Öz
Antimikrobiyal ajanlar kimyasal yapılarından dolayı bakterilere karşı aktiviteleri dışında bazı yararlı etkilere de sahiptirler. Bunlar arasında antienflamatuvar, immünomodülatör, anti-kanser, anti-anjiyogenik, nöroprotektif, kardiyoprotektif, gastrointestinal hareket artırıcı ve toksin bağlayıcı etkiler sayılabilir. Bu yazıda, konu çok geniş olduğundan dolayı sınırlı sayıda antibiyotiğin antimikrobiyal dışı etkileri ele alınmıştır. Penisilinlerin serviks ve lösemik kanser hücrelerinin çoğalmasını durdurma konusunda ümit vaat edici etkisi ve mantar zehirlenmesi tedavisinde kullanımı; seftriaksonun akciğer kanseri hücreleri üzerindeki çoğalmayı önleyici potansiyeli ve nöroprotektif etkisi derlenmiştir. Tetrasiklinler uzun süredir üzerinde durulan ve araştırılan ajanlardır ve bu gruptaki demeklosiklin, uygunsuz antidiüretik hormon salınımında kullanılmaktadır. Ayrıca tetrasiklinlerden doksisiklin düşük dozda periodontit tedavisi için onay almıştır ve anti-enflamatuvar etkiden sorumlu mekanizma matriks metalloproteinaz (MMP) enzimi inhibisyonudur. Ayrıca MMP inhibisyonu metastazda ve tümör anjiyogenezinde azaltma da sağlayabilmektedir. Diğer bir tetrasiklin olan minosiklin ise Alzheimer ve diğer nörodejeneratif hastalıklarda kilit rolü olan beta-amilod sentezini azaltmakta ve ayrıca gliyal indüklenebilir nitrik oksit (NO) sentaz salınımını ve NO aracılı nörotoksisiteyi de inhibe etmektedir. Makrolidlerden eritromisin gastrointestinal hareket artırıcı olarak kullanılmakta, azitromisin ise kistik fibrozisli hastalarda anti-enflamatuvar etkiyle erken bir iyileşme sağlamaktadır. Klaritromisinin fare akciğer kanseri ve melanomunda metastatik aktiviteyi azalttığı ve klindamisinin Staphylococcus aureus’un opsonizasyon kinetiği çalışması ile toksin bağlayıcı ve fagositozu artırıcı etkisi gösterilmiştir. İlave olarak bir protein sentezi inhibitörü olan linezolid, anti-enflamatuvar ve anti-kanser aktiviteye sahiptir. Tetra florokinolonlar meme ve akciğer kanseri kültürü hücrelerinde doza bağımlı olarak çoğalmayı önlemektedir. Florokinolonlar interlökin-1 ve tümör nekrozis faktör-alfa sentezini inhibe ederek ve koloni uyarıcı faktör sentezini artırarak immünomodülatör etki göstermektedir. Ayrıca, farelerde siprofloksasinin hepatositleri yenileyici etkileri bildirilmiştir. Gelecekte bazı antibiyotiklerin antimikrobiyal dışı etkileri bazı hastalıklarda ümit vaat eder gözükmesine rağmen insanlarda yapılacak klinik çalışmaların sonuçları beklenmelidir. İlave olarak, uzamış antibiyotik kullanımında antimikrobiyallere karşı direnç gelişmesi önemli bir problem oluşturabilir.
Anahtar Kelimeler: Antibiyotik, antimikrobiyal dışı etki, anti-enflamatuvar etki, anti-kanser etki, penisilin
Kaynakça
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