, Volume 5, Issue 5, pp 392-399
Date: 03 Nov 2012

Glucan-Based Macrophage Stimulators

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Summary

Sepsis and sepsis syndrome are significant causes of morbidity and mortality in critically ill surgical patients. Despite technological and therapeutic advances in critical care, sepsis continues to be a pivotal factor in 20 to 50% of deaths in surgical intensive care units. It is clear that alternative approaches to the prevention and/or treatment of sepsis must be found.

Preclinical data indicate that macrophage activation with (1 →3)-β-D-glucans will ameliorate sequelae associated with Gram-negative septicaemia. We and others have translated these preclinical observations to the clinical setting and have shown that macrophage activation with (1→3)-β-D-glucans will significantly reduce septic morbidity and mortality in trauma and/or high-risk surgical patients. The precise mechanism(s) by which (1→3)-β-D-glucans prevent or ameliorate infections have not been fully elucidated. However, recent data suggest the anti-infective efficacy of (1→3)-β-D-glucans is attributable, in part, to macrophage activation induced by binding of (1→3)-β-D-glucan to a specific receptor followed by modulation of macrophage pro-inflammatory cytokine expression.

This article reviews the anti-infective potential of (1→3)-β-D-glucans in the prevention of sepsis and septic sequelae.