Immunotherapy in the Management of Sepsis

Overview

Journal Postgrad Med J

Publisher Oxford University Press

Specialty General Medicine

Date 1995 Feb 1

PMID 7724438

Authors

E A Fagan

M Singer

Affiliations

Soon will be listed here.

Abstract

The pathophysiological effects of severe sepsis, septic shock and related syndromes result from tissues damaged by the uncontrolled production of the mediators of inflammation. Early deaths are related primarily to the acute effects of the systemic inflammatory response. Later deaths are related more closely to the consequences of multiple organ dysfunction. Monoclonal antibodies and other immunotherapies have been developed against bacterial products, cytokines and other mediators involved in this systemic inflammatory response. Immunotherapies may improve outcome in the critically ill with sepsis if used early and as part of the therapeutic regimen of antimicrobial agents and intensive care support.

References

Hesse D, Tracey K, Fong Y, Manogue K, Palladino Jr M, Cerami A . Cytokine appearance in human endotoxemia and primate bacteremia. Surg Gynecol Obstet. 1988; 166(2):147-53. View

Natanson C, Eichenholz P, Danner R, Eichacker P, Hoffman W, Kuo G . Endotoxin and tumor necrosis factor challenges in dogs simulate the cardiovascular profile of human septic shock. J Exp Med. 1989; 169(3):823-32. PMC: 2189288. DOI: 10.1084/jem.169.3.823. View

Kreger B, Craven D, McCabe W . Gram-negative bacteremia. IV. Re-evaluation of clinical features and treatment in 612 patients. Am J Med. 1980; 68(3):344-55. DOI: 10.1016/0002-9343(80)90102-3. View

Sun X, Hsueh W . Bowel necrosis induced by tumor necrosis factor in rats is mediated by platelet-activating factor. J Clin Invest. 1988; 81(5):1328-31. PMC: 442560. DOI: 10.1172/JCI113459. View

Widmer A . Infection control and prevention strategies in the ICU. Intensive Care Med. 1994; 20 Suppl 4:S7-11. DOI: 10.1007/BF01713976. View

Parker M, Shelhamer J, Natanson C, Alling D, Parrillo J . Serial cardiovascular variables in survivors and nonsurvivors of human septic shock: heart rate as an early predictor of prognosis. Crit Care Med. 1987; 15(10):923-9. DOI: 10.1097/00003246-198710000-00006. View

Bone R . The pathogenesis of sepsis. Ann Intern Med. 1991; 115(6):457-69. DOI: 10.7326/0003-4819-115-6-457. View

Danner R, Natanson C, Elin R, Hosseini J, Banks S, MacVittie T . Pseudomonas aeruginosa compared with Escherichia coli produces less endotoxemia but more cardiovascular dysfunction and mortality in a canine model of septic shock. Chest. 1990; 98(6):1480-7. DOI: 10.1378/chest.98.6.1480. View

Cobb J, Cunnion R, Danner R . Nitric oxide as a target for therapy in septic shock. Crit Care Med. 1993; 21(9):1261-3. DOI: 10.1097/00003246-199309000-00003. View

10.

Porat R, Johns M, McCabe W . Selective pressures and lipopolysaccharide subunits as determinants of resistance of clinical isolates of gram-negative bacilli to human serum. Infect Immun. 1987; 55(2):320-8. PMC: 260329. DOI: 10.1128/iai.55.2.320-328.1987. View

11.

Hannum C, Wilcox C, Arend W, Joslin F, Dripps D, Heimdal P . Interleukin-1 receptor antagonist activity of a human interleukin-1 inhibitor. Nature. 1990; 343(6256):336-40. DOI: 10.1038/343336a0. View

12.

Simon D, Koenig G, Trenholme G . Differences in release of tumor necrosis factor from THP-1 cells stimulated by filtrates of antibiotic-killed Escherichia coli. J Infect Dis. 1991; 164(4):800-2. DOI: 10.1093/infdis/164.4.800. View

13.

van der Poll T, Buller H, ten Cate H, Wortel C, Bauer K, van Deventer S . Activation of coagulation after administration of tumor necrosis factor to normal subjects. N Engl J Med. 1990; 322(23):1622-7. DOI: 10.1056/NEJM199006073222302. View

14.

BORDER J . Hypothesis: sepsis, multiple systems organ failure, and the macrophage. Arch Surg. 1988; 123(3):285-6. DOI: 10.1001/archsurg.1988.01400270019001. View

15.

Tracey K, Fong Y, Hesse D, Manogue K, Lee A, Kuo G . Anti-cachectin/TNF monoclonal antibodies prevent septic shock during lethal bacteraemia. Nature. 1987; 330(6149):662-4. DOI: 10.1038/330662a0. View

16.

Cannon J, Tompkins R, Gelfand J, Michie H, Stanford G, van der Meer J . Circulating interleukin-1 and tumor necrosis factor in septic shock and experimental endotoxin fever. J Infect Dis. 1990; 161(1):79-84. DOI: 10.1093/infdis/161.1.79. View

17.

Bone R . A critical evaluation of new agents for the treatment of sepsis. JAMA. 1991; 266(12):1686-91. View

18.

Sicignano A, Lorini F . Does flumazenil antagonize baclofen?. Intensive Care Med. 1994; 20(7):533. DOI: 10.1007/BF01711915. View

19.

Smith J, Magee D, Williams D, Graybill J . Tumor necrosis factor-alpha plays a role in host defense against Histoplasma capsulatum. J Infect Dis. 1990; 162(6):1349-53. DOI: 10.1093/infdis/162.6.1349. View

20.

Wang J, Dunn M . Platelet-activating factor mediates endotoxin-induced acute renal insufficiency in rats. Am J Physiol. 1987; 253(6 Pt 2):F1283-9. DOI: 10.1152/ajprenal.1987.253.6.F1283. View