EFFICACY OF UNILAMELLAR LIPOSOMAL AMPHOTERICIN-B IN TREATMENT OF PULMONARY ASPERGILLOSIS IN PERSISTENTLY GRANULOCYTOPENIC RABBITS - THE POTENTIAL ROLE OF BRONCHOALVEOLAR D-MANNITOL AND SERUM GALACTOMANNAN AS MARKERS OF INFECTION

被引：151
作者：
FRANCIS, P
LEE, JW
HOFFMAN, A
PETER, J
FRANCESCONI, A
BACHER, J
SHELHAMER, J
PIZZO, PA
WALSH, TJ
机构：
[1] NCI,PEDIAT BRANCH,INFECT DIS SECT,BETHESDA,MD 20892
[2] WARREN GRANT MAGNUSON CLIN CTR,DEPT CRIT CARE MED,BETHESDA,MD
[3] NIH,NATL CTR RES RESOURCES,VET RESOURCES PROGRAM,SURG & RADIOL BRANCH,BETHESDA,MD
来源：
JOURNAL OF INFECTIOUS DISEASES | 1994年 / 169卷 / 02期
关键词：
D O I：
10.1093/infdis/169.2.356
中图分类号：
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号：
100102 ;
摘要：
A model of primary pulmonary aspergillosis in rabbits was developed to reproduce the persistent levels of profound granulocytopenia and the histopathologic features of bronchopneumonia, vascular invasion, and hemorrhagic infarction encountered in humans. D-mannitol was detectable in bronchoalveolar lavage fluid by gas-liquid chromatography/mass spectroscopy, and galactomannan was measurable in serum by latex agglutination immunoassay. A pharmacokinetically distinctive unilamellar vesicle formulation of liposomal amphotericin B, 5 mg/kg/day intravenously, compared with high-dose conventional desoxycholate amphotericin B, 1 mg/kg/day intravenously, was more effective in preventing nephrotoxicity, increasing survival, reducing the number of viable organisms, and decreasing tissue injury due to Aspergillus organisms. Thus, D-mannitol in lavage fluid and galactomannan in serum may be useful markers of pulmonary aspergillosis, and liposomal amphotericin B was significantly more effective and safer than desoxycholate amphotericin B for treatment of pulmonary aspergillosis in profoundly granulocytopenic rabbits.
引用
收藏
页码：356 / 368
页数：13
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