Intravenous immunoglobulins as adjuvant therapy in patients with sepsis

Written by Shumatov V.B., Lazanovich V.A., Pavlov V.A., Ermakova N.D., Prosecova E.V.

  UDK: 616.94-085.37 | Pages: 42–45 | Full text PDF | Open PDF 


Objective. Treatment and prevention of postoperative complications in patients with purulent-septic pathology remain one of the most urgent problems of modern surgery. One of the groups of drugs that are used as an adjuvant therapy for surgical sepsis are intravenous immunoglobulins (IVIG). Methods. We observed 56 patients with sepsis, which were divided into 3 groups. 1st group (25 patients) received traditional treatment, 2nd group (14 patients) received standard IVIG (Ig G) in addition to traditional therapy, 3rd group (17 patients) in addition to conventional therapy received enriched IVIG (Ig M+Ig A). Results. Comparative assessment of the combination of intravenous immunoglobulin’s and traditional therapy indicated the clinical effectiveness of IVIG therapy, which results in reducing the severity of systemic inflammation, the severity of the disease and the mortality in patients with surgical sepsis. Conclusion. Thus, after analyzing the results obtained, it was shown that it is advisable to include IVIG in complex therapy of patients with surgical sepsis.

Links to authors:

V.B. Shumatov1, V.A. Lazanovich2, V.A. Pavlov3, N.D. Ermakova1,
E.V. Prosecova1
1 Pacific State Medical University (2 Ostryakova Ave. Vladivostok 690950 Russian Federation),
2 Primorye Regional Clinical Hospital No. 1 (57 Aleutskaya St. Vladivostok 690091 Russian Federation),
3 Vladivostok Clinical Hospital No. 2 (57 Russkaya St. Vladivostok 690105 Russian Federation)

1. Lazanovich V.A., Prosekova E.V. Intravenous immunoglobulins: mechanisms of therapeutic effects // Medical Immunology (Russia). 2014. No. 16. P. 311–322.
2. Lazanovich V.A., Smirnov G.A., Ischenko V.N. Dynamics of cytokines as one of the factors of the pathogenesis of surgical sepsis // Pacific Medical Journal. 2005. No. 4. P. 50–52.
3. Blasczyk R., Westhoff U., Grosse-Wilde H. Soluble CD4, CD8, and HLA molecules in commercial immunoglobulin preparations // Lancet. 1993. Vol. 341. Р. 789–790.
4. Ichiyama T., Ueno Y., Hasegawa M. Intravenous immunoglobulin inhibits NF-kappa B activation and affects Fc gamma receptor expression in monocytes/macrophages // Naunyn Schmiedebergs Arch. Pharmacol. 2004. Vol. 369. P. 428–433.
5. Iwashyna T.J., Cooke C.R., Wunsch H., Kahn J.M. Population burden of long-term survivorship after severe sepsis in older Americans // J. Am. Geriatr. Soc. 2012 Vol. 60. P.1070–1077.
6. Opal S.M., Laterre P.F., Francois B. [et al.]. Effect of eritoran, an antagonist of MD2-TLR4, on mortality in patients with severe sepsis: the ACCESS randomized trial // JAMA. 2013. Vol. 309. P. 1154–1162.
7. Orel L., Neumeier H., Hochrainer K., Binder B.R. Crosstalk between the NF-kappa B activating IKK-complex and the CSN signalosome // J. Cell. Mol. Med. 2010. Vol. 16. P. 1555–1568.
8. Pène F., Courtine E., Ouaaz F. Toll-like receptors 2 and 4 contribute to sepsis-induced depletion of spleen dendritic cells // Infect. Immun. 2009. Vol. 77. P. 5651–5658.
9. Ranieri V.M., Thompson B.T., Barie P.S. Drotrecogin alfa (activated) in adults with septic shock // N. Engl. J. Med. 2012. Vol. 366. P. 2055–2064.
10. Rhodes A., Evans L.E., Alhazzani W. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016 // Intensive Care Med. 2017. Vol. 43. P. 304–377.
11. Singer M. Deutschman C.S., Seymour C.W. [et al.]. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) // JAMA. 2016. Vol. 315. P. 801–810
12. Sjoberg A.P., Trouw L.A., Blom A.M. Complement activation and inhibition: a delicate balance // Trends. Immunol. 2009. Vol. 30. P. 83–90.
13. Takei S., Arora Y.K., Walker S.M. Intravenous immunoglobulin contains specific antibodies inhibitory to activation of T cells by staphylococcal toxin superantigens // J. Clin. Invest. 1993. Vol. 91. P. 602–607.
14. Vassilev T.L., Kazatchkine M.D., Duong Van Huyen J.P. [et al.]. Inhibition of cell adhesion by antibodies to Arg-Gly-Asp (RGD) in normal immunoglobulin for therapeutic use (intravenous immunoglobulin, IVIg ) // Blood. 1999. Vol. 93, No. 11. Р. 3624–3631.
15. Ward P.A. Sepsis, apoptosis and complement // Biochem. Pharmacol. 2008. Vol. 76. P. 1383–1388.


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