Sepsis pp 449-463 | Cite as

What Is Certain in the Treatment with Immunoglobulins?

  • H. G. Kress
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 18)

Abstract

Almost a century ago, in the time of von Behring, Ehrlich and Roux, the beneficial and in many cases live-saving concept of passive immunization with toxin- or pathogen-specific antisera was born and put into practice in Europe. The concept of passive immunotherapy and immunoprophylaxis against bacterial infections, although obviously efficacious, has been superseded by antimicrobial therapy with a continuously growing number of antibiotic agents. Interestingly enough, intramuscular immunoglobulins continue to be widely used in the prophylaxis and treatment of viral diseases such as measles, mumps, varicella, rubella and hepatitis.

Keywords

Placebo Hepatitis Pneumonia Polysaccharide Fractionation 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Ehrlich P (1891) Experimentelle Untersuchungen über Immunität, I. über Ricin; II. über Abrin. Dtsch Med Wochenschr 17:976–979; 1218-1219CrossRefGoogle Scholar
  2. 2.
    von Behring E, Kitasato (1890) Über das Zustandekommen der Diphtherie-Immunität und der Tetanus-Immunität bei Tieren. Dtsch Med Wochenschr 16:1113–1114CrossRefGoogle Scholar
  3. 3.
    Karelitz S (1938) Prophylaxis against measles with the globulin fraction of immune adult serum. Am J Dis Child 55:768–775Google Scholar
  4. 4.
    Tiselius A, Kabat EA (1938) Electrophoresis of immune serum. Science 87:416–417PubMedCrossRefGoogle Scholar
  5. 5.
    Cohn EJ, Luetscher JA Jr, Oncley JL et al (1940) Preparation and properties of serum and plasma proteins. J Am Chem Soc 62:3396–3400CrossRefGoogle Scholar
  6. 6.
    Schultze HE, Schwick G (1962) Über neue Möglichkeiten intravenöser Gammaglobulin-Applikation. Dtsch Med Wochenschr 87; 1643–1650PubMedCrossRefGoogle Scholar
  7. 7.
    Barandun S, Isliker H (1986) Development of immunoglobulin preparations for intravenous use. Vox Sang 51:157–160PubMedCrossRefGoogle Scholar
  8. 8.
    Gronski P, Hofstaetter T, Kanzy EJ et al (1983) S-sulfonation: a reversible chemical modification of human immunoglobulins permitting intravenous application. I. Physiochemical and binding properties of S-sulfonated and reconstituted IgG. Vox Sang 45:144–154Google Scholar
  9. 9.
    Morell A (1986) Various immunoglobulin preparations for intravenous use. Vox Sang 51[Suppl 2]:pp 44–49PubMedCrossRefGoogle Scholar
  10. 10.
    Römer J, Morgenthaler JJ, Scherz R, Skvaril F (1982) Characterization of various immunoglobulin preparations for intravenous application. Vox Sang 42:62–73PubMedGoogle Scholar
  11. 11.
    Schroeder DD, Tankersley DL, Lundblad JL (1981) A new preparation of modified immune serum globulin (human) suitable for intravenous administration. Vox Sang 40:373–394PubMedCrossRefGoogle Scholar
  12. 12.
    Stephan W (1969) Beseitigung der Komplementfixierung von Gammaglobulin durch chemische Modifizierung mit β-Propiolacton. Z Klin Chem Klin Biochem 7:282–286PubMedGoogle Scholar
  13. 13.
    Stephan W (1975) Undegraded human immunoglobulin for intravenous use. Vox Sang 28:422–437PubMedCrossRefGoogle Scholar
  14. 14.
    Stephan W (1980) Intravenöse Immunglobuline. Proteinchemische und immunbiologische Charakterisierung der verschiedenen Präparatetypen. Arzneimittelforschung/ Drug Res 30:116–117Google Scholar
  15. 15.
    Schreiber JR, Barrus VA, Siber GR (1985) Decreasd protective efficacy of reduced and alkylated human immune serum globulin in experimental infection with Haemophilus influenzae type b. Infect Immun 47:142–148PubMedGoogle Scholar
  16. 16.
    Stephan W, Dichtelmüller H (1984) Reduced efficacy of sulfitolysed intravenous immunoglobulin. Eur J Clin Microbiol 3:47PubMedCrossRefGoogle Scholar
  17. 17.
    van Furth R, Leijh PCJ, Klein F (1984) Correlation between opsonic activity for various microorganisms and composition of gammaglobulin preparations for intravenous use. J Infect Dis 149:511–517PubMedCrossRefGoogle Scholar
  18. 18.
    Stephan W, Dichtelmüller H, Schedel I (1985) Properties and efficacy of a human immunoglobulin M preparation for intravenous administration. Arzneimittelforschung/ Drug Res 35:933–936Google Scholar
  19. 19.
    Berger D, Beger HG (1990) Adjuvant septic therapy with immunoglobulin — in vivo and in vitro studies. Intensive Care Med 16[Suppl 1]:20Google Scholar
  20. 20.
    Garbett ND, Munro CS, Cole PJ (1989) Opsonic activity of a new intravenous immunoglobulin preparation: Pentaglobin compared with Sandoglobulin. Clin Exp Immunol 76:8–12PubMedGoogle Scholar
  21. 21.
    McCabe WR, DeMaria A Jr, Berberich H, Johns MA (1988) Immunization with rough mutants of Salmonella minnesota: protective activity of IgM and IgG antibody to the R 595 (Re chemotype) mutant. J Infect Dis 158:291–300PubMedCrossRefGoogle Scholar
  22. 22.
    Collins MS, Roby RE (1984) Protective activity of an intravenous immune globulin (human) enriched in antibody against lipopolysaccharide antigens of Pseudomonas aeruginosa. Am J Med 76:168–174PubMedCrossRefGoogle Scholar
  23. 23.
    Collins MS, Hector RF, Roby RE et al (1987) Prophylaxe gramnegativer und grampositiver Infektionen mit drei intravenösen Immunglobulin-Präparaten und Therapie der experimentellen polymikrobiellen Verbrennungssepsis mit intravenösem Pseudomonas-Immunglobulin G und Ciprofloxacin im Tiermodell. Infection 15[Suppl 2]:51–59CrossRefGoogle Scholar
  24. 24.
    Ferreira A, Garcia Rodriguez MC, Fontan G (1989) Follow-up of anti-IgA antibodies in primary immunodeficient patients treated with γ-globulin. Vox Sang 56:218–222PubMedCrossRefGoogle Scholar
  25. 25.
    Winter PM, Manndorff P (1988) The frequency of IgA-deficiency in the Austrian population. Infusionstherapie 15:221–224PubMedGoogle Scholar
  26. 26.
    Björkander J, Cunningham-Rundles C, Lundin P et al (1988) Intravenous immunoglobulin prophylaxis causing liver damage in 16 of 77 patients with hypogammaglobulinemia or IgG subclass deficiency. Am J Med 84:107–111PubMedCrossRefGoogle Scholar
  27. 27.
    Centers for Disease Control (1986) Safety of therapeutic immune globulin preparations with respect to transmission of human T-lymphotropic virus type III/lymphadenopathyassociated virus infection. MMWR 35:231–233Google Scholar
  28. 28.
    Cooperative Group for the Study of Immunoglobulin in Chronic Lymphocytic Leukemia (1988) Intravenous immunoglobulin for the prevention of infection in chronic lymphocytic leukemia: a randomized, controlled clinical trial. N Engl J Med 319:902–907CrossRefGoogle Scholar
  29. 29.
    John TJ, Ninan GT, Rajagopalan MS et al (1979) Epidemic hepatitis B caused by commercial human immunoglobulin. Lancet 1:1074PubMedCrossRefGoogle Scholar
  30. 30.
    Lever AML, Brown D, Webster ADB, Thomas HC (1984) Non-A, non-B hepatitis occurring in agammaglobulinaemic patients after intravenous immunoglobulin. Lancet 2:1062–1064PubMedCrossRefGoogle Scholar
  31. 31.
    Ochs HD, Fischer SH, Virant FS et al (1985) Non-A, non-B hepatitis and intravenous immunnoglobulin. Lancet 1:404–405CrossRefGoogle Scholar
  32. 32.
    Wells MA, Wittek AE, Epstein JS et al (1986) Inactivation and partition of human T-cell lymphotropic virus, type III, during ethanol fractionation of plasma. Transfusion 26:210–213PubMedCrossRefGoogle Scholar
  33. 33.
    Yap PL (1988) Hepatitis transmission by blood products. J Hosp Infect 11[Suppl A]:166–174PubMedCrossRefGoogle Scholar
  34. 34.
    Alexander JW, Stinnett JD, Ogle CK et al (1979) A comparison of immunologic profiles and their influence on bacteremia in surgical patients with a high risk of infection. Surgery 86:94–104PubMedGoogle Scholar
  35. 35.
    Zimmerli W (1985) Impaired host defence mechanisms in intensive care unit patients. Intensive Care Med 11:174–178PubMedGoogle Scholar
  36. 36.
    Marodi L, Kalmar A, Szabo I (1989) Opsonic activity in serum from septic infants treated with intravenous immunoglobulin. Arch Dis Child 64:530–534PubMedCrossRefGoogle Scholar
  37. 37.
    Dalhoff A (1984) Synergy between acylureidopenicillins and immunoglobulin G in experimental animals. Am J Med 76:91–100PubMedCrossRefGoogle Scholar
  38. 38.
    Dalhoff A (1984) In vitro and in vivo effect of immunoglobulin G on the integrity of bacterial membranes. Infection 12:214–222PubMedCrossRefGoogle Scholar
  39. 39.
    Offenbartel KS, Christensen P, Gullstrand P, Prellner K (1986) Synergism between gammaglobulin prophylaxis and penicillin treatment in experimental post-splenectomy sepsis in the rat. Int Arch Allery Appl Immunol 79:45–48CrossRefGoogle Scholar
  40. 40.
    Cunningham-Rundles C, Siegal FP, Smithwick EM et al (1984) Efficacy of intravenous immunoglobulin in primary immunodeficiency disease. Ann Intern Med 101:435–439PubMedGoogle Scholar
  41. 41.
    Kark JD, Witztum E, Mazkin H et al (1984) The three-year incidence of non-B viral hepatitis morbidity in a controlled trial of pre-exposure immune serum globulin prophylaxis. Infection 12:251–255PubMedCrossRefGoogle Scholar
  42. 42.
    Ohara H, Ebisawa I, Ohtani S (1986) Prophylactic efficacy of immune serum globulin against hepatitis A. Jpn J Exp Med 56:229–233PubMedGoogle Scholar
  43. 43.
    Sorenson RU, Polmar SH (1984) Efficacy and safety of high-dose intravenous immune globulin therapy for antibody deficiency syndromes. Am J Med 76[Suppl 3A]:83–90CrossRefGoogle Scholar
  44. 44.
    Glauser MP, Zanetti G, Baumgartner JD, Cohen J (1991) Septic shock: pathogenesis. Lancet 338:732–736PubMedCrossRefGoogle Scholar
  45. 45.
    Dwyre JM (1992) Manipulating the immune system with immune globulin. N Engl J Med 326:107–116CrossRefGoogle Scholar
  46. 46.
    Leung DYM, Burns JC, Newburger JW, Geha RS (1987) Reversal of lymphocyte activation in vivo in the Kawasaki syndrome by intravenous gamma globulin. J Clin Invest 79:468–472PubMedCrossRefGoogle Scholar
  47. 47.
    Mannhalter JW, Eibl MM (1986) Polymeric IgG down modulates antigen presentation by human monocytes. In Eibl MM, Rosen FS (eds) Primary immunodeficiency diseases. Elsevier, Amsterdam, pp 281–286Google Scholar
  48. 48.
    Mannhalter JW, Ahmad R, Wolf HM, Eibl MM (1987) Effect of polymeric IgG on human monocyte functions. Int Arch Allergy Appl Immunol 82:159–167PubMedCrossRefGoogle Scholar
  49. 49.
    Tsubakio T, Kurata Y, Katagiri S et al (1983) Alteration of T cell subsets and immunoglobulin synthesis in vitro during high dose γ-globulin therapy in patients with idiopathic thrombocytopenic purpura. Clin Exp Immunol 53:697–702PubMedGoogle Scholar
  50. 50.
    Pollack M, Young LS (1979) Protective activity of antibodies to exotoxin A and lipopolysaccharide at the onset of Pseudomonas aeruginosa septicemia in man. J Clin Invest 63:276–286PubMedCrossRefGoogle Scholar
  51. 51.
    Baker CJ, Melish ME, Hall RT et al (1992) Intravenous immune globulin for the prevention of nosocomial infection in low-birth-weight neonates. N Engl J Med 327:213–219PubMedCrossRefGoogle Scholar
  52. 52.
    Chirico G, Rondini G, Plebani A et al (1987) Intravenous gammaglobulin therapy for prophylaxis of infection in high risk neonates. J Pediatr 110:437–442PubMedCrossRefGoogle Scholar
  53. 53.
    Haque KN, Zaidi MH, Haque SK et al (1986) Intravenous immunoglobulin for prevention of sepsis in preterm and low-birth-weight infants. Pediatr Infect Dis 5:622–625PubMedCrossRefGoogle Scholar
  54. 54.
    Hill HR, Shigeoka AO, Gonzales LA, Christensen RD (1989) Intravenous immune globulin use in newborns. J Allergy Clin Immunol 84:617–624PubMedCrossRefGoogle Scholar
  55. 55.
    Magny JF, Bremard-Oury C, Brault D et al (1991) Intravenous immunoglobulin therapy for prevention of infection in high risk premature infants: report of a multicenter, double-blind study. Pediatrics 88:437–443PubMedGoogle Scholar
  56. 56.
    Stabile A, Miceli Sopo S, Romanelli V et al (1988) Intravenous immunoglobulin for prophylaxis of neonatal sepsis in premature infants. Arch Dis Child 63:441–443PubMedCrossRefGoogle Scholar
  57. 57.
    Bussel JB (1990) Intravenous gammaglobulin in the prophylaxis of late sepsis in very low-birth-weight infants: preliminary results of a randomized, double-blind, placebocontrolled trial. Rev Infect Dis 12[Suppl 4]:S457–S462PubMedCrossRefGoogle Scholar
  58. 58.
    Clapp DW, Kliegman RM, Baley JE et al (1989) Use of intravenously administered immune globulin to prevent nosocomial sepsis in low birth weight infants: report of a pilot study. J Pediatr 115:973–978PubMedCrossRefGoogle Scholar
  59. 59.
    Kinney J, Mundorf L, Gleason C et al (1991) Efficacy and pharmakokinetics of intravenous immune globulin administration to high-risk neonates. Am J Dis Child 145:1233–1238PubMedGoogle Scholar
  60. 60.
    Besa EC (1984) Use of intravenous immunoglobulin in chronic lymphocytic leukemia. Am J Med 76[Suppl 3A]:209–218PubMedCrossRefGoogle Scholar
  61. 61.
    Gordon DS, Hearn EB, Spira TJ et al (1984) Phase I study of intravenous gamma globulin in multiple myeloma. Am J Med 76[Suppl 3A] 111–116PubMedCrossRefGoogle Scholar
  62. 62.
    Schedel I (1983) Intravenöse Immunglobulinsubstitution bei Patienten mit multiplem Myelom, Morbus Waldenström und chronischer lymphatischer Leukämie. In: Schmidt RE, Stroehmann I (eds) Immunglobuline — Grundlagen und klinische Anwendung. Karger, Basel, pp 52–58Google Scholar
  63. 63.
    Schmidt RE, Hartlapp JH, Niese D et al (1984) Reduction of infection frequency by intravenous gammaglobulins during intensive induction therapy for small cell carcinoma of the lung. Infection 12:167–170PubMedCrossRefGoogle Scholar
  64. 64.
    Seybold JD, Bogdahn U, Seubert W, Krauseneck P (1991) 7S-Immunglobulin zur Infektprophylaxe bei Patienten mit malignen Hirntumoren unter zytostatischer Therapie, eine randomisierte prospektive Doppelblindstudie. Onkol Klin 3:38–48Google Scholar
  65. 65.
    Baumgartner JD, Glauser MP, McCutchan JA et al (1985) Prevention of gram-negative shock and death in surgical patients by prophylactic antibody to endotoxin core glycolipid. Lancet 2:59–63PubMedCrossRefGoogle Scholar
  66. 66.
    Duswald KH, Müller K, Seifert J, Ring J (1980) Wirksamkeit von i. v. Gammaglobulin gegen bakterielle Infektionen chirurgischer Patienten — Ergebnisse einer kontrollierten, randomisierten klinischen Studie. Munch Med Wochenschr 122:832–836Google Scholar
  67. 67.
    Glinz W, Grob PJ, Nydegger UE et al (1985) Polyvalent immunoglobulins for prophylaxis of bacterial infections in patients following multiple trauma — a randomized, placebo-controlled study. Intensive Care Med 11:288–294PubMedCrossRefGoogle Scholar
  68. 68.
    Kress HG, Scheidewig C, Engelhardt W et al (1989) Prediction and prevention, by immunological means, of septic complications after elective cardiac surgery. In: Schlag G, Redl H (eds) 2nd Vienna Shock Forum. Liss, New York, pp 1031–1035Google Scholar
  69. 69.
    Kress HG, Scheidewig C, Elert O (1990) Postoperative passive immunoprophylaxis prevents infections in “at-risk” patients after open-heart surgery. J Cardiothorac Anesth 4[Suppl 3]:67CrossRefGoogle Scholar
  70. 70.
    The Intravenous Immunoglobulin Collaborative Study Group (1992) Prophylactic intravenous administration of standard immune globulin as compared with core-lipopolysaccharide immune globulin in patients at high risk of postsurgical infection. N Engl J Med 327:234–240CrossRefGoogle Scholar
  71. 71.
    Kress HG, Gehrsitz P, Elert O (1987) Predictive value of skin testing, neutrophil migration and C-reactive protein for postoperative infections in cardiopulmonary bypass patients. Acta Anaesthesiol Scand 31:397–404PubMedCrossRefGoogle Scholar
  72. 72.
    Calandra T, Glauser M, Schellekens J, Verhoef J (1988) Treatment of gram-negative spetic shock with human IgG antibody to Escherichia coli J5: a prospective, double blind, randomized trial. J Infect Dis 158:312–319PubMedCrossRefGoogle Scholar
  73. 73.
    Zanetti G, Glauser MP, Baumgartner JD (1991) Use of immunoglobulins in prevention and treatment of infection in critically ill patients: review and critique. Rev Infect Dis 13:985–992PubMedCrossRefGoogle Scholar
  74. 74.
    Haque KN, Zaidi MH, Bakahim H (1988) IgM-enriched intravenous immunoglobulin therapy in neonatal sepsis. Am J Dis Child 142:1293–1296PubMedGoogle Scholar
  75. 75.
    Sidiropoulos D, Böhme U, von Muralt G et al (1981) Immunoglobulinsubstitution bei der Behandlung der neonatalen Sepsis. Schweiz Med Wochenschr 111:1649–1655PubMedGoogle Scholar
  76. 76.
    Just HM, Metzger M, Vogel W, Pelka RB (1986) Therapeutic effects of immunoglobulin in intensive care patients with severe infections. Klin Wochenschr 64:245–256PubMedCrossRefGoogle Scholar
  77. 77.
    Jesdinsky HJ, Tempel G, Castrup HJ, Seifert J (1987) Cooperative group of additional immunoglobulin therapy in severe bacterial infections: results of a multicenter randomized controlled trial in cases of diffuse fibrinopurulent peritonitis. Klin Wochenschr 65:1132–1138PubMedCrossRefGoogle Scholar
  78. 78.
    Dominioni L, Dionigi R, Zanello M et al (1991) Effects of high-dose IgG on survival of surgical patients with sepsis scores of 20 or greater. Arch Surg 126:236–240PubMedCrossRefGoogle Scholar
  79. 79.
    Schedel I, Dreikhausen U, Nentwig B et al (1991) Treatment of gram-negative septic shock with an immunoglobulin preparation: a prospective, randomized clinical trial. Grit Care Med 19:1104–1113CrossRefGoogle Scholar
  80. 80.
    Ziegler EJ, McCutchan JA, Fierer J et al (1982) Treatment of gram-negative bacteremia and shock with human antiserum to a mutant Escherichia coli. N Engl J Med 307:1225–1230PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1994

Authors and Affiliations

  • H. G. Kress

There are no affiliations available

Personalised recommendations