ArticlePloS one2026
Azithromycin and its non-antibacterial derivative EP317 attenuate select aspects of ventilator-induced lung injury in rats.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Ventilator-induced lung injury (VILI) is a significant complication of mechanical ventilation, contributing to morbidity and mortality in critically ill patients. Excessive mechanical stress triggers an inflammatory cascade, leading to lung damage, pulmonary oedema, and systemic complications. While macrolide antibiotics such as azithromycin (AZM) have demonstrated anti-inflammatory and epithelial barrier strengthening effects, their use is limited by concerns regarding antibiotic resistance. EP317, an azithromycin-derived compound with negligible antibacterial activity, was designed to retain the immunomodulatory and epithelial barrier enhancing effects of AZM while mitigating the risk of bacterial resistance. This study investigated the effects of AZM and EP317 in a rat model of VILI. Forty-eight rats were divided into six groups (N = 8 per group), receiving either placebo, AZM, or EP317 (5 mg/kg daily for seven days), with half of the animals subjected to mechanical ventilation with peak airway pressure at 35 cmH2O. Both compounds attenuated ventilation-induced pulmonary oedema, reflected in a smaller increase in lung wet/dry ratio, whereas ventilation-induced increases in total protein in bronchoalveolar lavage fluid (BALF) were not significantly reduced by either treatment. Cytokine profiling in plasma (L-Selectin, PAI-1, RANTES, MCP-3, IL-6, SCF, IL-17a, RAGE, MIP-3α, IL-13, G-CSF, IL-10, M-CSF, IFN-γ, GRO-KC and MMP9) revealed that both treatments attenuated inflammatory responses, while cytokine levels in BALF in ventilated animals were either unchanged or increased. Survival rates were improved in the treatment groups. Histological analysis indicated increased oedema in ventilated animals, likely due to the high-pressure ventilation, while drug-treated groups exhibited reduced oedema. Global gene expression profiling by RNA sequencing revealed robust upregulation of inflammatory and stress-response pathways in ventilated animals, with partial attenuation following AZM or EP317 pre-treatment. These findings suggest that EP317 and AZM offer protective effects against VILI. EP317 presents a promising alternative to conventional macrolide therapy by circumventing antibiotic resistance concerns.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.