of granulomatous inflammation and PF, when compared with the results of classical antifungal therapy using itraconazole alone [23]. | |
aIPF: Idiopathic pulmonary fibrosis, bPF: Pulmonary fibrosis, cPCM: Paracoccidioidomycosis